Core Concepts - Spinal and Sports Injuries

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What is Pain? Different Medical Conditions

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What is Core Stabilisation?

Core Stability is the training of the core muscles to support your spine, neck and shoulder blades. It is a fundamental principle to current physiotherapy treatments of back and neck pain.

Core stabilisation training is effective as a long-term solution to recurring back and neck pain. Compared to other treatments such as manual therapy, it has been shown to have longer sustained improvements.(See "Stabilisation Training vs Manual Therapy"

Core muscles lie deep within the torso and are generally attached to the spine, pelvis and shoulder blades. The contraction of these core muscles stabilises the spine, pelvis and shoulders to form a solid base for movements of the arms and legs.

The main concept of core strengthening programs involves using many muscles in a coordinated movement. Rather than isolating a specific joint as in most weight lifting workouts, core stability exercises focus on working the deep muscles of the entire torso at once.

For example at your lower trunk area, your abdominal muscle group is made up of your sit-up muscle (rectus abdominus) and 3 other muscles that wrap around your sides, your internal and external obliques (see figures) and your transversus abdominus or corset muscle.

The last of these muscles, your corset muscle, is found at the deepest layer. Research suggests that your corset muscle is one of the most important providers of support to your lower back. In fact, it has been suggested that in almost 90% of all your body movements, your core muscles are active supporting your entire trunk region.

The dynamic relationship between the control of the lower back area by your transversus abdominus and multifidus (intersegmental muscles between the vertebrae) working synchronously together with other your muscles that move the limbs is a fundamental part of the Core Stability concept.

References

1. Exercise as a treatment for chronic low back pain, Rainville et al. The Spine Journal 4 (2004) 106?15
2. Functional load abdominal training: part 1, C M Norris, Physical Therapy In Sport (2001) 2, 29-39
3. Functional load abdominal training: part 2, C M Norris Physical Therapy In Sport (2001) 2, 149-156
4. Rehabilitation of pelvic floor muscles utilizing trunk stabilization, Ruth Sapsforda,b,*, Manual Therapy 9 (2004) 3?2
5. Is there a role for transversus abdominis in lumbo-pelvic stability?, P. W. Hodges, Manual Therapy (1999) 4(2), 74-86
6. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain, Rasmussen-Barr et al, Manual Therapy (2003) 8(4), 233?41
7. Achieving Spine Stability: Blending Engineering and Clinical Approaches, S. McGill, 4th Interdisciplinary World Congree on Low Back & Pelvic Pain, November 2001
8. Morphology of the Transversus Abdominis, Obliquus Internus, and Obliquus Externus Muscles, Urquhart, Hodges et al, 4th Interdisciplinary World Congree on Low Back & Pelvic Pain, November 2001
9. The stabilising system of the spine. Part I.Function, dysfunction, adaptation and enhancement., Panjabi MM,  Journal of Spinal Disorder 4: 383?89,
10. The stabilising system of the spine. Part II.Neutral zone and instability Hypothesis. , Panjabi MM  Journal of Spinal Disorder 4: 390?97
11. What exercise would you prescribe?, Richardson CA, Jull GA 1995, Manual Therapy 1: 2?0
12. Therapeutic Exercise for Spinal Segmental Stabilisation in Low Back Pain., Richardson CA, Jull GA, Hodges PW, Hides J 1999  Scientific Basis and Clinical Approach. 1st edn. Churchill Livingstone, London

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