Working Core Training in 360 Degrees

The notion of core training has been around for years and years.  As far back as I can remember, people have been doing crunches, sit-ups, weighted side bends, and more.  You could walk into any gym in the world and probably see someone doing some sort of “core” exercise.

core training sit ups

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Even today, there are still people performing sit-ups or some other variation in their training program.  But as we continue to learn more about the spine, these traditional core exercises may actually be disadvantageous.  According to Dr. Stuart McGill, a noted spine biomechanist from the University of Waterloo:

“The spine may be more prone to injury when they are in a fully flexed posture.”

Last time I checked, when someone is performing a sit-up, they are in a great deal of flexion.  

Many other studies by McGill and other researchers have been published on the increased risk of high repetition and/or loaded lumbar spine motion.  Since this research has been published, there has been a pendulum swing towards performing more neutral spine movements such as planks.

core training plank

In another study by Cholewicki and McGill in Clinical Biomechanics:

“One important mechanical function of the lumbar spine is to support the upper body by transmitting compressive and shearing forces to the lower body during the performance of everyday activities. To enable the successful transmission of these forces, mechanical stability of the spinal system must be assured.”

By performing some type of plank or neutral spine exercise, this can potentially train the core to transmit force from the upper body to the lower body or vice versa without compromising the spine.

Performing plank variations is great, but as humans, we move in multiple planes of motion.  Therefore, we need to train the core to function in all planes of motion.

 

Core Musculature

360 degree core trainingThere are many muscles that contribute to the functioning of a stable core position.  These muscles include:

 

  • Rectus Abdominis
  • Internal Obliques
  • External Obliques
  • Transverse Abdominis
  • Multifidi
  • Quadratus Lumborum
  • Diaphragm
  • Pelvic Floor
  • Latissimus Dorsi

There have been studies performed over the years saying that transverse abdominis or multifidi are the main stabilizers of the lumbar spine.  Study after study, many by McGill, have refuted that 1 or 2 muscles are the primary stabilizers of the spine.  McGill et al. in the Journal of Electromyography and Kinesiology found that:

“The collection of works synthesized here point to the notion that stability results from highly coordinated muscle activation patterns involving many muscles, and that the recruitment patterns must continually change, depending on the task.”

Therefore, when we are training or treating our clients, we should not be attempting to isolate one muscle we performing lifting tasks.  Some muscles may be more active than others in one task as compared to another.  Instead, we should be working to maintain a neutral spine position and to resist motion through the lumbar spine.

The McGill Big 3

McGill came up with a series of 3 exercises, entitled “The Big 3” to help teach and re-educate patients or clients returning from a low back injury on how to properly stabilize their spine.

They include:

McGill Curl-Up

Key Points:

  • Place finger tips under low back.
  • Maintain a neutral spine position at low back and neck.
  • Slightly lift shoulders off ground while maintaining spine position.

Bird Dog

Key Points:

  • Maintain a neutral spine.
  • Imagine you have a drink on your low back. Don’t let it spill

Side Plank

Key Points:

  • Start on your side in a hip hinged position (hips slightly flexed).
  • Bring hips forward, not up.

These exercises are great implements to add into the beginning of a strength and conditioning program or during a rehab program for someone returning from a low back injury.  But, these exercises are a foundation for movement.  If we are going to build core stability throughout, thence need to have a solid foundation as well as solid “walls and a roof.”

 

Core Training Progression

There are typically two functions of the core:

  1. Transmit force from the lower body to the upper body or vice versa.  
  2. Resist motion.  

For example, if you are a baseball player and are throwing or swinging a bat, you want to have some motion through your lumbar spine, but predominantly through the hips and thoracic spine.  If we try to stop motion at the lumbar spine, your effectiveness as an athlete will be subpar.

Don’t forget…  the spine needs to move.  This is something Mike has covered in his article Are We Missing the Boat on Core Training?

Regarding the other aspect of resisting motion, if you are going to pick something heavy up off the ground, you want to maintain a neutral spine posture so that your core can transmit force from your legs and into your arms as you lift to the implement.

We need to appreciate these two different situations as we program for our clients.

The three planes of movement that the core musculature works in is the:

  • Sagittal Plane
  • Frontal Plane
  • Transverse Plane

The sagittal plane is lumbar spine flexion and extension. The frontal plane is lateral flexion or sidebending.  The transverse plane is rotation to the right or left.

The following progressions are a big part of Mike Reinold and Eric Cressey’s Functional Stability Training For the Core program.

 

Anti-Extension Core Training

Anti-extension core training consists of the body’s ability to resist movement into lumbar spine extension or to slow down motion from a flexed position to neutral, or from neutral to extension.

Exercises that focus on anti-extension stability are:

RKC Plank

Key Points:

  • Pull your elbows toward your toes.
  • Squeeze your glutes as hard as you can.
  • Maintain a neutral spine.

TRX Fallouts

Key Points:

  • Maintain a neutral spine.
  • Tuck tailbone/bring belt towards chin.
  • Slide arms out while keeping neutral spine.

Farmer’s Carries

Key Points:

  • Hold relatively heavy weight in each hand.
  • Ribs down/neutral spine.
  • Walk.  Don’t lose neutral spine posture as you walk.

Dead Bugs

Key Points:

  • Flatten low back to ground so that spine is neutral.
  • Bring right arm overhead and left leg out away from body.
  • Do not lose neutral spine position.  Return to starting position.
  • Repeat on other arm/leg.

Tall Kneeling Anti-Extension Press

Key Points:

  • Setup cable at head height when in tall kneeling.
  • Maintain a neutral spine and press cable overhead.
  • Cable will try to pull you into extension.  Don’t let it.
  • The only thing moving should be your arms.

Anti-Lateral Flexion Core Training

Anti-lateral flexion core training consists of the body’s ability to resist movement into lumbar spine lateral flexion to the right or left or to slow down motion from a flexed position to neutral, or from neutral to the opposite laterally flexed position.

Exercises that focus on anti-lateral flexion core stability are:

Suitcase Carries

Key Points:

  • Hold weight in one hand.
  • Do not let weight pull you out of a tall, neutral posture.
  • Don’t overcompensate to and flex to the opposite side.
  • Walk.

Side Planks

Key Points:

  • Start on your side in a neutral spine, slightly hips flexed position.
  • Maintain neutral spine and bring hips forward.
  • Maintain a straight line from your head, shoulders, spine, hips, knees, and ankles.

Racked Carries

Key Points:

  • Maintain a tall posture similar to the suitcase carries.
  • Walk.

Anti-Rotation Core Training

Anti-rotation core training consists of the body’s ability to resist movement into lumbar spine rotation to the right or left or to slow down motion from a rotated position to neutral, or from neutral to a rotated position.

Exercises that focus on anti-rotation core stability are:

Anti-Rotation Press

Key Points:

  • Start behind cable arm.
  • When you press your hands away, don’t let the machine rotate you.  Maintain a neutral spine.
  • Perform facing both directions.

1/2 Kneeling Chops

Key Points:

  • Leg closest to the machine should be up.
  • Bring arms down and across your body to you far side hip.
  • Only move head and arms.
  • Perform on both sides.

1/2 Kneeling Lifts

Key Points:

  • Leg closest to machine should be down.
  • Same cues as chops, but bring cable to far side shoulder.

TRX Anti-Rotation Press

Key Points:

  • Feet should be in tandem.
  • Maintain a neutral spine position.
  • Don’t let your body rotate or sidebend during press.
  • Perform on both sides.

 

Multi-Planar Movements and Rotational Sport Athletes

Once the body has mastered the basic core progressions and anti-movement-based drills, it is important to incorporate multi-planar and rotational movements.  These movements work on incorporating movement through the hips and thoracic spine versus some of the movements before where basically no movement was occurring.

As mentioned before, these exercises will help the athlete and client to control themselves going from one position to another.  As a rotational sport athlete, we don’t want to completely limit any spine motion.  We want the body to be able to control and decelerate the body using the musculature versus passive restraints (ie. bone, ligament, etc.) at end range.  These can also be used by non-rotational sport athletes as well.

Sledgehammer Hits

Key Points:

  • Bring the sledgehammer up over one shoulder.  Don’t let it bring you into lumbar extension.
  • Hit the tire while maintaining a neutral spine.
  • Alternate per side.

Medicine Ball Overhead Slams

Key Points:

  • Raise the medicine ball overhead.
  • Avoid going into lumbar extension.
  • Slam the ball to the ground while maintaining a neutral spine.

Medicine Ball Overhead Rotational Slams

Key Points:

  • Bring the ball up overhead.  Don’t let it bring you into lumbar extension.
  • Throw while maintaining a neutral spine.

Medicine Ball Scoop Toss

Key Points:

  • Load your back leg with your weight.
  • Transfer weight quickly from back to front leg.
  • Majority of the motion should be coming from the thoracic spine and hips.
  • Perform on both sides.

Medicine Ball Shotput Toss

Key Points:

  • Load medicine ball at shoulder height.
  • Load back hip/leg.
  • Quickly drive off back leg and twist through hips/thoracic spine.
  • Perform on both sides.

 

Breathing and Core Training

Implementing breathing with core training is very important.  If we are constantly holding our breath while performing core exercises, then we are compensating using the valsalva maneuver versus training the musculature to have to stabilize throughout the exercise.

Related Articles:

*Disclaimer*: if you have heavy weight in your hands or on your back in the cases of a deadlift or squat, then I am a proponent of using the breath to brace the core and spine.  When it comes to core exercises as mentioned above, remember to breath.  

With the said, here are a couple of exercises where implementing the breath adds another component to the movement.

Anti-Rotation Press with Full Exhale

Key Points:

  • Same as before with Anti-rotation Press.
  • Complete full exhale when hands are out in front of your body.
  • Maintain proper form during exhale and inhale.

Prone Plank with Full Exhale

Key Points:

  • Same as before with Plank.
  • Complete full inhale and exhale without losing form.

 

Strength Training and Core Stability

Lastly, we can’t go through an entire article and not discuss the use of core stability and strength training.  I am a firm believer that just performing squats and deadlifts are not enough to improve core and trunk stability.  Adding some of the movements mentioned above can add another component to create a well-rounded training program.

When it comes to performing squats, deadlifts, etc., maintaining a neutral spine during the lifts is extremely important.  Yes, there are some elite level lifters out there who can sway away from a neutral position in one direction or the other.   For the vast majority of people performing strength movements such as these, a neutral spine should be maintained.

There you have it.  By incorporating core stability exercises throughout all planes of motion, it will allow your clients and/or athletes to reduce their risk for injuries as well as improve their performance.

 

Learn More About Core Training

If you want to learn even more about functional core training, check out Mike Reinold and Eric Cressey’s Functional Stability Training for the Core.  The program goes over many of these progressions and a whole lot more to help you completely understand the true role of the core and how to incorporate functional core training into your rehab and strength training programs:

 

About the Author

andrew_millettAndrew Millett is a Boston-based physical therapist in the field of orthopedic and sports medicine physical therapy.  He helps to bridge the gap between physical therapy and strength and conditioning.  Visit his website at AndrewMillettPT.com.

 

 

 

 

Integrating Performance Based Physical Therapy

The latest Inner Circle webinar recording on Integrating Performance Based Physical Therapy is now available.

 

Integrating Performance Based Physical Therapy

Integrating Performance Based Physical TherapyThis month’s Inner Circle webinar is on Integrating Performance Based Physical Therapy.  This presentation is actually my talk from the recent Champion Bridging the Gap From Rehab to Performance Seminar that we conducted in Boston last month.  

I wanted to share this with Inner Circle members as I feel the topic is important as performance based therapy is definitely the future of our professions.  Performance therapy is something that is performed to help people optimize themselves and improve performance, no matter what performance means to you.  You don’t need to be injured to benefit from performance therapy.  This is a lot of what we do at Champion and something that I really wanted to share.

We are actually going to be releasing an online version of the Champion Bridging the Gap From Rehab to Performance Seminar, which will include this presentation, plus others from Lenny Macrina, Dave Tilley, Rob Sutton, and Kiefer Lammi.  

Inner Circle members can access my talk now, and get early access to purchase the seminar.  Everyone else will have to wait until the official launch next week!  Plus, if you’d like to purchase the seminar, I also have a $10 off coupon just for Inner Circle members.  All the links will be in the Inner Circle Dashboard.

This webinar will cover:

  • What is “performance therapy”
  • The need for a paradigm shift in what we do
  • What I look for in my movement assessments
  • The components of manual therapy I perform
  • How to integrate and maximize your outcomes with corrective exercises

 

To access this webinar:

 

An Easy Drill to Enhance Thoracic Extension

Thoracic mobility drills are commonly given to people to enhance mobility.  I have shown some common thoracic mobility drills in the past, and recently showed a newer muscle energy technique I have been using.  If you haven’t seen these yet, you should check them out:

 

One of my big principles of rehabilitation and corrective exercises is that you follow up mobility drills with some sort of activation or strengthening drill.  You want to use the body in this newly gained mobility.

For some reason, I feel like this is often ignored with thoracic mobility.

I would actually argue that a very common reason for having limited thoracic mobility is poor endurance into thoracic extension.  The muscles can’t maintain an extended posture and resort to the path of least resistance, a slouched posture.

If you are going to spend time working on thoracic extension mobility, you should follow that up by working on thoracic extension endurance.

In the video below I show an extremely easy way to start working on thoracic extension endurance.  Certainly not groundbreaking, but an important drill that is often overlooked.

 

An Easy Drill to Enhance Thoracic Extension

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

 

Enhancing Thoracic Mobility

enhancing thoracic mobilityLimited mobility of the thoracic spine is a common finding and something that tends to get worse over time.  To me, it’s one of those “use it or lose it” types of mobility in the body.  Several issues can occur from limited thoracic mobility, such as shoulder, neck, and even low back pain.

Thoracic mobility drills are common, but only part of the puzzle.  I have a new presentation where I’ll be reviewing some of the self mobility, manual therapy techniques, and corrective exercises I use to enhance thoracic mobility.

 

Enhancing Thoracic Mobility

This presentation will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

 

Access the Presentation

You can purchase access to this presentation for only $10, or join my online Inner Circle Mentorship program for only $10/month and gain access to this and ALL my past presentations, product discounts, exclusive content, member only forum, and more!

 

 

Thoracic Mobility Muscle Energy Technique

Have you ever worked with someone that never seemed to improve their thoracic mobility, especially thoracic rotation?

I work with the occasional person that doesn’t respond to many of the common thoracic mobility drills.  Sometimes their daily posture, especially if working a desk job for years, needs more than the simple drills.  Sometimes I feel that thoracic mobility limitations can be true mobility restrictions, but other times I also feel there may be some tone or guarding involved.

A common technique that can be used to enhance mobility drills, especially when tone is involved, is muscle energy technique, or MET.  Muscle energy is commonly used to enhance mobility in other areas of the body, like the shoulder or hamstring, but less frequently used for thoracic mobility for some reason.

In the video below I show a very easy muscle energy technique that you can use to enhance thoracic mobility into rotation.  This is very easy to perform on your own too.

Give it a try and let me know what you think, I’ve been pretty amazed at how much more mobility I can achieve in a short amount of time using this muscle energy technique, especially for those stubborn thoracic mobility limitations.

 

Thoracic Mobility Muscle Energy Technique

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

How Neural Tension Influences Hamstring Flexibility

Many people think they have tight hamstrings.  This may be the case for some but there are often times that people feel “tight” but aren’t really tight.

I’ve been playing around with how neural tension influences hamstring flexibility and have been having great results.

Watch this video below, which is a clip from my product Functional Stability Training: Optimizing Movement, to learn more about what I mean.

 

How Neural Tension Influences Hamstring Flexibility

 

Learn Exactly How I Optimize Movement

Want to learn even more about how I optimize movement?  Eric Cressey and I have teamed up on Functional Stability Training: Optimizing Movement, to show you exactly how we both assess, coach, and build programs designed to optimize movement.

Click the button below for more information and to sign up now!

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What Exactly is Optimal Movement Quality?

What exactly does optimal movement quality mean?

Have you ever thought of that?  How do you define “optimal” movement?”  I would argue optimal movement is slightly different for everyone as we are all unique.

However, I usually think of optimal movement as simply two things:

  1. Do the right joints move (and the wrong ones don’t)?
  2. Do the right muscles work (and the wrong ones don’t)?

Simple.

Watch this video below, which is a clip from my product Functional Stability Training: Optimizing Movement, to learn more about what I mean.

 

What is Optimal Movement Quality?

 

Learn Exactly How I Optimize Movement

Want to learn even more about how I optimize movement?  Eric Cressey and I have teamed up on Functional Stability Training: Optimizing Movement, to show you exactly how we both assess, coach, and build programs designed to optimize movement.

Click the button below for more information and to sign up now!

large-learn-more

The Use of Non Motorized Treadmills to Facilitate Gait and The Posterior Chain

We’ve recently started playing more with non motorized treadmills at Champion and have been very happy with the results.

Non motorized treadmills have gained popularity in the fitness realm as alternatives to self-powered conditioning machines like bikes and rowers. The Assault Air bikes and Concept 2 rowers have long been popular for their ability to produce amazing workouts.

I am a big fan of conditioning machines that increase their intensity based on the amount of effort exerted. Essentially, the harder you go, the harder they push back!

These have done wonders for high intensity interval training and sprint conditioning work.

Woodway has recently developed the Woodway Curve self-powered manual treadmill. Past non motorized treadmills seemed really cheap to me, but Woodway, who makes some of the best treadmills, has really made an exceptional machine with the Curve. I started using them for sprint work with the Red Sox, but have recently been using it more and more with my rehabilitation clients at Champion.

Because it is nonmotorized, your posterior chain is nicely engaged while walking and running on the Curve. A simple period of ambulation on the Curve does a great job engaging the hamstrings and glutes. I’ve been using these in everyone with diagnoses like patellofemoral pain, low back pain, and even postoperative. We start with a slow walk and slowly build up the speed and eventually get to running.

In the video below I explain more. I’m a big fan of nonmotorized treadmills to facilitate a proper gait form and engage the posterior chain.


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