Core Stability Exercises

The core refers to the lower back and abdominal muscles, which form the connection between your upper and lower body. If it is springy and weak, so will be your transference of power from lower body to upper body and vice versa. The deep trunk muscles, transversus abdominis (TA), multifidus (MF), internal oblique (IO), paraspinal and pelvic floor are key to the active support of the lumbar spine. The co-contraction of these muscles produce forces via the theracolumbar fascia (TLF) and the intra-abdominal pressure (IAP) mechanism, which stabilise the lumbar spine, and the paraspinal and MF muscles, which act directly to resist the forces acting on the lumbar spine. It is not just the recruitment of these deep trunk muscles, but how they are recruited that is important. Hodges and Richardson[1] showed that the co-contraction of the TA and MF muscles occurred prior to any movement of the limbs. This suggests that these muscles anticipate dynamic forces that may act on the lumbar spine and stabilise the area prior to any movement. Hodges and Richardson showed that the timing of coordination of these muscles was very significant.

Abdominal hollowing
Core stability training begins with learning to co-contract the TA and MF muscles effectively as this has been identified as key to the lumbar-support mechanism. To perform the TA and MF cocontraction, you must perform the abdominal hollowing technique with the spine in the neutral position. Use the following guidelines: Start by lying on your back with knees bent. Your lumbar spine should be neither arched up nor flattened against the floor, but aligned normally with a small gap between the floor and your back. This is the neutral lumbar position you should learn to achieve. Breathe in deeply and relax all your stomach muscles. Breathe out and, as you do so, draw your lower abdomen inwards as if your belly button is going back towards the floor. Pilates teachers describe this as zipping up, as if you are fastening up a tight pair of jeans. Hold the contraction for 10 seconds and stay relaxed, allowing yourself to breathe in and out as you hold the tension in your lower stomach area. Repeat 5-10 times.

It is absolutely vital that you perform this abdominal hollowing exercise correctly otherwise you will not recruit the TA and MF effectively. Bear in mind the following points: Do not let the whole stomach tense up or your upper abdominals bulge outwards, as this means you have cheated by using the large rectus abdominus muscle (the six-pack) instead of TA.

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Do not brace your TA muscle too hard; just a gentle contraction is enough. Remember it is endurance not max strength you are trying to improve. Do not tilt your pelvis nor flatten your back, as this means you have lost the neutral position you are trying to learn to stabilise. Do not hold your breath, as this means you are not relaxed. You must learn to breathe normally and maintain the co-contraction of TA and MF. Use your fingers for biofeedback on either side of your lower abdomen to feel the tension in the TA muscle.

Once you have mastered abdominal hollowing lying on your back, practise it lying on your front, four-point kneeling, sitting and standing. In each position, get your lumbar spine into neutral before you perform the hollowing movement.

The warm-up reminder

Your muscles and nervous system work much more efficiently when warmed up. The warm-up consists of two phases: general and movement specific. The general warm-up raises your heart rate and pulse above normal and the specific phase moves into the early stages of the exercise movement patterns.

Core stability exercises

The latest low back research by Stuart McGill, PhD lists three main exercises for developing an injury resistant lower back: curl up, side bridges and leg and arm extensions. 1. Curl-up The muscle activated in these exercises is the rectus abdominis. Beginners exercise Lay supine on the floor (facing the ceiling). Place your hands under the small of your back do not flatten your back to the floor, as this increases unnecessary stress on lower back. This position helps to keep the lumbar spine from actually flattening against the floors surface. Bend one leg to about 90 degrees at the knee and leave the second leg in a relaxed position on the floor. Keep the head and neck rigid and do not curl them up as you move upward. Focus on the ceiling. Raise the head and shoulders a short distance off the floor, hold for seven to eight seconds and lower back down. Focus on the thoracic spine without cervical or lumbar flexion occurring during the movement.

Intermediate exercises Lay supine on the floor (facing the ceiling). Place your hands under the small of your back do not flatten your back to the floor, as this increases unnecessary stress on lower back. Bend both legs to about 90 degrees at the knee. Keep the head and neck rigid and do not curl them up as you move upward. Focus on the ceiling.
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Raise your elbows off the floor an inch or so. Raise the head and shoulders a short distance off the floor, hold for seven to eight seconds and lower back down.

Advanced exercise Lay supine on the floor (facing the ceiling). Place your hands under the small of your back do not flatten your back to the floor, as this increases unnecessary stress on lower back. Bend both legs to about 90 degrees at the knee. Keep your head and neck straight throughout the move. Place your fingers lightly on your forehead. Raise your head and shoulders up as in the original curl-up exercise. Hold for seven to eight seconds and return to the beginning position.

2. Side bridges
The muscles activated in these exercises are the quadratus lumborum, transverse abdominis and the abdominal obliques. Beginners exercise Begin on your right side supported by your elbow and hip. You should be in an inclined position on the floor. The body is in a straight line from floor to shoulders. Straighten out the body as you lift the hips off the floor. Hold for seven to eight seconds and return to the beginning position. Repeat on the left side.

Intermediate exercise Lay on the floor on your right side. Lift both legs off the ground. Hold for seven to eight seconds and return to the beginning position. Repeat, lying on your left side.

Advanced exercise Lay on the floor on your right side Support yourself on your right hand (arm extended) and hip. Lift your hips off the ground. The body is in a straight line from floor to shoulders. Hold for seven to eight seconds and return to the beginning position. Repeat, lying on your left side.

3. Leg and arm extensions

The muscles activated in these exercises are the back extensors including the longissimus, the iliocostalis and the multifidii. Beginners exercise
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Begin on the floor on your hands and knees. Raise left arm straight to the front while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Raise right arm straight to the front while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Raise right leg out straight to the rear while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Raise left leg out straight to the rear while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Keep the hips and shoulders square to the floor at all times.

Intermediate exercise Begin on the floor on your hands and knees. Raise right leg out straight to the rear while maintaining a position that is parallel to the floor. Raise left arm straight to the front while maintaining a position that is parallel to the floor. Hold steady with the arm, leg and hips parallel to the floor at all times. Hold for seven to eight seconds and return to the beginning position. Raise left leg out straight to the rear while maintaining a position that is parallel to the floor. Raise right arm straight to the front while maintaining a position that is parallel to the floor. Hold steady with the arm, leg and hips parallel to the floor at all times. Hold for seven to eight seconds and return to the beginning position. Keep the hips and shoulders square to the floor at all times.

Advanced exercise Begin on the floor on your hands and knees. Raise right leg out straight to the rear while maintaining a position that is parallel to the floor. Raise left arm straight to the front while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Do not rest at the bottom, simply sweep the floor with your hand and knee back into the extended position. Repeat five times. Return to the beginning position. Raise left leg out straight to the rear while maintaining a position that is parallel to the floor. Raise right arm straight to the front while maintaining a position that is parallel to the floor. Hold for seven to eight seconds and return to the beginning position. Do not rest at the bottom, simply sweep the floor with your hand and knee back into the extended position. Repeat five times. Return to the beginning position.

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Strength and endurance development

The lower back extensors need to be well developed, first by increasing endurance and then through strengthening exercises. Endurance is increased by holding the pose for seven to eight seconds and then adding more repetitions.

Potential benefits
Performing these three core stability exercises on a daily basis may help prevent low back pain and possibly stave off injury in the process.

Danny M ODell, MA CSCS*D Strength and conditioning coach, USA

References 1. Hodges and Richardson (1996) Spine 21, 2640-2650 Resources 1. Ultimate Back Fitness and Performance, McGill, Stuart (2004) Wabuno Publishers 2. McGill, S (2002) Low Back Disorders, Human Kinetics 3. Training and rehabilitation for the lower back, NSCA quick series guide 2001 4. ODell, DM (2003) Strength Training Secrets, www.Explosivelyfit.com 5. ODell, DM, The Ten Essentials, www.Explosivelyfit.com

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