Core Stability in Athletes: A Critical Analysis of Current Guidelines

Abstract

Over the last two decades, exercise of the core muscles has gained major interest in professional sports. Research has focused on injury prevention and increasing athletic performance. We analyzed the guidelines for so-called functional strength training for back pain prevention and found that programs were similar to those for back pain rehabilitation; even the arguments were identical. Surprisingly, most exercise specifications have neither been tested for their effectiveness nor compared with the load specifications normally used for strength training. Analysis of the scientific literature on core stability exercises shows that adaptations in the central nervous system (voluntary activation of trunk muscles) have been used to justify exercise guidelines. Adaptations of morphological structures, important for the stability of the trunk and therefore the athlete's health, have not been adequately addressed in experimental studies or in reviews. In this article, we explain why the guidelines created for back pain rehabilitation are insufficient for strength training in professional athletes. We critically analyze common concepts such as 'selective activation' and training on unstable surfaces.

Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain

“…intern./extern.) serves as a compensation strategy to enhance core stability and protect the trunk from further negative loading (Kibler et al, 2006; Hibbs et al, 2008; Prieske et al, 2015; Wirth et al, 2016). It is also known that the stability provided by the trunk muscles is meaningful in counteracting single and repetitive loading during high-intensity performance (Kibler et al, 2006).…”

“…Consequently, optimizing neuromuscular core stability is considered beneficial for protection against repetitive and excessive overloading of the trunk (Kibler et al, 2006; Borghuis et al, 2008; Saragiotto et al, 2016; Wirth et al, 2016). In line with the results presented here, core stability exercises (with additional repetitive loading) addressing the complex interaction of transverse, straight, ventral and dorsal muscles in adolescent athletes with back pain should be preferred (Pedersen et al, 2004; Saragiotto et al, 2016).…”

“…In a recent systematic review, Abboud et al could moreover show evidence for back pain related decreased erector spinae and increased external obliquus muscle reflex amplitudes (Abboud et al, 2016). In addition, trunk strength capacity is considered essential for the compensation of external forces and loads in young and adult athletes (Kibler et al, 2006; Zazulak et al, 2006, 2007; Wirth et al, 2016). …”

Vpliv kratkotrajnega programa stabilizacijske vadbe na zmogljivost mišic trupa pri košarkaricah

“…Vadba za krepitev mišic trupa je aktualna tema v medicini in fizioterapiji športa, vendar raziskave na tem področju še ne dosegajo konsenza o njenih dejanskih učinkih (1). Pojavljajo se vprašanja o vplivu tovrstne vadbe na preprečeva-nje poškodb hrbta in spodnjih udov ter o njenih vplivih na moč in vzdržljivost med izvedbo specifične športne dejavnosti (2).…”

Increased strength is associated with lower trunk muscle activation during loaded back squats and dynamic body weight jumps

“…Several researchers have demonstrated effectiveness of loaded, compound exercises in activating trunk stabilizers . Traditional core stability exercises, characterized by isolated isometric exercises do not reflect trunk control in dynamic human movement . Several studies reported effective trunk muscle activation for selected dynamic exercises, squats, standing, seated, unilateral and bilateral exercises, and deadlifts .…”