My issue with core strengthening

[Valentina R]

I made a post on my blog today that I wanted to post here as well:

My Issue with Core Strengthening

Core strengthening is a popular treatment modality among physical therapists, as well as being popular in the mainstream of exercise. There have been a number of articles written critical of core strengthening (see The Myth of Core Stability: http://www.google.com/url?sa=t&sour...mN8xCaRP2-yLHspQA&sig2=9InG9yIZlTrHHc3h3ww0kw). Based on my experience, one serious flaw has to do with tightness that most physical therapists pay little attention.

Tightness of the anterior (front) spinal and pelvic musculature can play a great role in back, sciatic, and pelvis pain. Shortness or tightness of the iliopsoas musculature can cause the lumbar spine to become drawn forward and downward. The psoas originates at the transverse process of L1-L5, with fascial slips into each of the lumbar discs. Tightness of one or both sides of the psoas and surrounding fascia can lead to commonly felt back pain and dysfunction. I find this a repeating theme among patients with back pain and one that I spend a great deal of time in education and treatment. Repeated exercise can lead to shortening of a muscle, if not properly stretched.

Some common symptoms that can result from shortness in this region are pain with prolonged standing, or standing while leaning forward (doing dishes), pain on rising to stand after sitting, especially when you are leaning forward (computer use or bleacher sitting), and lying flat on your back with the legs flat.

If the psoas and surrounding fascia is restricted, further strengthening these areas easily leads to further examassageplanetation of the back pain. This is what often results from core strengthening. The traditional medical model, including the traditional physical therapy model, pays little attention to these interplays. While your therapist may have put you on a general stretching program for your pain, the prescribed exercises seldom target the hip flexors. Strengthening the trunk and back to better support is a repeating theme among the patients I see who have not been helped (or have been hurt) by this approach to pain.

Myofascial release stresses identifying the restricted or shortened musculature and soft tissue that may be causing excessive strains on the body. In my Foundations in Myofascial Release Seminars™, I stress a unique deep model of evaluation as a part of Myofascial Release training. Without this proper type of evaluation, this tightness is often overlooked. Demand more of your therapist. Don’t settle for what each and every back pain patient receives. No two cases are alike, so why allow yourself to be treated by everyone else?

Walt Fritz, PT

http://www.MyofascialResource.com

It is interesting that I chose an article by Lederman to bring doubt on core strengthening, even though he wrote the paper mentioned in this thread here:
http://www.massageplanet.com/forum/viewtopic.php?f=22&t=22177
He certainly chooses topics that pull folks into action.

What are your thoughts on core strengthening?

Walt

 

[Pompal 09.]

My issue with core strengthening

YES!!!! What drives me CRAZY is people thinking they have THE ANSWER for any specific (general!!) pain, such as low back pain. There are so many intricasies involved in the low back function, that it's just plain silly to say one treatment "works" - or one treatment *doesn't* work. Each body has its own history, unlike any other in the world. We're going to have to pay close attention to the one on the table, not only to somebody's research. I love research.....but not the arrogance that so often goes with it.

I love your blogs, Walt!!!

 

[sarah c]

My issue with core strengthening

Oh.......thoughts on core strengthening.. forgot.

I love core strengthening, too. It's a great tool and I have seen incredible results when it was the tool needed for the particular job.

 

[Matt hardy Brand]

My issue with core strengthening

"Core strengthening" is oversold because it is misunderstood and therefore misused and abused. Unfortunately, it has become a popularly-believed meme that is hard to avoid. Tons of companies, trainers, therapists, etc. are hawking it like crazy because it is an easy sell and can be very profitable.

It would be helpful for people to understand what the "core" muscles are and what they do. It would also be great if people understood that you can easily overtrain some core muscles while neglecting others, and that it can't be used for "spot reduction" of belly/waist fat. (I could go on and on...)

"Weak core muscles" is never a direct cause of pain. Perceived/measurable muscle weakness is a symptom, never a cause. If detected, it is also important to determine whether the perceived weakness is the result of ACTUAL weakness, or if it the result of muscle inhibition. If it's a case of inhibition, the underlying cause needs to be identified and addressed in order to resolve the perceived weakness. In my experience, very little strengthening of the "weak" muscles is required, as removal of inhibition results in immediate functional strength gains.

It's a tool, but not a "universal multi-tool" for all problems.

 

[hydropowerman34]

My issue with core strengthening

Thanks for sharing, Walt!

 

[farhad]

My issue with core strengthening

just doing strengthening like a workout can cause more damage if it is not flexible

the best thing to do is muscle strengthening combined with stretching. some great things to do with this are yoga because is balances the muscles keeping them strong and flexible and also balance training it forces the body strengthen itself while keeping flexible

balance board trainers are amazing indo boards work well