Network Magazine Winter 2017 | Page 48

CEC ARTICLE EVIDENCE-BASED PRACTICE: CORE STABILITY AND TRANSVERSUS ABDOMINIS Clients may desire washboard abs, whereas trainers may focus on the role of core stability in injury prevention and overall health. But how effective is specific core training? WORDS: DR MARK MCKEAN PhD bdominal and trunk aesthetics is a common discussion topic between personal trainers and their clients. Social media perpetuates this, showcasing an endless array of individuals with lean hard trunks and ripped abdominal sections performing a huge variety of the most obscure exercises imaginable. Every trainer you talk to about this will have a personal favourite exercise that hits them in just the ‘right’ spot. Trainers from different fields of exercise will all have different cues and language that describes the way you should contract your core muscles to get the best outcome. Of course, it’s not just about how good your six-pack looks. The key reason why core stability training has become prominent in training and research is the critical link of the lumbar spine providing structural control between the trunk and the hips and its role in prevention of low back pain and lower limb injury. However, core stability is now more commonly referred to as motor control stability. This allows us to use the concept globally across all joints and regions rather than just the trunk and lumbar spine. It must also be remembered that the value of motor control stability is in the way it acts to prevent motion rather than initiate it. In looking at trunk stability, it must be remembered that the anatomy of the structures around the trunk and ‘core’ are far more complex than just the abs. Passive stiffness of the lumbar spine is provided by the osseoligamentous structures. The thoracolumbar fascia acts like a proprioceptor giving feedback to lifting activities, as well as being a large A 48 | NETWORK WINTER 2017 attachment structure for transversus abdominis (TrA). The paraspinals are essentially thoracic muscles that act on the lumbar via a long tendon that attaches to the pelvis (Akuthota et al. 2004). The quadratus lumborum has no direct action on the lumbar spine, but is thought to be a major stabiliser of the spine (McGill 2001). The TrA and obliques increase abdominal pressure by reducing the circumference of the waist. In isolation, the TrA will increase the lumbar curve when contracted by pulling the lumbar