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Core Stability and Injury Prevention

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Core stability is essential for proper form and mechanics while performing sports skills. It is also important for injury prevention during those sport activities as well. Core stability deals with the proper coordination of the key muscles used to support the spinal column in its naturals-curve.

What is Core Stability?
Core stability is the coordinated effort of the deep muscles of the trunk, pelvis, hips, abdominal muscles and small muscles along the spinal column. These muscles contract together to create force used to hold the spinal column in alignment.

The strength of these muscles is less important than their endurance and the co-contraction of the muscles to provide support. Since these muscles must stabilize the spinal column during all movement they must have good endurance with enough strength to counter forces placed on them during extreme activities. The muscles must be equal in strength and contract in correct proportions to maintain the proper posture of the spine during all activities.

Anatomy involved
The deep muscles of the trunk and hip region are involved in core stability. The transverses abdominus (TA), the multifidus (MF), internal oblique (IO), paraspinal, and the muscles of the pelvic floor are all essential for core stability. The contraction of these muscles increases the force along the theracolumbar fascia that covers the spinal column. Intra-abdominal pressure increases as well, increasing support to the lumbar spine.

It has been shown that the TA and MF contract simultaneously when movement of the limbs is anticipated. This stabilizes the spine and creates a solid base for all movement.

How do you improve Core Stability?
It is important to differentiate between core strengthening and core stability. Core stability deals with the ability to stabilize the spinal column during all movements. This does not pertain to the strength of the muscles or force of their contraction. The muscles involved are also different. Core strength deals with the superficial muscles of the core; the abdominals, the gluteals, adductors, abductors, the spinal erectors and other trunk and hip muscles. Core stability deals with the deeper trunk and hip muscles.

Improving core stability requires working the muscles in their specific function. These muscles are stabilizer muscles and therefore contract with a static or isometric contraction. They do not move, which means they must be worked with static exercises.

These muscles are under static stress all day long, as long as a person is standing or moving. This requires a high degree of endurance, along with adequate strength to handle sport or fitness-related movements. The exercises must stress endurance under increasing workloads to focus on gradual strengthening of the muscles while enhancing endurance.

Finally, the muscles must be worked in their correct anatomical position. The spine has a natural S-curve that is designed to absorb the most shock and hold the body in correct alignment. Exercises for core stability must place the spine in its neutral position to ensure adequate involvement of all the muscles.

Precautions
When exercising to improve core stabilization it is essential that activities be done in correct alignment. It is also important that all the muscles be recruited together and in correct proportions.

Starting with static exercises to work the endurance of the muscles in a controlled environment is a safe way to start building stability. Gradually increase the difficulty with other joint and muscle involvement, as your comfort level increases, thereby working dynamic core stability.

It is important to get instruction on the proper performance of these exercises as well.

Sample exercises
Core stability starts with recruiting the TA and MF muscles and you can train your body to do this by a technique called “Hollowing.” To do this you lie on your back on the floor with your knees bent. There should be a natural space between your lumbar region and the floor. Then you breathe in deeply while relaxing your abdominal muscles. Breathe out while pulling your navel back toward your spine. Hold the contraction for 10 seconds, staying relaxed and allowing yourself to breathe in and out while holding the tension. Repeat this for 5 to 10 repetitions. Once you can accomplish this activity successfully you can progress to more dynamic exercises.

Body weight exercises
These exercises can be ether static or dynamic, meaning holding a contraction without movement or moving through a range of motion while stabilizing the core.

A static bodyweight exercise might look like the Side Plank. To perform this exercise you lie on one side, keeping the top and bottom hips in alignment. The top arm is resting on your side and the bottom arm is bent at the elbow, forearm on the floor, and the elbow directly under the shoulder. This arm braces the torso. Push up so there is a straight line through the feet, hips and head. Hold the position and then slowly lower to the start. Gradually increase the time of the hold (working toward a 30 second hold) and repeat for 2 to 3 repetitions on each side.

For a dynamic bodyweight exercise you might try the straight leg raise. Lie on your back with your knees bent. Make sure your spine is in a neutral position and contract your abdominals for stability. Lift one leg straight in the air, making sure your spinal alignment does not change. Then lift the other leg straight up as well. Lower one leg slowly toward the floor. Only move down until you feel your back move (placing your fingers in the lumbar space may help to feel this at first.) Keeping the abdominals tight, slowly bring the leg back up and repeat with the other leg. Perform 2 to 3 sets of 8 to 10 repetitions, alternating legs during each set.

Swiss Ball exercises, etc.
The Swiss Ball adds an extra dimension to core stability training by adding the balance element. As with bodyweight exercises, these exercises come in static or dynamic varieties as well.

A good example of a static Swiss Ball exercise is the Gluteal Bridge. To perform this you place your head and shoulders on top of the Swiss Ball with your feet on the floor. Feet should be hip-width apart for stability. Slowly lift the hips, using the muscles of the hips and spinal column, until there is a straight line through the knees, hips and shoulders. Do not raise the hips too high or allow the ribs to flare, causing hyperextension of the back. Hold for 30 seconds and repeat for 2 to 3 repetitions.

Overhead Pulls are a good dynamic Swiss Ball exercise. Place your shins on the Swiss Ball and your hands on the floor under your shoulders in the push-up position. Set the lumbar spine in a neutral position and make sure the shoulders are stable by pulling the shoulder blades down and the chest out. Roll your legs backward over the ball, maintaining a straight body position and good spinal alignment, until your arms are overhead. Continue to brace the abdominals and pull yourself back to the beginning position. Do 2 to 3 sets of 5 to 10 repetitions.

And remember; stretching is important too!

Stretching is one of the most under-utilized techniques for improving athletic performance, preventing sports injury and properly rehabilitating sprain and strain injury. Don't make the mistake of thinking that something as simple as stretching won't be effective.

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Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit
The Stretching Institute.
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