Running Blog Series: Part 4: Core stability for runners
Firstly, you need to know what core stability is.
The medical definition is the following:
Core stability is defined as the ability to control the
position and motion of the trunk over the pelvis to allow optimum production,
transfer and control of force and motion to the terminal segment in integrated
athletic activities.
Core muscle activity is best understood as the
pre-programmed integration of local, single-joint muscles and multi-joint
muscles to provide stability and produce motion.
Where does it come from?
Core stability started in the late 1990’s.
It was derived from studies that demonstrated a change in
timing of the trunk muscles in back injury and chronic lower back pain (CLBP)
patients.
However, there have been assumptions on how this relates to injury prevention and sporting performance:
Certain muscles are more important for stabilisation of the
spine, in particular transverse abdominis (TrA):
Transverse abdominis is absent or fused to the internal
oblique muscle as a normal variation in some people and they don’t all have
poor core stability and injury! (Gray’s Anatomy 36th edition 1980, page 555).
Weak abdominal muscles lead to back pain:
No correlation between sit-up performance and
backache. (Fast et al., 1990).
There is a unique group of “core” muscles working
independently of other trunk muscles:
No single muscle is dominated in the enhancement of spine
stability.
Their individual roles continuously change across tasks.
Clinically, if the goal is to train for stability, enhancing
motor patterns that incorporate many muscles rather than targeting just a few
is justifiable. (Kavic et al 2004).
So how does this relate to runners?
Like anything, injuries in running are often caused by many
factors which essentially means that no one thing will prevent or cure the
problem.
In runners it is common to see that they have poor core
stability and this is often one of the reasons for their injuries, often
resulting in abnormal movements and technique.
So what does the research say on core stability for injury prevention in runners?
Unfortunately the evidence for this is lacking but this is
true of any research into preventative medicine as it is very difficult, some
may say impossible to prove that you prevented something from happening.
Kibler (2006) and Fredericson and Moore (2005) recommend
core stability training for injury prevention but this is more down to linking the evidence that supports the
principles of core work rather than showing a direct connection.
There are some schools of thought that believe your core is working with strength training just as well, if not better than specific “core” exercises. For example:
Core stability exercises are no more effective than, and will not prevent injury more than, any other forms of exercise or physical therapy (Lederman 2010). So Lederman is saying core stability does work but so do other things. Well Duh… This is obvious. Even if you read this blog series on running you will see quotes for evidence showing injury prevention from strengthening, technique, flexibility etc. etc. Core stability is just another way to cover all bases to prevent injury but as with anything in isolation it won’t be as good!
This is re-emphasised by Okada et al (2011): Core & functional movement training are important for injury prevention but they should not be the primary emphasis of any training program.
So what about core stability’s effect on performance?
Well, the jury is out on this as you can see from the evidence below:
For:
Core stability training caused a significant improvement in
5km running speed but no change in stability. Runners in the core training
group improved their time by an average of 47 seconds while the control group
(who didn't do core work) improved by just 17 seconds (Sato & Mokha 2009).
And:
There appears to be a link between core stability testing
& athletic performance testing (Sharrock et al 2011).
Against:
Swiss ball training improved core stability but there was no
significant change in performance or running economy (Stanton et al 2004).
Again you need to think of core stability being part of the
bigger picture. For example if a runner has poor cardiovascular conditioning
and then trains their core stability they won’t improve. I know this is obvious
but the same will be true of poor flexibility or strength or technique etc. So
think of core stability as part of the overall picture and remember some people
will need it more than others.
So if you are going to train your core, what are the muscles we are supposed to be targeting and how do we train them?
Martuscello et al (2013) found the following evidence in the
literature out there:
Multifidus
Moderate quality evidence was found showing greater muscle
activity during free weight exercises than ball/ device exercises. 'Core
stability' (plank, side bridge etc) had similar results to ball/ device
exercises.
But also:
Limited quality evidence suggested free weight exercises
(squats, deadlifts etc) had more recruitment than 'traditional core' (back
extensions, sit ups). Greater activity was found during 'core stability' than
'traditional core' exercises.
Conclusion – exercise with free weights appear to be most
effective in recruiting multifidus.
Transversus Abdominis
Moderate quality evidence was found suggesting 'core
stability' and ball/ device exercises achieved similar results.
Limited quality evidence suggested 'traditional core' and
'core stability' achieved similar recruitment to each other.
'Non-core free weights' (shoulder press, bicep curls etc)
were more effective than ‘core free weights’.
There was conflicting evidence between 'traditional core'
and ball/ device exercises and many areas had no evidence.
So overall No firm conclusions can be made on recruitment of
transversus abdominis.
Right so now I’m going to throw a spanner in the works and
say all this specific individual muscle training above doesn’t matter, hence
the ambiguity. Basically as long as you
train your stability and control of motions that are involved in running then
you are improving your run specific core stability and this will improve your
running and reduce your injury risk more than any fancy muscle specific
exercise for either transverse abdominis or multifidus.
Core stability has long placed too much focus on stability
and not enough on movement. To be functionally better at running you need
reciprocal strategies and coordination of movement that you actually use.
So how do I go about my core stability training?
You can train with as much volume and frequency as want but
10 reps, several times per week is fine.
Core muscles are slow twitch fibre muscles and designed to
work all day everyday.
Effort levels need to be below 25% to stop bracing effects.
It all about quality not quantity!
First need to learn good posture and spinal alignment
awareness.(Below pic: Poor posture)
You are best starting with more stable based exercises and
advance to more unstable but always they should have some resemblance to
running actions.
So what are some good example exercises for core stability in runners?
AXE CHOP:
Hold a medicine ball or heavy book beside your right ear.
Take a step forward with your left foot and quickly draw the heavy object to
the outside of your left hip. Stop the object abruptly while staying tall and
not flexing your spine. Repeat going from left to right. Perform 3 to 5 sets of
10 repetitions per side three times a week.
UNILATERAL CARRY:
This is also known as a single-arm farmer's carry, and it's
a fantastic exercise to develop lumbar and pelvic stability. When walking with
a heavy weight held in one hand, the lower back and abdominal muscles have to
stabilize the lumbar spine and the pelvis. The gluteus medius and minimus
muscles on the stance leg also have to contribute a great deal of stability to
the pelvis. Hold a heavy weight in one hand; a 5-gallon water jug works great.
Walk around your house for about 30 seconds and repeat on the other side. Perform
3 to 5 sets per side three times a week.
THE DEAD BUG:
Lie on your back with your legs and arms off the floor. Keep
your ribs down and lower back close to the floor. Brace your abs and form a
90-degree angle at your hips, knees and shoulders — pretend you’re a bug, dead
on its back. Next, move your legs and arms slowly in the air as if you’re
running. Keep your low back from arching off the ground. Perform three sets of
60 seconds
STABILITY WEIGHTED LUNGE FOR RUNNERS:
Step into a wide lunge & reach a medicine ball as far
out in front of you towards the ground as you can. Keep your back as straight
as possible throughout. Shift your weight forward on your front foot. While
keeping the ball forward, lift your back leg off the ground and rise up to a perfect
running position.
RUNNER TOUCH THE FLOOR:
Strike a pose in perfect running position with one leg in
high knee position. Balancing on the one leg, bend at the hip and touch the toe
that's on the ground with the opposite hand while the leg in the air rotates
under and back. Make sure the standing leg remains stable and as straight as
possible while enabling you to touch the ground. Be sure to prevent the moving
knee from crossing midline while that leg straightens out behind you. Come back
up to running position quickly without losing balance, pause for a second or
two, and repeat. Switch legs and repeat.
SWISS BALL MOUNTAIN CLIMBERS:
Drop to a plank position with your forearms on a
medium-sized stability ball. Keeping your core tight, bring one knee to the
ball. Try to keep the ball and torso as steady as possible. Alternate knees to
the ball throughout the exercise.
RUNNER PULLS:
Balance on one leg and grab a pulley system or elastic band
in front of you with the opposite hand. Raise the free knee up toward your
waist while simultaneously pulling the elbow to your side and rotating your
body in the same direction as you would when you run.
If you need any further information or would like to book an
appointment then call Hawkes Physiotherapy on 01782 771861 or 07866195914
WWW.HAWKESPHYSIOTHERAPY.CO.UK
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