FIRSTLY, YOU NEED TO KNOW WHAT CORE STABILITY IS.
The medical definition is the following:
Core stability is defined as the 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.
Core muscle activity is best understood as the pre-programmed integration of local, single-joint muscles and multi-joint muscles to provide stability and produce motion.
WHERE DOES IT COME FROM?
Core stability started in the late 1990's.
It was derived from studies that demonstrated a change in timing of the trunk muscles in back injury and chronic lower back pain (CLBP) patients.
HOWEVER, THERE HAVE BEEN ASSUMPTIONS ON HOW THIS RELATES TO INJURY PREVENTION AND SPORTING PERFORMANCE:
CERTAIN MUSCLES ARE MORE IMPORTANT FOR STABILISATION OF THE SPINE, IN PARTICULAR TRANSVERSE ABDOMINIS (TRA):
Transverse abdominis is absent or fused to the internal oblique muscle as a normal variation in some people and they don't all have poor core stability and injury! (Gray's Anatomy 36th edition 1980, page 555).
WEAK ABDOMINAL MUSCLES LEAD TO BACK PAIN:
No correlation between sit-up performance and backache. (Fast et al., 1990).
THERE IS A UNIQUE GROUP OF "CORE" MUSCLES WORKING INDEPENDENTLY OF OTHER TRUNK MUSCLES:
No single muscle is dominated in the enhancement of spine stability.
Their individual roles continuously change across tasks.
Clinically, if the goal is to train for stability, enhancing motor patterns that incorporate many muscles rather than targeting just a few is justifiable. (Kavic et al 2004).
IF THERE IS NO PROOF THAT SINGLE MUSCLE ACTIVATION IS POSSIBLE, WHY DO WE TRY?
SO HOW DOES THIS RELATE TO RUNNERS?
Like anything, injuries in running are often caused by many factors which essentially means that no one thing will prevent or cure the problem.
In runners it is common to see that they have poor core stability and this is often one of the reasons for their injuries, often resulting in abnormal movements and technique.
SO WHAT DOES THE RESEARCH SAY ON CORE STABILITY FOR INJURY PREVENTION IN RUNNERS?
Unfortunately the evidence for this is lacking but this is true of any research into preventative medicine as it is very difficult, some may say impossible to prove that you prevented something from happening.
Kibler (2006) and Fredericson and Moore (2005) recommend core stability training for injury prevention but this is more down tolinking the evidence that supports the principles of core work rather than showing a direct connection.
There are some schools of thought that believe your core is working with strength training just as well, if not better than specific "core" exercises. For example:
Core stability exercises are no more effective than, and will not prevent injury more than, any other forms of exercise or physical therapy (Lederman 2010). So Lederman is saying core stability does work but so do other things. Well Duh This is obvious. Even if you read this blog series on running you will see quotes for evidence showing injury prevention from strengthening, technique, flexibility etc. etc. Core stability is just another way to cover all bases to prevent injury but as with anything in isolation it won't be as good!
This is re-emphasised by Okada et al (2011): Core & functional movement training are important for injury prevention but they should not be the primary emphasis of any training program.
SO WHAT ABOUT CORE STABILITY'S EFFECT ON PERFORMANCE?
Well, the jury is out on this as you can see from the evidence below:
FOR:Core stability training caused a significant improvement in 5km running speed but no change in stability. Runners in the core training group improved their time by an average of 47 seconds while the control group (who didn't do core work) improved by just 17 seconds (Sato & Mokha 2009).
AND:
There appears to be a link between core stability testinga 5-gallon water jug works great. Walk around your house for about 30 seconds and repeat on the other side. Perform 3 to 5 sets per side three times a week.
THE DEAD BUG:
Lie on your back with your legs and arms off the floor. Keep your ribs down and lower back close to the floor. Brace your abs and form a 90-degree angle at your hips, knees and shoulders -- pretend you're a bug, dead on its back. Next, move your legs and arms slowly in the air as if you're running. Keep your low back from arching off the ground. Perform three sets of 60 seconds
STABILITY WEIGHTED LUNGE FOR RUNNERS:
Step into a wide lunge & reach a medicine ball as far out in front of you towards the ground as you can. Keep your back as straight as possible throughout. Shift your weight forward on your front foot. While keeping the ball forward, lift your back leg off the ground and rise up to a perfect running position.
RUNNER TOUCH THE FLOOR:
Strike a pose in perfect running position with one leg in high knee position. Balancing on the one leg, bend at the hip and touch the toe that's on the ground with the opposite hand while the leg in the air rotates under and back. Make sure the standing leg remains stable and as straight as possible while enabling you to touch the ground. Be sure to prevent the moving knee from crossing midline while that leg straightens out behind you. Come back up to running position quickly without losing balance, pause for a second or two, and repeat. Switch legs and repeat.
SWISS BALL MOUNTAIN CLIMBERS:
Drop to a plank position with your forearms on a medium-sized stability ball. Keeping your core tight, bring one knee to the ball. Try to keep the ball and torso as steady as possible. Alternate knees to the ball throughout the exercise.
RUNNER PULLS:
Balance on one leg and grab a pulley system or elastic band in front of you with the opposite hand. Raise the free knee up toward your waist while simultaneously pulling the elbow to your side and rotating your body in the same direction as you would when you run.
If you need any further information or would like to book an appointment then call Hawkes Physiotherapy on 01782 771861 or 07866195914
WWW.HAWKESPHYSIOTHERAPY.CO.UK
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