FOR REFERENCE PURPOSES ONLY - THE QUIZ MUST BE PURCHASED AND COMPLETED ONLINE IN ORDER TO EARN CEUS Core Training: Evidence Translating to Better Performance and Injury Prevention 1. Which of the following core muscles are typically trained with repeated spinal flexion despite their primary function as stabilizers? a. external obliques b. rectus abdominus c. quadratus lumborum 2. Which of the following core muscles did the author mention had evidence in assisting hip function while strongman training? a. quadratus lumborum b. rectus abdominis c. multifidus 3. When interpreting the biomechanics of a new client, which of the following is one of the most simple way to first assess them? a. Observe the way they walk in and sit down. b. Utilize movement screening tests to determine where to start. c. Perform provocative tests to identify motor patterns that are tolerated. 4. If an individual has chronic back pain, they might be utilizing their________________ as hip extensors rather than their _______________. a. gluteal muscles; erector spinae b. hamstrings; gluteal muscles c. erector spinae; hamstrings 5. The author discussed that the rectus abdominis muscles were not meant to stretch, rather they are meant to function as a spring; instead of flexing the muscles, they are meant to stiffen and thus transfer energy generated at the hips. Which of the following core exercise would be most appropriate to train this movement pattern? a. Stability ball pike b. Stability ball curl up c. Stability ball ‘stir the pot’ 6. In order to build endurance while avoiding cramping from oxygen starvation, the author recommends isometric exercises of what duration? a. 10 seconds b. 15 seconds c. 20 seconds 7. Which of the following repetitive motions did the author cite as the damaging mechanism for spinal disc herniations? a. Lumbar flexion b. Thoracic rotation c. Cervical extension 8. Those with back pain typically utilize poor mechanics for walking, sitting, standing, and lifting. What is this irregular movement pattern defined as in the article? a. “Quad drivers” b. “Glute amnesia” c. “Hamstring restlessness” 9. The article discusses how the “Big 3” exercises (modified curl-up, side bridge, and quadruped bird-dog) were used as a successful injury prevention program in which of the following sports? a. Co-ed swimming b. Men’s basketball c. Women’s gymnastics 10. What time of day are spinal discs most swollen from osmotic superhydration? a. Morning b. Afternoon c. Evening Core Training: Evidence Translating to Better 02/11/2019 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3OleNjk5BaNwPefXLhnAlTZrujou63UXsScGTFDP3Ayw= by https://journals.lww.com/nsca-scj from Downloaded Downloaded Performance and Injury from https://journals.lww.com/nsca-scj Prevention Stuart McGill, PhD Spine Biomechanics, Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3OleNjk5BaNwPefXLhnAlTZrujou63UXsScGTFDP3Ayw= SUMMARY progressions for their clients. The core bending of the spinal discs is a potent is composed of the lumbar spine, the injury mechanism (10,61). Another THIS REVIEW ARTICLE RECOG- muscles of the abdominal wall, the example of misdirected practice com- NIZES THE UNIQUE FUNCTION OF back extensors, and quadratus lumbo- monly occurs when some trainers have THE CORE MUSCULATURE. IN rum. Also included are the multijoint their clients pull in their abdominals to MANY REAL LIFE ACTIVITIES, muscles, namely, latissimus dorsi and ‘‘activate their transverse abdominis’’ to THESE MUSCLES ACT TO STIFFEN psoas that pass through the core, enhance stability. First, this does not THE TORSO AND FUNCTION linking it to the pelvis, legs, shoulders, target the major stabilizers of the spine PRIMARILY TO PREVENT MOTION. and arms. Given the anatomic and because studies that measure stability THIS IS A FUNDAMENTALLY DIF- biomechanical synergy with the pelvis, show that the most important stabil- FERENT FUNCTION FROM THOSE the gluteal muscles may also be con- izers are task specific. MUSCLES OF THE LIMBS, WHICH sidered to be essential components as For example, sometimes the quadratus CREATE MOTION. BY STIFFENING primary power generators (the synergy lumborum is most important, yet many THE TORSO, POWER GENERATED of these components is outlined else- trainers neglect this muscle (19). Sec- AT THE HIPS IS TRANSMITTED where (36)). ond, drawing the abdominals inward MORE EFFECTIVELY BY THE CORE. The core musculature functions differ- reduces stability (57). Third, evidence RECOGNIZING THIS UNIQUENESS, ently than the limb musculature in that on transverse abdominis shows that IMPLICATIONS FOR EXERCISE core muscles often cocontract, stiffening activation disturbances may occur in PROGRAM DESIGN ARE DIS- the torso such that all muscles become some people with specific types of back CUSSED USING PROGRESSIONS synergists—examples in a wide variety of disorders, but that these same distur- on BEGINNING WITH CORRECTIVE training and athletic activities are pro- bances are not unique to transverse 02/11/2019 AND THERAPEUTIC EXERCISES vided in Refs. (2,3,5,13,14,15,19,20,53,55). abdominis because they occur in many THROUGH STABILITY/MOBILITY, Thus, training the core effectively means muscles (11,59). People are unable to ENDURANCE, STRENGTH AND training it differently than the limb activate this muscle in isolation beyond POWER STAGES, TO ASSIST THE muscles. very low levels of contraction because PERSONAL TRAINER WITH A Evidence and common practice are not it is designed to activate with internal BROAD SPECTRUM OF CLIENTS. always consistent in the training com- oblique muscle for athletic tasks (18). It munity. For example, some believe that would appear that trainers who focus repeated spine flexion is a good method on this muscle are misdirected. INTRODUCTION to train the flexors (the rectus abdom- Other evidence shows how the core he well-trained core is essential inis and the abdominal wall). Interest- makes the rest of the body more for optimal performance and ingly, these muscles are rarely used in capable. For example, in our work T injury prevention. This article this way because they are more often introduces several elements related to used to brace while stopping motion. KEY WORDS: the core to assist personal trainers in Thus, they more often act as stabilizers core; exercise; back pain designing the most appropriate than flexors. Furthermore, repeated Copyright Ó National Strength and Conditioning Association Strength and Conditioning Journal | www.nsca-lift.org 33 Core Training for Better Performance quantifying the tasks of strongman Thoughts are provided here for exer- swollen from the osmotic superhydra- training, we documented how the core cise professionals who deal with issues tion of the disc that occurs with bed assisted hip function to allow the related to the assessment and design of rest, has been proven very effective competitors to accomplish tasks that therapeutic exercise for the core. Core with this type of client (60). Further- they did not have the hip strength to training is of interest given the preva- more, typically, when this client bends perform (53). Specifically, the quad- lence of back pain among clients. Core to pick up a weight, they flex the spine ratus lumborum assisted in pelvis training is associated with spine stabil- adding to the cumulative trauma. This elevation to allow the swing leg to ity and instability that results from back often continues without correction make a step. This was the first evidence disorders. Evidence from the back from the trainer. This is a missed oppor- suggesting that a strong core allows disorders’ literature shows that poor tunity. Realize that the spine discs only strength to radiate out peripherally to movement patterns can lead to back have so many numbers of bends before more distant regions of the body. disorders. In this way, trainers should they damage (10). Keep the bends for Similarly, in training, our recent work consider the quality of movement essential tasks such as tying shoes (58) demonstrated how an individual patterns in all clients and by default rather than using them up in training. can only bench press half of their body should consider beginning any exercise Many lifestyle and occupational exam- weight when standing—otherwise they program with corrective exercises. ples have been provided elsewhere (28) would push themselves over. While Many trainers follow a ‘‘recipe’’ for to guide the elimination of the cause of laying, bench press performance was assessment, corrective exercise, or per- a client’s back troubles; the trainer will primarily governed by the chest and formance training. Using this generic find that half of their initial effective- shoulder musculature, whereas stand- approach ensures ‘‘average’’ results— ness will be because of preventing the ing press performance was governed some clients will improve and get cause (i.e., a flawed movement pattern). by core strength, particularly one-arm better, but many will fail simply This need not be so complicated. Con- presses. Thus, the limiting factor in because the approach was above or sider the client who stands slouched standing press ability was core strength. below the optimum level necessary to where the back muscles are chronically contracted to the point of chronic The core, more often than not, func- address the deficit. The program and muscle pain. The family doctor typically tions to prevent