CORE Flashcards
T/F there is a universally accepted definition of core stability
F
What comprises the core
no clear agreement
Are core stability and core strength synonymous
yes
What is the most popular current idea for how to test core stability
subjective assessment via observation (sport specific movements or loaded barbell exercises)
Which exercises are best for core stability training
- Squats, olympic lifts, farmer walks
Are abdominal exercises and bracing thought to be effective in core stability training
no
What is the most popular view for general training type to strengthen core
normal, progressive exercise training
What is core stability
Ability to control the position and motion of the trunk over the pelvis to allow optimum production, transfer and control of force and motion to the terminal segment in integrated athletic activities
What are the 3 primary systems for controlling movement
Control subsystem (neural) Active subsystem (spinal muscles) Passive subsystem (spinal column, ligaments)
Stability is the result of ____
stiffness
What does stability do
- stops micro-movements that cause pain
- facilitates limb movement
What does the way the muscles contract around the spine determine
stability - not strength
Muscles of the limbs are designed to _____ while muscles of the core are primarily designed to ____
create motion
stop motion
What are the proposed effects of deficient core
- Poor gait mechanics
- Poor postural alignment
- Poor transfer of forces (UE to LE and vice versa)
- Inability to accelerate/decelerate with minimal loss of speed and force
- inability to withstand and control external forces
- increased risk of injury
What are the proposed effects of an athlete with good core stability
- Can change directions more efficiently
- Has a great capacity to accelerate and decelerate
- Is less likely to experience disruptions in the transfer of load through the kinetic chain
- can better manage stress to the lumbopelvic region
- less likely to get injured
Who will most benefit from core exercises
someone who was previously sedentary
Core training and LBP
Many studies showed positive effects, still some discrepency - in part due to terminology
Is the inner unit phasic or tonic
tonic
Is the outer unit phasic or tonic
primarily phasic
What are the characterisitcs of global stabilizers
- superficial
- Cross multiple segments
- Produce motion
- Guy wire function (compression)
What are some examples of global stabilizers
- EO, IO, QL
- Spinalis
- Glute med
What are the characteristics of local stabilizers
- Deep (close to axis)
- Attach to each segment
- Control segmental motion (segmental guy wire)
- More type I fibers (endurance)
What are some examples of local stabilizers
- TA, multifidus, pelvis floor, diaphragm
- Psoas major (some people include)
Is your core a local or global stabilizer
local stabilizer
What are the characteristics of global mobilizers
- Multi-joint muscles
- Non-weight bearing (acceleration: concentric activation),
- phasic
What are some muscular examples of global mobilizers
- Iliocostalis
- Rectus abdominus
- Rectus femoris
- Hamstrings
- Latissimus Dorsi
What forms of dysfunction do we tend to see in Local stabilizers
Atrophy
Weaken and change to phasic activation (instead of tonic)
What forms of dysfunction do we tend to see in Global stabilizers
Tend to atrophy
Weaken (lengthen) and become more phasic
What forms of dysfunction do we tend to see in Global mobilizer
Tend to hypertrophy do to always trying to help out
Shorten and become more tonic
What is the pirate ship concept for core
Spine is main mass - without the guy wires (muscles) to support it it would be unstable
What is seen in upper crossed syndromes
- Weak deep neck flexors
- Tight upper trap + lev scap
- Tight Pec & SCM
- Weak rhomboids, lower trapezius & serratus anterior
What is seen in lower crossed syndrome
- Tight lumbar erector spinae
- Weak abdominal muscles
- Weak glutes
- Tight hip flexors
What do lower crossed patients do when squating
they use their hamstrings and erector spinae to drive the extension motion when rising from a squat - this results in increased loads on the spine and loss of neutral spine
What is the concern with crossed positions
Pulling patients into a postural fault - adds stress to tissue that are designed for it and this results in damage and breakdown
What is a sling
a connection of myofascial systems that stabilize the pelvis between the thorax and legs. These integrated muscle systems produce slings of forces that assist in transfer or load
- Store, release, and transfer energy
What makes up the posterior oblique sling
Lat dorsi and contralateral glut max connected via thoracolumbar fascia
What makes up the anterior oblique sling
External oblique, anterior abdominal fascia, contralateral internal oblique
What are 3 common examples of issues with anterior sling
- Splitting of fascia in rectus abdominis
- Sport hernia
- Repeated adductor strain
What is a good exercise for anterior sling
dead bug
What is the longitudinal sling
Tibialis anterior, peroneus longus, biceps femoris, sacrotuberous ligament, deep lamina of thoracolumbar fascia, and the erector spinae (all on the same side)
What is the lateral sling
Glut med/min, TFL, ipsilateral adductors, and contralateral stabilizers of the thoracopelvis (QL)
What exercises activate the lateral sling
anything single leg
If somehow has an unstable joint you wan to increase ____
form closure
What is joint centration
- neutral joint position
How do you achieve joint centration as a therapist
through joint mobilization - allow effective arthrokinematics
What is the importance of joint centration
ensures ideal path of instantaneous center of rotation
What is the low threshold strategy
Slow, tonic, local stabilizer, stabilizing muscle contraction that are for low-load tasks and reflexive postural control. this is necessary for joint centration
What is the high threshold strategy
Fast, phasic, prime move, global mobilizer, mobilizing muscle contractions that are for high-load tasks and force production. This is necessary for strength training/athletic performance
What must occur first, low threshold or high threshold strategy
low-threshold to stabilize and centrate the body
which is more likely to become dysfunctional - low or high threshold strategy
high - with poor training strategies
How do you assess for threshold strategy
by looking at breathing, posture, and alignment
- breath holding, splinting, and bracing excessively are signs of high threshold strategies
High-threshold strategy is a dysfunctional pattern when
- used in substitution for low threshold
- Cannot turn muscles off (results in splinting, not stabilizing)
- Global mobilizing muscles have to move and stabilize
- Places the body in poor alignment/posture
- Sacrifices mobility for force production
What type of breathing is indicative of low threshold strategies
parasympathetic diaphragm breathing
What breathing is indication of high threshold strategies
breath holding and valsalva
How much muscle force is transmitted to the tendon and how much to the connective tissue around the muscle
70% to tendon
30% to connective tissue
What is the role of fascia
helps distribute loads throughout the body - having fascial adhesions effects this ability
do you want to work on mobility or stability first?
mobility - get range and normal movement before loading
Mobility or stability - foot?
Stability
Mobility or stability - ankle?
mobility
Mobility or stability - knee
Stability
Mobility or stability - hip
Mobility
Mobility or stability - lumbar spine
Stability
Mobility or stability - thoracis spine
mobility
Mobility or stability - scapula
stability
Mobility or stability - GH
mobility
Mobility or stability - elbow
stability
Mobility or stability - wrist + hand
mobility
When might you switch the order of stability vs. mobility
in someone who in hypermobile - may want stability first
Is abdominal hollowing maneuver or bracing more effective? why?
AHM primarily activates TA, inhibits obliques, and narrow the base for guy wires
Bracing engages everything and is more stiff
What are inner unit activation cue
- Elevate pelvic floor 2. activate TA (pull ASIS together), maintain breathing, dont flare ribs
Why is balanced activity of stabilization muscles important ?
allows for symmetrical loading of individual sections of the spine - without this you may get overloading of certain segments of the spine and development of degenerative changes such as disc herniation and OA - symmetrical breathing is therefore important as it is a component of the core
What are two quantitative tests to assess core
- Inner unit activation with pressure biofeedback unit under lower back or abdomen
- Real time ultrasound
- Testing muscle endurance
What are some qualitative tests for core
- Tests for motor control (walk plank test, ASLR, side-lying abduction, 4-point kneel rocking_
- Test core in functional positions (pertubation in squat or lunge, trying to dissociate the Tsp and pelvis
- Ability to maintain neutral spine in variety tasks
What were the findings looking at muscle activation during core-x compared to traditional core exercises
Core-X system had greater activation of multifidi, glute med, glute max
Traditional had greater activation of RA
Obliques similarly activated
What is a typical core exercise progression
- kinesthetic training -neutral spine
- activation of deep core (inner unit)/braching
- Add extremity motions (dynamic stabilization) - emphasize transverse plane
- Progress reps, load - emphasize endurance first, then strength
- Use alternating isometric contractions and rhythmic stabilization techniques (theraband around pelvis example)
- transitional stabilization - position changes while keeping neutral spine
- Perturbation training - unstable surfaces, destabilizing forces
What at McGill’s Big 3 core exercises? and what are the exercise perscriptions for them
- Curl-ups
- Side bridges
- Bird dog
All have beginner, intermediate and advanced
Perform daily
8-10 second holds, build up reps (not hold time)
What is the goal of motor skill training
activation - wanting activation to become automatic
How do you facilitate the automaticity of inner unit activation
- Verbal cues
- manual pressure
- Biofeedback units
- RUTS
Why is core strengthening in transverse plane most important
injuries very common due to rotational movements
What sling is the chip lift exercise utilizing
Anterior oblique sling
What are two purposes for strengthening the core
- stabilization and injury prevention. Focus is on endurance
- Enhance transfer of energy from the core to the extremities. Focus is on increasing performance
What type of exercises is best for improving transfer of energy from the core to the extremities
Multi-joint, free weiht exercises + Integration exercises
not core specific or isolation exercises
How can you progress?
- increase load or duration
- Increase volume (reps/sets)
- Decrease rest period
- More challenging exercise
Only change one of these at a time
