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Core Stability Workout

 

WORKING ON YOUR CORE STABILITY
(Exercises Based on The Stuart McGill Program)

The science of spine stability

Clinical pratice and Biomechanics are interrelated and it is better to have a good grasp of the loads imposed on the spine in flection and extension to understand sheer forces on the spine during movement. (McGill, S. M. 2009)
Understanding and linking muscular anatomy with spinal function is the way forward for better therapeutic outcomes. True spinal stability is achieved with a “balanced” stiffening of the entire spinal musculature including the rectus abdominis and the abdominal wall, quadratus lumborum, latissimus dorsi and the back extensors of longissimus, iliocostalis and multifidus. It is quite impossible to just target a particular muscle group without the other coming into play. In addition to that, you will need to determine the tolerance and capacity of the individual to ensure that a given exercise dosage is matched to the patient. The loading tolerance on the spine should not be exceeded. For example, a “bird dog” extension posture is better than a “superman” extension posture over a gym ball, which will impose two times the compressive load on the lumbar spine. Sitting on an exercise ball, performing movement exercises increases compressive forces on a flexed spine. It is not a good choice of exercise until quite late in a therapeutic progression.

The following exercises are based on Stuart McGill’s essential exercises for the spine. Stuart McGill is a professor and researcher who specializes in spine biomechanics under the Department of Kinesiology at the University of Waterloo, Canada. He has had many publications on evidence based prevention of lower back disorders and rehabilitation of the spine. 

We are sharing with you a sample overview. For more insights, please look up McGill S. M. 2007, 2009. Some of the more recent ones as appended below:

  1. Moreside*, J.M. and McGill, S.M. (2013) Improvements in hip flexibility and/or core stability does not transfer to mobility in functional movement patterns. J. Strength & Condit. Research. 27(10):2635-2643

  1. Casthanhero, R., Duarte, M., McGill, S.M. (Accepted Nov 2013) Corrective sitting strategies: an examination of muscle activity and spine load. J. EMG. Kinisiol.

  1. Badiuk, B.W.N., Andersen, J.T., McGill, S.M. (Accepted August 2013) Exercises to activate the deeper abdominal wall muscles: The Levit. J. Strength Condit. Res.

We hope that this information will benefit every physiotherapist in creating awareness of the need to choose your back strengthening program with care and enhance your therapeutic paradigms which will in turn lead to increased patient satisfaction.


1.    Modified Sit-up
           
   
The hands are placed under the lumbar spine to preserve a neutral spine posture. Do not flatten the back to the floor as it flexes your lumbar spine, increasing loads on disc and ligaments. Keep one knee flexed and the other straight to lock the pelvis-lumbar spine. Then raise the head and upper shoulders off the floor. The motion takes place in the thoracic spine, not in the lumbar or cervical region. Hold the posture for 7 to 8 seconds. This exercise can be made more challenging by activating abdominal bracing before attempting to sit up.

  
2.  Side Plank (with Legs Bent)



Side Plank (with Legs Straight)



The side planks help to increase lateral stability and improve quadratus lomborum strength. Side planks also target the oblique abdominals.


4.  Bird and Dog

                            
                                          
During the “bird dog”, when making a fist and co-contracting the arm and shoulder enhances contraction levels in the upper erector spinae. It also helps with gluteal muscle reintegration to offload stress on the back when the leg is lifted up and down.


 Dead Bug

   
This exercise serves to facilitate bracing of the abdomen muscles, a key component to low back rehabilitation and injury prevention. You can assist your patient with support in the beginning.


6.   Ball Roll-Out


Kneel on the mat and place hand on the ball. Brace abs and slowly lean forward, rolling your hands and forearm arm over the ball while it moves away from your body. Keep your body in a straight line and go out as far as you can. Contract your abs and return to the starting position. 


7.    Stir The Pot
      

The Rectus Abdominis is not designed for optimal length change. Comprising the longitudinal contractile components interrupted with transverse tendons, it actually acts as a spring. Thus, this exercise serves to enhance the spring (Rectus Abdominis) and spare the spine

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