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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Tag: core exercise

I utilize bridging as an assessment and exercise tool in my training and rehab programs.  Posterior chain/hip stability is poor in many clients.  The ability to maintain a neutral spine, engage the glutes and fight rotation is NOT an easy task by any means. So, coaching and cueing proper bridging is a great way to enhance pillar strength and reduce injury risk, while facilitating better movement patterns in sport.

I wrote a recent column for PFP magazine entitled iso bridge with alternate knee extension.  Click here to read the column and the application, regression and progression of the exercise.  In addition, I have included a short video below showing double leg and single leg bridge exercises that can be used to work on the hips and core.  The second exercise is the dynamic version of the iso alternate knee extension bridge I write about. I show you some of the single leg progressions that come after mastering the iso bridge as well.

I hope this video and article is useful to you.  I also want to take this opportunity to thank you for reading my blog and wish you a very Happy New Year!

It is widely accepted that decreased hip strength and stability leads to knee valgus. Excessive frontal plane motion and valgus torque increase the risk for non-contact ACL injuries. While we know that hip abductor weakness is more of an issue in females than males, the question remains to what degree other factors are involved.

knee-valgus-add-ir

Claiborne et al (1) noted that only 22% of knee variability could be linked solely to hip muscles surrounding the hip. In light of this we must look at the whole kinetic chain when assessing movement dysfunction and injury risk. In the most recent issue of the IJSPT, researchers sought to discover how activating the core during a single leg squat would impact the kinematics of 14 female college-age women. They excluded participants with current pain or injury to the lower extremities or torso, or if they had a history of any lower extremity injuries or surgeries in the past 12 months.

The participants were assessed for their capacity to recruit core stabilizer muscles using lower abdominal strength assessment as described by Sahrman (2). This testing model has 5 levels of increasing difficulty used to challenge participants to maintain a neutral spine. The draw back of this method is that it is done in supine versus the standing position of this study, but the author acknowledges this limitation. Out of a possible high score of 5, five of the participants scored a 1 or 2, while the other nine scored a zero.

For the study, a six inch step was used to assess 2 reps of a single leg squat. Each participant was asked to perform the test with the dominant leg to standardize conditions. They performed the reps under two conditions:

1. CORE – engaged abdominal muscles as they had been instructed to do so during the Sahrman test

2. NOCORE – no purposeful engagement of abdominal muscles

Results

  • The CORE condition resulted in smaller hip displacements in the frontal plane but had no effect on hip angular range of motion – essentially there was less medial/lateral movement
  • The CORE group did not exhibit any changes in knee displacement but did exhibit greater degree of knee flexion – this may suggest higher function assuming more knee flexion is desired during squat tasks in sports and functional activities
  • Those scoring the lowest on the core assessments had larger improvements in performance when they did in fact activate the core musculature

How do we use this information to affect our practice?  Well, in terms of rehab it seems straightforward and many of us may already encourage patients to activate their core during treatment.  However, I think the greater contribution may come in injury prevention programs (particularly ACL programs) where we are looking at all facets of neuromuscular control and appropriate muscle activation patterns.

With any prehab or rehab strategy, we as clinicians, trainers and strength coaches are essentially trying to reprogram the brain to summon and execute a better motor pattern or strategy – feedforward training.  We know that healthy individuals tend to have better transverse abdominus and multifidus muscle activation, so it only makes sense to consider activation of local stabilizers as we work on global muscles.  Improving core and pelvic stability should only help reduce unwanted frontal plane motion.

With that said, the authors of this study readily acknowledge more work needs to be done with larger clinical populations (including EMG work) to more clearly identify what magnitude the core musculature has on lower extremity motion and displacement.

Keep in mind the proper program will always stem from your ability to assess movement impairment and tissue dysfunction.  I suggest beginning with a FMS in the athletic population and incorporating parts of that or the SFMA to compliment your evaluation in the clinic.  This will generally reveal the priorities for the corrective exercises.  For now, we can use this information in this particular study to be more intentional with our patients and clients suffering knee and hip dysfunction by adding this one simple step to our programming.

References

1. Claiborne TL, Armstrong CW, Gandhi V, Princivero DM. Relationship between hip and knee strength and knee valgus during a single leg squat. Journal of applied biomechanics. 2006;22(1):41.

2. Faries MD, Greenwood M. Core training: stabilizing the confusion. Strength & Conditioning Journal. 2007 ;29(2):10.

Through my clinical practice and sports performance training, I continue to focus on eliminating core and hip dysfunction.  I think many of the knee problems I see in runners and females are related to weakness in the glutes and small lateral rotators.  There has also been quite a buzz about a recent article written in the Strength & Conditioning Journal on crunches and whether spinal flexion may actually be good for you.

This topic alone could take up several posts so, I will not delve into that today.  However, as one who has experienced sciatica and disc injury firsthand, I probably tend to fall a little more in the camp of focusing on a neutral spine and resisting external forces as I feel this helps improve performance and reduce injury risk.  In that vain, I have been continuing to develop my own core and hip stability progressions with my advanced clients/athletes.

I have been doing a series of posts for BOSU and PFP in my Functionally Fit Column.  In my last post, I covered a 3D mountian climber with hip extension.  In today’s post,  I am covering a great core exercise with the BOSU Ballast Ball focusing on hip extension with the goal of improving shoulder, core and hip stability while promoting hip extension and disassociation.

In the video below you can check out the progressions (incline and decline)

Click here to read the full article on technique and application.  The article reviews a regression for those not ready to tackle this quite yet.  I think you will find this exercise challenging and rewarding.

Most adult males are in search of that ever elusive six pack, right?  Well, most intelligent trainers and strength coaches are well aware that there is so much more than just crunches to making the core functional.

how-to-get-six-pack-abs

With that said, I believe abs may be one of the most over trained sets of muscles today.  Some people are doing ab work daily.  Why?  Our abs function daily to stabilize and resist force, as well as activate trunk movements.

In reality, the aesthetics of the midsection have far more to do with nutrition and body fat than the number of crunches one does.  My aim today is not to discuss this, but instead to talk about an interesting article in the latest Strength and Conditioning Journal that discusses the effects of over training the rectus abdominis on weightlifting performance.

In this article, Ellyn Robinson discusses the best way to allow athletes to stabilize weight overhead during complex lifts such as snatches, cleans and jerks.  She aptly points out that if an athlete cannot stabilize the weight overhead, he/she could miss the lift in front or behind the body.


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