Core Training

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Posted on May 26, 2015

Let me tell you a story about a recent patient I saw. This gentleman has had a history of low back pain off and on for the past 5 year or so. Just like with every patient I evaluate, he was taken through a comprehensive movement assessment utilizing the Selective Functional Movement Assessment (SFMA). He demonstrated multiple dysfunctional movement patterns whose breakouts determined fundamental core instabilities. As I am discussing the results of his movement assessment with him and mention core instability, he gets this confused look on his face and says, “I work on my core every day at the gym.” When I ask him what he does at the gym, he tells me he does sit-ups and leg lifts.

This scenario is far too common and I see this as an opportunity to educate the public about core training. There is a multitude of evidence to support that core training should be included in the rehabilitation of back pain, ACL reconstruction, shoulder pain, hip pain, neck pain, and numerous other musculoskeletal pathologies. When people hear the word “core,” one thing tends to come to mind, the rectus abdominus. But the core encompasses much more, including the diaphragm, multifidus, pelvic floor, transverse abdominus, internal and external obliques, the erector spinea, and even the gluteals. The core’s primary function is transfer energy to and from an extremity so that a task can be completed, such as throwing, kicking, lifting, pulling, and pushing. Rarely is the function of the core to lie on your back and lift your chest. Simply doing sit-ups may get you those six-packs abs that everyone desires, but it is not an effect means of training the core. Once more functional core training was implemented and incorporated into this patient’s gym program, his back pain resolved and he was able to return to his previous activity level.