O'Grady hoped the time spent on his core exercise routines would help to control a muscle a few inches lower!

Core Exercise Training: Essential Routine Or Potentially Damaging? Chapter 9

Core routines are now considered an essential part of any serious athletes training. But why did this approach become so popular? Is it based on a misunderstanding of the problem. For talks I often use the title Core Stability or Pure Stupidity?, yes okay it's a little provocative but it does get people's attention!

It has become a term used increasingly in rehabilitation, remedial exercise and more recently in sports training. But what is meant by it and does anyone know if it is really desirable and beneficial? But are these specific core-strengthening exercises, originally devised for people with spinal injuries, relevant for athletes with no pathology?

In 1989 the International Union of Physiological Sciences Conference debated the head-neck sensory motor systems as a factor in movement and balance (a component of Alexander’s primary control). As a result, over one hundred papers were written on the subject in the following three years. In the editor’s preface to the publications Berthoz wrote: -

"The need for a thorough analysis of all aspects of head movement control is all the more important because head movements are a core element of orienting behaviour involving a number of interactive sensory and motor systems."

It is therefore difficult to explain and justify the current popularity of core exercise training used by many therapists to promote what is known as ‘core stability’ (increasing the strength of specific abdominal muscles). These exercises were devised in response to the perceived problem of poor support. The patient is encouraged to concentrate on using targeted muscles to stabilise the core to support an area known to have a weakness. The problem with this action is that it is contrary to the function of the nervous system.



Gerald Gottlieb, a respected scientist working in the field of motor control stresses that one of the functions of our central nervous system is to minimize muscle stress. This, he argued, is why we should not override this directive by concentrating on individual muscle activation during activity. Are we in danger of over doing it when we try to control the actions of specific muscles? Remember this is physiologically impossible anyway! Whilst the nervous system is in favour of minimising stress to help maintain free joint movement and reduce pressure on the internal organs, we are consciously doing the opposite with core exercise training. Following on the back of this paper sports scientist Dr Mel Siff writes: -

" … how can one prescribe specific set ways of recruiting muscles in any complex natural movement if research now shows that these highly deterministic patterns of muscle action are not characteristic of human movement?"

Perhaps we should not attempt to directly control muscle recruitment for movement or exercise as it should be the thought of an act that initiates our total muscle response and the subsequent movement that determines ongoing involvement. When the managing director decides to sweep the factory floor instead of staying in the boardroom making the big decisions, they interfere with the operation of the whole organisation.

Natural Coordination And Core Exercise Training

If Alexander’s ‘primary control’ or the balance and co-ordination mechanisms are allowed to perform its function unimpeded there is no need to consciously engage muscle or strengthen the middle of the structure independently. In the absence of interference, our innate reflexes responding to gravity will help to ensure optimum balance and movement. Mulder and Hulstyn’s research published over twenty years ago ('Sensory feedback therapy and theoretical knowledge of motor control and learning'. Am J Phys Med 63:226-244, 1984.) stated

"Normal movement does not consist of isolated actions that are cortically (consciously) controlled. Rather it is a sequence of synergic movement patterns that are functionally related. Besides initiating muscle activation, which produces the movement, synergies also serve to maintain equilibrium. Therefore, another goal of treatment may be to improve dynamic postural and movement synergies available, decreasing the tendency for excessive and prolonged recruitment of muscle activity to stabilise posture during movement. Thus, muscle re-education sequences should NOT be performed in isolated movements. Instead they should be incorporated immediately into functional, goal-oriented tasks."

More recently Stuart McGill Ph.D (Physiology) published a paper stating

"The task of daily living is not compromised by insufficient strength but rather insufficient endurance. After an injury it has been demonstrated that the motor system loses its fitness, and abnormal relationships of muscle activity occur. Endurance training is emerging to be far more important in stabilizing the spine than strength. Strong abdominal muscles do not provide the preventive or therapeutic benefit that was thought. Sit ups, with knees bent or even abdominal crunches have not demonstrated any real benefit for the low back. Further, pelvic tilts may actually make the low back worse. There is little support for low back flexibility to improve back health and reduce the risk of future back trouble. Research is demonstrating that endurance has a much greater preventive value than strength. In fact, emphasis on endurance should precede specific strengthening exercise in a gradual exercise program. Increasing evidence supports endurance exercise in both reducing the incidence of low back injury and as treatment. This would include such daily activities as walking, cycling, swimming or repetitive low demand exercise to specific muscles. Co-operative muscle activity is a necessary prerequisite to obtain the desired endurance. That co-operative muscle activity is dependent on proper joint mechanical motion as is proper joint motion dependent on co-operative muscle activity."

also

"…spinal stability is achieved with very low levels of abdominal co-contraction, focusing on a single muscle is misguided, and that "sucking in" the TVA (transverse abdominal muscles) in fact compromises, not improves, spinal stability."

So perhaps a misunderstanding of the problem has led to a short-term remedy. A number of therapists are starting to question the thinking behind core exercise routines as to date there is little convincing clinical evidence to prove their effectiveness (the studies often cited as evidence are by a small number of researchers that many others have been unable to replicate).

Because it may appear to achieve a result and 'feel' good it is not surprising to find the core stabilisation theory featuring in numerous popular exercise philosophies. Again Dr Siff writes: -

"At the very outset, we have to dispel the belief that it is possible to focus on 'core stability' on its own. Unless one's entire body is off the ground or is immersed in water, the idea of stabilising the core separate from other parts of the body is sheer nonsense, since the ability of the core in all sports in which one is in touch with a static or moving surface depends strongly on peripheral stability (the limbs). If one is carrying out some movement such as lifting weights, doing aerobics, running, jumping or playing some ground-based sport, the body stabilises as a whole, with interacting contributions from the periphery and the core….. The world of core stabilisation currently remains far too heavily based in marketing and belief than in valid science."

The few disciplines that do recognise the importance of the head, neck and back relationship resort to what they know best to ‘improve’ it - exercising the muscles of the neck! The exercises designed to achieve this have the effect of increasing interference in an area that requires none. Alexander’s primary control is not about right position or strength of the neck and shoulder muscles.

In reality the only thing we can directly do in relation to our primary control is to unknowingly interfere with its function. Anthropologist, Raymond Dart, wrote:

"The prime factor about human body movement is that it entails the co-operation or integration of both conscious and unconscious mechanisms, i.e. the ‘will’ and the ‘reflex’."

To achieve the level of integration necessary for optimum movement we need to prevent the conditions likely to impede this co-operation. If the amount of effort applied to a task is excessive, the resulting muscle activity is likely to interfere with the reflex by reducing sensitivity. Activation of the reflex could either be delayed or even totally restricted. When the reflex is finally activated, movement is limited due to the reduced capacity of a shortened muscle to contract further or its inability to lengthen when required.

Alexander stressed that if we stop doing the wrong things the right things take care of themselves. If we learn to stop stiffening the neck, the head will ‘find’ its own balance and bring about the most appropriate muscle tone for the current situation to facilitate our innate righting reflexes, there fore no need for core exercise training. As we do not know what the optimum tone should be for each muscle it is not something we should try to achieve. Activities performed with minimal interference with our balance mechanisms will ensure the most appropriate muscle response. Good quality movement promotes the right type of conditioning and removes the need for additional ‘specialist’ core exercise.

So how do we attain good movement in order to get into shape? First we need to establish what it is we have been doing to get out of shape, and then we have to learn to stop doing it before we attempt anything else.

We shall look at this in the next chapter.

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