The structures that make up the lumbo-pelvic-hip-complex (LPHC), including the lumbar spine, the pelvic girdle, abdomen, and the hip joint.
The core musculature has been divided into 3 different systems - what are they?
1. Local stabilization system
2. Global stabilization system
3. Movement system
List the muscles that make up the LOCAL STABILIZATION SYSTEM.
Transverse abdominis, Internal obliques, Multifidus
Pelvic floor musculature, and Diaphragm
The muscles of the LOCAL STABILIZATION SYSTEM attach __________________________.
Directly to the vertebrae.
The muscles of the GLOBAL STABILIZATION SYSTEM attach from __________________________________.
From the pelvis to the spine.
List the muscles that make up the GLOBAL STABILIZATION SYSTEM.
Quadratus lumborum, Psoas major, External obliques,
Portions of the internal obliques, Rectus abdominis, Gluteus medius, & Adductor complex
The MOVEMENT SYSTEM includes muscles that attach the _______________________________.
The spine and/or pelvis to the extremities.
List the muscles that make up the MOVEMENT SYSTEM.
Latissimus dorsi, Hip flexors,
Hamstring complex, Quadriceps
All muscles in the local stabilization system, global stabilization system and movement system work together to stabilize the entire core (LPHC). However, they must be trained in a certain order to work properly. What order is this?
Local, global, movement (you must be stabilized before you can produce movement, just like a house has to have a foundation before it can be built).
What happens when the movement system musculature of the core is strong and the local stabilization system is weak?
The kinetic chain senses imbalance; leads to compensation, synergistic dominance, and inefficient movements. (Example: performing lunge, squat, or overhead press w/ excessive spinal extension
True or False: one result of a weak core is low back pain, which is due to increased forces throughout the LPHC
True or False: the global stabilization system are muscles that provide support from vertebra to vertebra.
False - this is true of the local stabilization system.
The Global stabilizers are muscles that act to transfer loads between the upper and lower extremities and provide stability between the pelvis and spine.
True or False: the movement system includes muscles that attach the spine and/or pelvis to the extremities.
US adults with chronic low back pain have decreased activation of which muscles/muscle groups?
Transverse abdominis, Internal obliques, Pelvic floor muscles,
Multifidus, Diaphragm, & Deep erector spinae
Trunk muscle weakness by itself is an independent risk factor for developing _____________
Low back pain
How does core training support the prevention and rehabilitation of low back pain?
Core stabilization exercises restore the size, activation, and endurance of the multifidus (deep spine muscles) in people with LBP.
A maneuver used to recruit the local core stabilizers by drawing the navel in toward the spine.
Occurs when you have contracted both the abdominal, lower back, and buttock muscles at the same time.
Why is the drawing-in maneuver important?
It keeps the cervical spine in a neutral position during core training, which helps to improve posture, muscle balance, and stabilization.
How do you perform the drawing-in maneuver and when should this be done?
Should be done for CORE training.
Pull in the region just below the navel toward the spine and maintain the cervical spine in a neutral position.
When performing the drawing-in maneuver for core training it is important to maintain eyes level during movement. Why is this?
It prevents a forward protruding head, which causes the sternocleidomastoid (large neck muscle) to be recruited, which increases the compressive forces in the cervical spine and can lead to pelvic instability and muscle imbalances as a result of the pelvo-ocular reflex.
A co-contraction of global muscles, such as the rectus abdominus, external obliques, and quadratus lumborum.
True or False: bracing focuses on global trunk stability instead of segmental vertebral stability, meaning that the global muscles will work to stabilize the spine.
True or False: core training should initially be done in a proprioceptively enriched (controlled yet unstable training environment).
True - this has been demonstrated to increase activation of the local and global stabilization system when compared with traditional trunk exercises. Example: using a stability ball
True or False: the use of weight belts is recommended for healthy adults engaging in a moderately intense exercise program.
False - weight belts are NOT recommended. They may raise one's heart rate and systolic blood pressure and often give individuals a false sense of security and the misconception they can lift heavier loads. Instead, trainers need to educate their clients as to appropriate exercise techniques and proper activation of the core musculature (the body's natural belt)
True or False: clients with low back pain activate their core muscles less and have a lower endurance for stabilization
By performing the drawing-in maneuver or bracing, this can __________________________________, which prevents abnormal forces through the LPHC.
Help stabilize the pelvis and spine during core training and other functional movements.
How do you know when a client has mastered the local stabilization system, or can properly demonstrate intervertebral stability?
The client is able to maintain the drawing-in position while performing various exercises.
How do you know when a client has mastered the global stabilization system, or has appropriate lumbopelvic stability?
The client is able to perform functional movement patterns (squats, lunges, step-ups, single-leg movements, pressing, pushing, etc.) without excessive spinal motion (flexion, extension, lateral flexion, rotation, singly or in combination).
The sequence in core training is critical in order to move on to the next level. What is the proper sequence?
A proper core training program follows the same systematic progression of the OPT model: stabilization, strength, and power. What are the different phases when it comes to core training?
Phase 1: Core-Stabilization Training
Phases 2, 3, 4: Core-Strengthening Training
Phase 5: Core-Power Training
In phase 1 of core training (core-stabilization), the exercises involve little motion through the ___________ and _______________.
Spine and pelvis
What are the exercises in the Core-Stabilization phase of core training designed to do?
Improve neuromuscular efficiency
Improve intervertebral stability
What should one focus on during Phase 1 of core training (core stabilization)?
Drawing-in and then bracing
A client would typically spend ____________ at the phase 1, Core Stabilization, level of training.
What are some sample exercises in Phase 1, Core-Stabilization Training?
Marching: lie supine, knees bent - bring leg towards face
Floor Bridge - Lie supine, knees bent - lift pelvis
Floor Prone Cobra - Lie prone, basically the superman
Marching is an exercise that should be performed in the _____________ level of core training. Demonstrate this.
Phase 1 - Core Stability Training
Lie supine on floor, knees bent, feet flat, toes pointing straight ahead, arms by side.
Lift 1 foot off floor as high as can be controlled. Maintain drawing-in. Hold 1-2 seconds, Slowly lower & repeat on other leg.
During the Marching exercise that should be performed in phase 1 (core-stability training), watch for pelvic rotation or abdominal protrusion. If a client does either of these, what does that mean?
Indicates lack of neuromuscular control and the local core stabilizers.
Demonstrate the floor bridge exercise done in Phase 1 of core training. What should a health professional watch for in this exercise?
Lie supine, knees bent, feet flat on floor, toes shoulder-width apart. Lift pelvis until knees, hips & shoulders in line.
***Make sure client does not raise hips too far up off the floor (hyperextending the low back). This places extensive stress to the lumbar spine. Make sure at the end position, the knees, hips & shoulders are in alignment and the gluteal muscles are fully contracted.
Demonstrate the floor prone cobra, an exercise performed in phase 1 of core training (core-stability training). What should the personal trainer watch for during this exercise?
Lie prone on floor. Activate butt muscles, pinch shoulder blades together. Lift chest off floor w/ thumbs pointed up & arms externally rotated. Hold 1-2 sec. Return to ground, keep chin tucked.
***Like the floor bridge, do not come too high off the floor (hyperextending the low back)
How do the exercises change in Phases 2, 3 and 4 - Core Strength Training?
They involve more dynamic eccentric and concentric movements of the spine throughout a full range of motion while clients perform the activation techniques learned in core-stabilization training (drawing-in and bracing).
List some exercises that would be performed in Phases 2, 3 and 4 (Core Strength) of Core Training.
What is a progression of the Ball Crunch exercise (a Core-Strength exercise, Phase 2, 3, & 4)?
Perform crunches as long-lever exercises (arms raised overhead) rather than arms crossed over chest or behind head
When a client is performing the Ball Crunch, what should the fitness professional ensure the client does with the chin? Why?
Keep the chin tucked - this will take stress off of the muscles of the cervical spine.
The Back Extension is another exercise in the Core-Strength level (phases 2, 3 & 4). What should end position look like when a client performs this exercise?
The ankle, knee, hip, shoulders and ears should all be in alignment. Make sure the client is not hyper-extending the low back.
The Reverse Crunch is another exercise in the Core-Strength level (phase 2, 3 & 4) of core training. How is this exercise performed?
Lie supine on bench w/ hips & knees bent at 90-degree angle; feet in air; hands gripping stable object behind head for support.
Lift hips off bench while bringing knees toward chest. Lower hips back to start position.
What should the client avoid doing when performing Reverse Crunches?
Swinging legs - lower extremities should NOT move from setup during execution of this exercise. This increases momentum, which increases risk of injury & decreases effectiveness of exercise.
The Cable Rotation should be performed in which phase of core training?
Core Strength (phase 2, 3 & 4)
What are the exercises in the Core Power phase designed to do?
Designed to improve the rate of force production of the core muscles. It allows clients to dynamically stabilize and generate force at more functionally applicable speeds.
List the exercises in Phase 5 of core training - Core Power.
Rotation Chest Pass
Ball medicine ball (MB) pullover throw
Front MB oblique throw
Demonstrate the Rotation Chest Pass - a core power exercise.
Stand upright, feet shoulder-width apart, toes straight ahead. Hold medicine ball (5%-10% of body weight).
-Use abs & hips to rotate body quickly & explosively 90 degrees. As body turns, pivot back leg & allow it to go into triple extension (hip extension, knee extension & ankle plantarflexion).
-Throw ball w/ rear arm extending
Before moving onto the Core Power phase, clients should be able to execute proper _______________ & ________________ to avoid compensations, muscle imbalances, and eventually injury.
Core stabilization & core strength
Demonstrate the Ball Medicine Ball Pullover Throw.
Lie on stability ball (ball under low back), knees bent 90 degrees.
-Hold MB overhead w/ arms extended.
-Quickly crunch up, throwing MB against wall or to partner. As MB releases, let arms completely follow through.
Before performing the Ball Medicine Ball Pullover Throw, it is important that a client has proper extensibility of the _____________________ before performing this exercise to decrease stress to the low back and shoulders.
True or False: it is important that will all core-power exercises that you go as fast as you can while maintaining proper technique.
In Core-Stabilization training (phase 1), the emphasis is on _________________________________.
Stabilization of the LPHC
In Core-Strength training (phases 2, 3 & 4), these exercises improve ______________________ of the entire kinetic chain by moving the spine dynamically through a full range of motion, with exercises that require greater specificity, speed, and neural demand.
In Core-Power training (phase 5), exercises are meant to improve ___________________________.
Improve the rate of force production in the muscles of the LPHC.
In the Core Training program design, core training exercises are only mandatory in the __________________.
Core Stabilization phase - Phase 1.
True or False: when implementing a core training program, the fitness professional should follow the progression of the OPT model (i.e. if the client is in the stabilization level of training, the trainer should select core-stabilization exercises).
True or False: core strength exercises can be performed even after the client has moved on to the Power Level of the OPT model
False - if a client is in the Power Level of the OPT model, he should be doing core-power exercises.
How many different exercises should be performed for a client still in Phase 1 of core training - core stabilization?
What is the appropriate amount of sets and reps for a client in the core stabilization phase?
How much of a rest time should a client get in between exercises in the core-stabilization phase?
True or False: in phase 2 of the OPT model, some clients have the goal of hypertrophy or maximal strength. In these cases, core training may be optional.
True - core training is optional, yet still recommended
How many core-training exercises should be performed in the Core Strength phase?
0-4 (people who have the goal of hypertrophy or maximal strength do not always need to do core training)
How many sets and reps should be done in the Core Strength phase? How much rest time should they get?
0-60 seconds rest
In the Core Power phase, how many exercises should be performed for core training?
0-2 - core exercises do not always need to be done in this level because many times the resistance training portion of the program will incorporate core exercises. Core training is typically performed in the dynamic warm-up portion of the program so separate core training may not need to be done
How many sets and reps should be performed in the Core Power phase of core training? How much rest time?