The
core is where most of the body’s power is derived. It
provides the foundation for all movements of the arms and
legs. The core must be strong, have dynamic flexibility and
function synergistically in its movements in order to
achieve maximum performance. Motion of the human body is not
isolated to one muscle or tissue moving in one specific
direction. Rather, it is a complex event involving agonists
and antagonist structures that work together to create
changes in position and/or location, and to stabilize the
body in all three directional planes. Regardless of what
sport one plays, it is essential to have core strength and
trunk stability to maximize performance and prevent injury.
What Makes Up the Core
The foundation of the core is much more than the abdominal
muscles. It includes muscles deep within the torso, from the
pelvis up to the neck and shoulders. The core includes the
following structures:
- Multifidus
– Deep spinal muscles that run
segmentally from the neck (C2) to the sacrum. They
produce extension and, to a lesser degree, rotation and
lateral flexion forces that provide stability to joints
at individual levels of the spine.
- Interspinales,
Intertransversarii, Rotatores
– Deep structures that attach directly to the spinal
column. These are very important for rotatory motion and
lateral stability.
- External Obliques
– Abdominal muscles that attach at the lower ribs,
pelvis and abdominal fascia.
- Internal Obliques
– Abdominal muscles that attach at the lower ribs,
rectus sheath, pelvis and thoracolumbar fascia.
- Transversus Abdominis
– Abdominal muscles that attach at the lower ribs,
pelvis and thoracolumbar fascia and rectus sheath.
These abdominal muscles work together
to transmit a compressive force and act to increase
intra-abdominal pressure that stabilizes the lumbar
spine. They also work individually to perform trunk
rotation, while the internal and external obliques on
the same side can work synergistically to laterally flex
the spine.
- Rectus Abdominis
- Abdominal muscle that attaches
at the fifth through seventh ribs, the lower sternum and
the front of the pubic bone. This muscle flexes the
spine, compresses the internal organs of the abdomen and
transmits forces laterally from the obliques. It is a
common fallacy that the upper and lower rectus are
isolated differently. Training the rectus can be done
with one exercise.
- Erector Spinae
– Help to counterbalance all the forces involved in
spinal flexion. They begin as the sacrospinalis tendon
that attaches at the sacrum and ilium. This tendon then
gives rise to different muscles that run up the spine
and obliquely to attach at lateral parts of the
vertebrae and the ribs. In the cervical region, these
muscles attach at the base of the skull.
- Quadratus Lumborum
– Attaches at the twelfth rib and the upper four lumbar
vertebrae and the pelvis. It stabilizes the lumbar spine
in all planes of motion, stabilizes the twelfth rib and
the attachment of the diaphragm during respiration and
laterally flexes the trunk.
- Latissimus Dorsi
– This is the largest spinal
stabilizer. It attaches via the thoracolumbar fascia to
the lumbar vertebrae, sacrum and pelvis and runs upward
to the humerus. It assists in lumbar extension and
stabilization and also performs pulling motions through
the arms.
- Thoracolumbar Fascia
– Connects the latissimus dorsi,
gluteal muscles, internal obliques and transverse
abdominis, supplies tensile support to the lumbar spine
and is used for load transfer throughout the lumbar and
thoracic regions.
- Abdominal Fascia
– Connects to the obliques and rectus abdominis and to
the pectoralis major. Fascial connections that cross the
midline transmit forces to the muscles of the opposite
side of the body.
Training the Core
The common myth is that training the core
simply involves sit ups and back extensions. An efficient
core routine consists of multiplanar movements. As the body
moves, the center of gravity changes, and forces exerted by
and on the body’s tissues are constantly changing. Dynamic
stabilization must be included to increase proprioception
and stability in the trunk as well as in the rest of the
body. This allows the parts of the body to react efficiently
to external forces and stresses such as gravity, changes in
terrain and carrying loads. It also allows the body to react
to internal forces exerted by other muscles.
Dynamic stability is best achieved through training in
functionally practical positions that mimic activities or
movements in one’s particular sport or in life as a whole.
With this in mind, one can conclude that most core training
that is done while sitting or lying down and limiting pelvic
movement has little functional value.
Medicine balls, balance boards and stability balls are great
tools for core training and should be integrated into every
program. Core exercises should include strengthening as well
as challenges such as standing one-legged and/or two-legged
on stable and unstable surfaces, reacting to external forces
such as a partner’s light push or the catching and throwing
of a medicine ball and moving the joints of the body through
all planes of motion. (For examples of all of these
exercises, please see the PTN Exercise Library.)
The goal of functional core training is to develop in the
core a system of efficient automatic responses to work as a
stable base from which to generate optimal force and motion.
Postural Distortion and Biomechanical Dysfunction
Consider how the chronic shortening of just one
muscle, which happens to be a core muscle, can impede
performance and cause imbalances that lead to injuries.
The rectus abdominis is a good example of an overworked
muscle. As this muscle is overworked, the other core muscles
are often ignored. Crunches, leg raises and exercises using
abdominal machines all work only in the sagittal plane,
therefore limiting any benefit to muscles that produce hip
and trunk flexion. (Note that repetitive trunk flexion
places increased injury-causing stress on the intervertebral
discs of the lumbar spine). Therefore, it is imperative to
train the core in a multiplanar fashion, especially in the
transverse plane, in order to create stabilization in the
trunk and in effect more optimal posture, strength and
motion in the entire body.
The following is a common example of the result of
overworking the rectus abdominis. A tight rectus abdominis,
when creating tension or pull on its upper and lower
attachments including the anterior pelvis, anterior ribs and
inferior sternum, produces a flexion force in the trunk.
This has consequences beyond the immediate structures
affected. The consequences include a chain of effects that
begin with shortening and tightening of the pectoral
muscles. These muscles will exert an inferior tension on the
clavicle, superior ribs and the anterior scapula and will
assist in internally rotating the humerus.
The force of gravity also contributes to the internal
rotation of the glenohumeral (i.e., shoulder joint) as the
trunk flexes forward. Internal rotation of the humerus
tensions and lengthens the external rotators of the shoulder
that, in combination with the tension exerted on the
anterior scapula by the pecs, will bring the scapula into
protraction, lengthening and weakening the middle and lower
trapezius and rhomboid muscles. (Note that a tight
latissimus dorsi can also be a primary contributor to
internal rotation of the humerus.) The internally rotated
humerus and protracted scapula will place the rotator cuff
muscles at a biomechanical disadvantage in dynamically
stabilizing the glenohumeral joint. The rotator cuff will
not function effectively, increasing the risk of injury.
The reaction at the cervical spine is two fold. The lower
segments of the cervical spine follow the forward and
downward movement of the trunk, and they themselves flex,
causing lengthening and weakening of the deep cervical
flexor muscles. (This can also stress the outer layer of the
intervertebral discs, which over time may lead to injury.)
Naturally, if the lower cervical spine flexes forward, the
head will follow, and if this force is not countered,
gravity will cause the head to fall forward. In order to
prevent this from happening, tension will develop in the
cervical extensors, including the upper trapezius, splenius,
semispinalis, spinalis and sub-occipital groups that attach
to the base of the skull. The upper cervical segments
including the base of the skull are extended, shortening the
sub-occipital muscles. This extension will allow the skull
to remain somewhat level as it rests on the atlas (i.e., the
uppermost cervical vertebra).
The over working of the upper trapezius muscle and
lengthening and weakening of the middle and lower trapezius
and the rhomboids will also contribute to early elevation of
the scapula with shoulder motion. This will worsen the
position of the glenohumeral joint and will further stress
the rotator cuff.
The example I have illustrated has been limited to the
rectus abdominis. It is important to understand that single
muscles are rarely the isolated culprits in postural
distortions and biomechanical dysfunction. (An exception
would be an acute specific muscle injury that has not healed
correctly and has caused compensatory overloading in other
areas.) Because muscles act synergistically and as agonists
and antagonists, there is usually more than one contributor.
There are also connections between muscles through tough
fascial connective tissue, which help to transmit forces
between tissues. These cases of dysfunction can be rooted in
other parts of the body, as the musculoskeletal system
functions as a whole.
Not only will these faulty positions and compensatory
biomechanics cause an athlete to move inefficiently. Over
time, they may lead to degenerative processes in the soft
tissues and joints that will lead to further injury and
impairment.
The neurological system also adapts to these changes,
applying muscle memory, as it controls the musculature.
Training this system is essential in developing healthy
neurological pathways and muscle firing patterns. This is
achieved through the methods mentioned above such as using
medicine balls, balance boards and stability balls and
challenging the neuromuscular system.
Any of the muscles mentioned above may be the source of
dysfunctional patterns, but it will most likely be a
combination of them that will be the cause. It is important
to follow the entire kinetic chain when assessing and
treating these conditions.
Cycling
Most cyclists focus on their hamstrings, quadriceps and
gluteal muscles and forget about the importance of core
stability. Consider how many hours a cyclist spends bent
over in a flexed position on the aero bars, with no
rotational or side bending motions. A strong core is needed
to counter balance these forces.
With a focus on the core, a cyclist can
generate more power and can sustain a higher level of
intensity for longer periods. A stronger core also means
less stress on the primary muscle movers and a delay in the
build up of lactic acid. Even minor changes such as brake
position can affect core stability. If the brake handle
position is too low, the cyclist is forced to reach too far
forward with his forearms. This reaching position forces the
cyclist to raise his head, forcing the pelvic girdle
posterior. This position can cause a restriction in several
key muscles in the core, thus reducing performance. The
ideal position for the forearms is to have the elbows bent
and the forearms flattened out. In this position, the
cyclist head drops into a more comfortable aerodynamic
position, and the pelvis tilts forward. In this position,
the cyclist is able to use all the core muscles with
improved efficiency.
Running
Now consider how a shortened rectus abdominis affects a
triathlete's performance during running. Although opinions
about the "ideal running form" vary greatly, most
authorities will agree that the less energy expended, the
more effective and efficient the running style will be.
|
Common
Running Recommendations
|
How a
Shortened Rectus Abdominis Affects Your Running
|
| Run upright. Your
back should be straight, roughly at a 90 degree
angle to the ground. |
A shortened
rectus abdominis will pull the runner's posture
forward, causing a braking action that reduces
running economy.
|
| Look straight
ahead. Your eyes should be focused straight down the
road on a point moving about 10 meters in front of
you. This helps to keep you in a straight line. |
As the rectus is
shortened, it pulls the chest forward, allowing
gravity to pull the head down. In order to look
straight ahead as instructed, the athlete wastes a
considerable amount of force in trying to overcome
the contracted rectus abdominis. |
| Swing your arms
naturally. The angle at the elbow between your upper
and lower arms should be about 90 degrees. Your
hands should be loosely cupped, about belly level. |
As the shoulders
move forward, a shortened rectus abdominis causes
the arms to rotate internally. This makes keeping
your arms relaxed at the recommended 90 degree angle
much more difficult, reducing running economy. |
...
Educating yourself on how the core works will help to avoid
injury, improve your athletic performance and increase
training efficiency. Far too often, people read the most
popular book or take advice from someone who they think
knows more than they do. This cookie cutter approach does
not take into account a person's specific needs and goals.
In my opinion, anyone who participates in any sport or
activity should have a professional evaluate them for any
weaknesses or poor movement patterns. I can't tell you how
many patients have told me, “It just started hurting. I
never did anything to it.” A simple evaluation can save you
from repetitive stress injuries.
References:
- McGill, S, Ultimate Back Fitness and
Performance: Ontario. Wabuno Publishers. 2004.
- Kendall FP, McCreary EK, Provance PG.
Muscles: Testing and Function. 4th ed. Philadelphia:
Lippincott Williams and Wilkins. 1993.
-
www.Runnersworld.com