Personal Trainers Forum

[Personaltrainer]

Core stability training and exercise programme

The basics...
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 co-contraction you must perform the 'abdominal hollowing' technique with the spine in the neutral position. To do this 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.
Sounds easy? Well maybe, but it is absolutely vital that you perform this abdominal hollowing exercise correctly otherwise you will not recruit the TA and MF effectively. These coaching points must be followed to ensure your practice is correct.

1.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.
2.Do not brace your TA muscle too hard; just a gentle contraction is enough. Remember it's endurance not max strength your are trying to improve.
3.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.
4.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.
5.Use your fingers for biofeedback on either side of you lower abdomen to feel the tension in the TA muscle.

Once you have mastered the 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 next step...
Having learnt to recruit the TA and MF muscles correctly in various positions, which can take anything from one session to one month or more, it is time to move onto simple core-stability exercises. These exercises may also involve the oblique muscles, other lumbar muscles and gluteals to assist the TA and MF in maintaining the lumbar spine in a stable neutral position. I have chosen two very useful examples, but there are many others included in Pilates lessons and used by trainers and physiotherapists that can be incorporated at this stage of core-stability learning.

Lying leg-lift stabilisation
Lying on your back with your knees bent. Ensure your back is in neutral. Place your hands on your hips for biofeedback.
Breathe in and relax. Breathe out and, as you do so, perform the abdominal hollowing or zipping-up action. Once you have established some TA tension, slowly slide your left leg out along the floor until it is straight and then slide it back. Your back should not have moved, and you pelvis should not have tilted as you performed this action. If your back or pelvis moved, you did not achieve the correct stability. Remember the coaching points from above, and ensure you follow them, otherwise you will jeopardise the training. Repeat for the other side 10 times each leg.
Variations include the same exercise with knee lifts up and knee drops out to the side. Again, the aim is to retain a stable lumbar spine in the neutral position as the legs move.

The waiter's bow
Stand up with good posture; knees soft, lumbar spine in neutral, head up and shoulders back and relaxed.
Breathe in and relax. Breathe out and as you do so perform the abdominal hollowing action. Keeping the tension, slowly lean forward from the hips 20 deg and stop, like a waiter's bow, keeping your back completely straight and long as you lean. Hold the lean position for 10 seconds - you will feel your TA and MF supporting you if you hold the correct position. Keeping the tension and the alignment, slowly return to your start position. Repeat 10 times. Again, remember the coaching points from above.
These exercises are two examples of learning how to keep the spine in neutral, using slow and controlled, static contractions of the trunk stabiliser muscles. Notice how technique is vital and the aim is to build up the time you are able to maintain good stability.

Getting functional...
The ultimate aim of core-stability training is to ensure the deep-trunk muscles are working correctly to control the lumbar spine during dynamic movements, e.g., lifting a heavy box or running. Therefore it is important that once you have achieved proficiency of the simple core exercises, you must progress on to achieving stability during more functional movements. I have chosen two examples.

(1) The lunge
A classic exercise, but done slowly and with care it can teach you a great deal about body awareness and core stability. Interestingly, it is used by Alexander Technique teachers to help establish better movement patterns.
Stand with feet hip-width apart in front of a mirror. Ensure your lumbar spine is in neutral and your back is tall with your shoulders back and head up.
Lunge forward and bend your knee only half way down. Ensure that your front knee is in line with your toes and your back has remained upright with your lumbar spine in neutral and your hips level.
Push back up, initiating the movement by pushing down into the floor with your front foot. The force from your legs should bring you back up quickly and easily to your start position. Your back should have remained totally still and your hips level as you performed the push back.
Many people wrongly initiate the up movement by pulling their heads and shoulders back first; this extends the lumbar spine, losing the neutral position. Others have problems keeping their pelvis level while performing the lunge. You must learn to use your deep trunk and gluteal muscles to hold your lumbar spine in neutral and pelvis level as you perform the movement up and down. The movement should only come from the leg muscles.

(2) The press up
Another classic exercise, but more often than not it is performed with questionable core stability. Start from your knees - even if this means it is easy for your upper body - to learn the correct technique.
Your hands should be slightly wider that your shoulders and your head must be in front of your hands. Lift your hips so that there is a straight line from your knees through your pelvis and lower back, through your shoulders and all the way to your head. Ensure your lumbar spine is in neutral, using a mirror or a partner/trainer to help you. To maintain a neutral spine and a straight back during the exercise, the trunk muscles must provide active support. Slowly lower down, bending your arms all the way to the floor. Keep your head still with your neck straight relative to your back. Push up, initiating the movement by pressing down into the floor with your hands. Your back should remain still, straight and your lumbar spine in neutral throughout.
Many people allow their lumbar spine to arch and sag downwards as they perform the press up; this is because they are not using their trunk stabilisers enough to support the body.
These two exercises, used in a non-traditional manner, enable you to learn core stability while performing dynamic movements. By reducing the resistance - i.e., doing only half lunges and knee press ups - your are able to focus on the trunk stabilisers and achieving perfect technique rather than working the major muscle groups. The whole essence of core stability training is quality of movement and relaxation. The more you practise, the easier it becomes until you can control your lumbar stability at all times and during complex movements.