These days you would be hard-pressed reading a fitness or rehabilitation article without it having some reference to “Core Stability”. Terms such as core strengthening, stability training and core training seem to be used interchangeably, however they have quite different meanings.
To understand the difference between the various terms a review of the different types of muscles involved is necessary. There are two different types of muscles to consider – the ‘movers’ and the ‘stabilisers’. When you look at the actual makeup of these muscles, they have different muscle fibres and this is one of the reasons for the need to be specific about what muscles you train. The ‘mover’ muscles have greater strength but less endurance than the ‘stabiliser’ muscles. When we ask ‘mover’ muscles to undertake the role of a stabiliser it is able to achieve this for only a short period of time without fatiguing and then becoming damaged itself. This secondary damage results in exacerbation of the pain and, over time, the development of a new source of pain. In practice, we often see patients who have undertaken a core strengthening program that had good short-term effects; unfortunately once the ‘mover’ muscles are exhausted and damaged the ‘benefits’ of the program are then undone!
With core stability, the key is to re-activate the body’s natural pattern of muscle recruitment. Research has proven that once damaged, the lumbar core muscles will not automatically recover, even once the pain has subsided. The body then compensates by recruiting ‘mover’ muscles and the chance to reactivate the normal recruitment pattern is lost.
Your core muscles, when working as the body intended, will result in increased stability between the vertebral segments as well as between the trunk and the pelvis. This is achieved by increasing intra-abdominal pressure without increasing intra-discal pressure. Of prime importance is that the activation and training of the ‘mover’ muscles may increase intra-abdominal pressure but at the expense of increased intra-discal pressure.
Sit-ups, planks, side planks, crunches, incline situps and ball situps are all exercises that will work the abdominals, however they will not improve your core stability unless you already have excellent core recruitment patterns. Even worse than this, they will make your core worse. Sadly, if you are female they will also over time increase the likelihood that you will suffer incontinence.