Despite its popularity, core stability has failed to deliver the benefits that were attributed to it. In this lecture Eyal will discuss the problems with core stability principles and why this approach was doomed to fail as a therapeutic tool and a method for improving human performance. He will present an alternative, science-based approach to enhancing movement rehabilitation and performance. This lecture will aim to untangle this mix and provide the participants with a better understanding of how to work more effectively with proprioception. It will explore the role of proprioception in human movement, how this system is affected and recovers in musculoskeletal and pain conditions and how this recovery can be enhanced in rehabilitation.
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I am always a fan of the counter-intuitive approach and after reading it I can say that everything posited in the paper is accurate but I can also say that the findings are not particularly useful to me. Weak or dysfunctional abdominal muscles will not lead to back pain. Tensing the trunk muscles is unlikely to provide any protection against back pain orreduce the recurrence of back pain.
The bottom line from my perspective is that it is better to be strong than weak, simple as that. Also though what he says in this paper, The Myth of Core Stability is accurate technically, I have seen so many people get relief from back pain and lead more productive lives by developing better core strength. I only have my own experience to go by but I have worked with a lot of bodies.
The second and most important part of developing core stability for pack pain relief is that it has to be coupled with changing ones posture and movement patterns.
I would like to see a study that examines this type of two part solution. Build both core stability and change the way one walks and stands and I think his findings would be very different. Everything written in the paper contradicts the piece of my approach that advocates building specific muscle tone to help people with lower back pain and chronic lower back pain.
Again I have no hard data to go on but I have seen first-hand the efficacy of building core strength as a means of creating a healthier body that can age more gracefully due to better muscle tone and balance. Lederman has very little interest in the very big interest that many pain professionals have in the transverse abdominis muscle of the abdomen. I teach that in the case of many actions requiring abdominal engagement the brain often recruits the rectus abdominis when the transverse abdominis should be more in the game.
We should live naturally—when teaching someone who is very weak to walk I might tell them to engage their muscles to feel them but in the long run they want to build tone through specific exercise that is then supplied unconsciously during movement.
When I do a demonstration of a pose in a yoga class I am just doing the pose, not making a muscle to make it happen. From my perspective posture and walking patterns are the most common reasons that people with lower back pain and chronic lower back pain fail to alleviate their problems.
He makes a distinction between two types of back injury—load related and accident related. But I have found in both of these types of injury the two fold approach of building core tone and changing movement patterns to be highly effective.
The Myth Of Core Stability
For example with the ankle instability, when people sprain their ankles, we know that something happens to the motor control so they become unstable when they are standing on one leg and so on. We knew that it was happening elsewhere in the body. The consequence of that is that people took this idea to mean that the recovery from back pain depends on somehow normalizing these kind of motor control issues, but we have to remember that these are protective strategy. I call it the injury response. Basically, the body is trying to prevent more injury from occurring.
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