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LEARNING OBJECTIVES
Upon completion of this chapter the student should be able to demonstrate the following competencies and proficiencies concerning core stability:
Describe the core and the muscles that comprise it
Describe the functional anatomy of the core
Understand the relationship of the muscles acting on the core
Describe the role of the core in activity
Evaluate core muscles for weakness
Describe, implement, and progress exercises for the core muscles
Design a core strengthening and endurance program
Understand the relationship between core muscles and lumbar stability
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Core training has become a central component of many rehabilitation, athletic, and fitness programs. This chapter will focus on the importance of core musculature and how to use scientific research to design a safe, effective training program for individuals of all abilities. A plethora of core strengthening exercises can be used to help prevent injury; strengthen muscles of the abdomen, hips, and shoulder girdle; or treat lumbar spine pathology. These exercises can also increase function and performance for the athlete when participating in daily or sporting activities. It is up to the clinician to choose exercises that will increase the function and strength of core musculature, while at the same time limiting undue or unnecessary stress on spinal structures.
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The core provides proximal stability for most athletic movement and generation and transfer of forces. Because proximal stability provides distal mobility, the core is central to movement and function. For a joint to be stable, compression and the coordination of muscular and ligamentous control are necessary. The ability of a joint to react to forces and produce movement therefore depends on the strength of the muscles and ligaments surrounding it and the stability they provide.1 Core muscles provide stability mainly to the joints of the lumbopelvic region, which includes the vertebral joints of the lumbar spine, sacroiliac joints, and hip joints, but it also encompasses the scapulothoracic junction.
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Clinical Pearl 8-1
The core encompasses the hips, shoulder girdle, and trunk.
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The words core training commonly describe the muscles located in the abdominal and lumbopelvic region, including the hips, to produce core stability. Stability is not solely defined as the strength of the core, but rather a combination of strength, endurance, balance, efficiency of movement patterns, and motor control of core muscles. Stability can be divided into two groups: static and dynamic. Static stability incorporates the maintenance of posture and balance. Dynamic stability involves the production and control of movement incorporating a coordination of muscular strength, endurance, flexibility, and cardiorespiratory fitness.2,3
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To define core stability, the combination of a global and local stability system has been used. The global stability system refers to the larger, superficial muscles around the abdominal and lumbar region, such as the rectus abdominis, paraspinals, and obliques4,5...