Chapter 9: Core Training Concepts Flashcards
core
the structures that make up the lumbo-pelvic-hip complex (LPHC), including the lumbar spine, the pelvic girdle, abdomen, and the hip joint
drawing-in maneuver
a maneuver used to recruit the local core stabilizers by drawing the navel in toward the spine
bracing
occurs when you have contracted both the abdominal, lower back, and buttock muscles at the same time
what is the objective of core training?
to uniformly strengthen the deep and superficial muscles that stabilize, align, and move the trunk of the body, especially the abdominals and muscles of the back
what does a properly designed core training program help an individual gain?
neuromuscular, stability, muscular endurance, strength, and power of the core
where is the body’s center of gravity located?
the core
where does all movement originate?
the core
what is a strong and efficient core necessary for?
maintaining proper muscle balance throughout the entire human movement system (kinetic chain)
what establishes neuromuscular efficiency throughout the entire human movement system?
- optimal lengths (or length-tension relationships), recruitment patterns (or force-couple relationships), and joint motions (or arthrokinematics) in the muscles of the LPHC
- these factors allow for efficient acceleration, deceleration, and stabilization during dynamic movements, as well as the prevention of possible injuries
what is the core musculature divided into?
- local stabilization system
- global stabilization system
- movement system
what is required to maintain core stability?
neuromuscular control of the local and global stabilization systems and the movement system, ensuring sequential coordinated activation of all systems at the right time with the right amount of force
where do the local stabilizers attach?
directly to the vertebrae
what do the local stabilizer muscles primarily consist of?
type 1 (slow twitch) muscle fivers with a high density of muscle spindles
what are core stabilizing muscles primarily responsible for?
intervertebral and intersegmental stability
what do core stabilizing muscles work to limit?
excessive compressive, shear, and rotational forces between spinal segments
what is the function of the core stabilizing muscles
- to provide support from vertebra to vertebra
- aid in proprioception and postural control because of their high density of muscle spindles
primary muscles of the local stabilization system?
- transverses abdominis
- internal obliques
- multifidus
- pelvic floor musculature
- diaphragm
how to the local stabilizers contribute to segmental spinal stability?
- by increasing intra-abdominal pressure (pressure within the abdominal cavity)
- by generating tension in the thoracolumbar fascia (connective tissue of the low back), thus increasing spinal stiffness for improved intersegmental neuromuscular control
what does optimal neuromuscular control allow for?
- normal length-tension relationships, force-couple relationships, joint arthrokinematics
- these factors lead to optimal sensorimotor integration, optimal neuromuscular efficiency, and optimal tissue recovery
primary muscles of the global stabilization system
- quadratus lumborum
- psoas major
- external oblique
- portions of internal oblique
- rectus abdominis
- gluteus medius
- adductor complex (adductor magnus, adductor longus, adductor brevis, gracilis, pectineus)
primary muscles of the movement system
- latissimus dorsi
- hip flexors
- hamstring complex
- quadriceps
where do the muscles of the globalization system attach?
from the pelvis to the spine
what do the global stabilization system muscles do?
- transfer loads between the upper extremity and lower extremity
- provide stability between the pelvis and the spine
- provide eccentric control of the core during functional movements
where do the movement system muscles attach?
the spine and/or pelvis to the extremities
what are the movement system muscles primarily responsible for?
concentric force production and eccentric deceleration during dynamic activities
what do all of the muscles within each system provide?
dynamic stabilization in all planes of movement during functional activities and neuromuscular control of the entire core (LPHC)
what do all the muscles within each system do?
- produce force (concentric contractions)
- reduce force (eccentric actions)
true or false: the core muscles can effectively achieve stabilization of the LPHC in isolation
- in isolation these muscles do not effectively achieve stabilization of the LPHC
- it is through their synergistic interdependent functioning that they enhance stability and neuromuscular control
stabilization systems from the inside out
local stabilization system > global stabilization system > movement system
true or false: training the movement system muscles before training the muscles of the global and local stabilization systems would not make sense from both a structural and biomechanical standpoint
- TRUE
- doing so would be analogous to building a house without a foundation
- the foundation must be developed first to provide a stable platform for the remaining components of the house to be built on
- one must be stable first to move efficiently
true or false: few people have properly developed the local stabilization muscles required for intervertebral stabilization
TRUE
what is required for the body to effectively use the strength, power, and endurance that has been developed in the primer movers?
the body’s core stabilization system has to be operating with maximal efficiency
what happens if the movement system musculature of the core is strong and the local stabilization system is weak?
- the kinetic chain senses imbalance and forces are not transferred or used properly
- this leads to compensation, synergist dominance, and inefficient movements
what does a weak core cause?
- inefficient movement, which can lead to predictable patterns of injury
- this results in lack of stabilization and unwanted motion of the individual vertebrae, thus increasing forces throughout the LPHC that may result in low-back pain and injury
what happens if the core is unstable during movement?
it does not allow for optimal stabilization, force reduction, force production, and transference to occur throughout the kinetic chain
individuals with chronic low-back pain have decreased activation of what muscle groups?
- transverse abdominis
- internal obliques
- pelvic floor muscles
- multifidus
- diaphragm
- deep erector spinae
- also weaker back extensor muscles and decreased muscular endurance
what is an independent risk factor for developing low-back pain?
trunk muscle weakness
true or false: numerous studies support the role of core training in the prevention and rehabilitation of LBP
TRUE
what do core stabilization exercises restore in individuals with low-back pain?
the size, activation, and endurance of the multifidus (deep spine muscle)
what is neuromuscular activation of the local stabilization system called?
drawing in
what is neuromuscular activation of the global stabilization system called?
bracing
what to traditional low-back hyperextension exercises without proper lumbo-pelvic-hip stabilization result in?
- an increase of the pressure on the discs to dangerous levels
- can cause damage to the ligaments supporting the vertebrae, which may lead to a narrowing of openings in the vertebrae that spinal nerves pass through
electromyography (EMG)
a procedure that measures the electrical conducting function of nerves in the muscles
what can an EMG identify?
differences in muscle or muscle group activation when performing different movements or exercises
is EMG activity increased or decreased during pelvic stabilization and transverse abdominis activation when an abdominal drawing-in maneuver is initiated before activity?
increased
when properly activated, what does the transverse abdominis create?
tension in the thoracolumbar fascia, contributing to spinal stiffness, and compressing the sacroiliac joint, increasing stability
how do you perform the drawing-in maneuver?
pull in the region just below the navel toward the spine and maintain the cervical spine in a neutral position
what does maintaining a neutral spine during core training help to improve?
- posture
- muscle balance
- stabilization
what happens if a forward protruding head is noticed during the drawing-in maneuver?
-the sternocleidomastoid (large neck muscle) is preferentially recruited, which increases the compressive forces in the cervical spine and can lead to pelvic instability and muscle imbalances as a result of the pelvo-ocular reflex
why is it important to maintain the eyes level during the drawing-in maneuver?
not keeping the eyes level can lead to pelvic instability and muscle imbalances as a result of the pelvo-ocular reflex
what happens if the sternocleidomastoid muscle is hyperactive and extends the upper cervical spine?
- the pelvis rotates anteriorly to realign the eyes
- this can lead to muscle imbalances and decreased pelvic stabilization
bracing is referred to the co-contraction of what muscles?
the global muscles, such as the rectus abdominis, external obliques, and quadratus lumborum
what is bracing also commonly referred to as?
a “bearing down” or tightening of the global muscles by consciously contracting them
true or false: muscular endurance of the global and local musculature, when contracted together, create the most benefit for those with LBP compared with traditional LBP training methods
TRUE
true or false: bracing focuses on segmental vertebral stability, not global trunk stability
FALSE
-bracing focuses on global trunk stability, not on segmental vertebral stability, meaning that the global muscles, given the proper endurance training, will work to stabilize the spine
what strategies can be implemented in a core training program to help retrain motor control of local and global stabilization systems and movement musculature, as well as to help retrain the strength and endurance of these muscles?
- drawing-in maneuver
- bracing
what should a comprehensive core training program be?
- systematic
- progressive
- functional
- should emphasize the entire muscle action spectrum focusing on force production (concentric), force reduction (eccentric), and dynamic stabilization (isometric)
core training parameters - variables
- plane of motion
- range of motion
- type of resistance
- body position
- speed of motion
- duration
- frequency
- amount of feedback
core training parameters - exercise selection
- progressive
- systematic
- activity / goal-specific
- integrated
- proprioceptively challenging
- based in current science
why are weight belts not recommended?
weight belts may raise an individual’s heart rate and systolic blood pressure, and often give individuals a false sense of security and the misconception that they can lift heavier loads
what is the goal of core training?
to develop optimal levels of neuromuscular efficiency, stability (intervertebral and lumbopelvic stability- local and globalization systems), and functional strength (movement system)
what is the focus of a core training program?
- neural adaptations (instead of absolute strength gains)
- function
- quality of movement over quantity
true or false: increasing external resistance is more important that increasing proprioceptive demand
FALSE
-increasing proprioceptive demand by using a multisensory environment is more important that increasing the external resistance
when does a client have appropriate intervertebral stability?
when able to maintain the drawing-in position while performing various exercises
when does a client have appropriate lumbopelvic stability?
when able to perform functional movement patterns (squats, lunges, step-ups, single-leg movements, pressing, pushing, etc.) without excessive spinal motion (flexion, extension, lateral flexion, rotation, singly or in combination)
it is critical that the core training program is designed to achieve the 3 following functional outcomes (the sequence is critical!)
- intervertebral stability
- lumbopelvic stability
- movement efficiency
core-stabilization training (phase 1)
exercise involve little motion through the spine and pelvis
what are core-stabilization exercises designed to improve?
neuromuscular efficiency and intervertebral stability
what do core-stabilization exercises focus on?
drawing-in and then bracing during the exercise
how long would a client typically spend at the core-stabilization level?
4 weeks
examples of core-stabilization exercises
- marching
- floor bridge
- floor prone cobra
- prone iso-ab (plank)
marching technique
- keep abdominals drawn-in throughout the entire movement
- keep the pelvis in a neutral position
two-leg floor bridge technique
- do not raise hips too far off the floor (hyperextending the low back) - this places excessive stress to the lumbar spine
- make sure at the end position, the knees, hips, and shoulders are in alignment and the gluteal muscles are fully contracted
floor prone cobra technique
-do not come too high off the floor (hyperextending the low back)
prone iso-abs (plank) regression options
- perform in a standard push-up position
- perform in a push-up position with knees on the floor
- perform with the hands on a bench and feet on the floor
core-strength training (phases 2, 3, and 4)
the exercises involve more dynamic eccentric and concentric movements of the spine through a full range of motion while clients perform the activation techniques learned in core-stabilization training
what is progressed in the core-strength level?
specificity, speed, and neural demands
how long would a client typically spend at the core strength level?
4 weeks
what are core-strength exercises designed to improve?
- dynamic stabilization
- concentric strength (force production)
- eccentric strength (Force reduction)
- neuromuscular efficiency of the entire kinetic chain
examples of core-strength exercises
- ball crunch
- back extensions
- reverse crunch
- cable rotations
ball crunch technique
-keep the chin tucked - this will take stress off the muscles of the cervical spine
ball crunch progression
perform as a long-lever exercise (arms raised overhead)
back extension technique
- make sure that at the end position, the ankle, knee, hip, shoulders, and ears are all in alignment
- do not hyperextend the low back
reverse crunch technique
- do not swing the legs
- once you have positioned the lower extremities during the setup, they should not move during the execution of the exercise
- swinging the legs increases momentum, increasing the risk of injury and decreasing the effectiveness of the exercise
cable rotation technique
- to decrease stress to the low back, make sure to pivot the back leg into triple extension: hip extension, knee extension, ankle plantarflexion (extension)
- this also ensures proper neuromuscular efficiency of the muscles that extend the lower extremities (gluteus maximus, quadriceps, gastrocnemius and soleus)
core-power training (phase 5)
-exercises are designed to improve the rate of force production of the core musculature
what to core-power exercises prepare an individual to do?
dynamically stabilize and generate force at more functionally applicable speeds
examples of core-power exercises
- rotation chest pass
- ball medicine ball (MB) pullover throw
- front MB oblique throw
- soccer throw
ball medicine ball pullover throw technique
it is important that an individual has proper extensibility of the latissimus dorsi before performing this exercise to decrease stress to the low back and shoulders
soccer throw technique
-it may be easier to perform this exercise using a D-ball (a medicine ball that does not bounce back) or close to a wall for the medicine ball to bounce off of
what happens if individuals try to perform core-power exercises without proper stabilization and strength?
may lead to movement compensations, muscle imbalances, and eventually injury
true or false: it is important with all core-power exercises that you go as fast as you can while maintaining proper exercise technique
TRUE
what does the core musculature help protect the spine from?
the harmful forces that occur during functional activities
core stabilization acute variables
- number of exercises: 1-4
- sets: 1-4
- reps: 12-20
- tempo: slow (4/2/1)
- rest: 0-90s
core strength acute variables
- number of exercises: 0-4
- sets: 2-3
- reps: 8-12
- tempo: medium
- rest: 0-60s
core power acute variables
- number of exercises: 0-2
- sets: 2-3
- reps: 8-12
- tempo: as fast as can be controlled
- rest: 0-60s
true or false: for the goal of muscle hypertrophy and maximal strength, core training is required
FALSE
-for the goal of muscle hypertrophy and maximal strength, core training may be optional (although reccomended)
