Controversies of the core

by Analee Matthews | Friday, April 15, 2011

By freelance editor Helen Jones

Professor Paul Hodges presented on the many controversies of the core on the first day of FILEX 2011. Core stability has been discussed at length, and in some ways the debate is getting quite heated, so he looked into how we might be able to resolve some of these controversies.

“Back pain is a huge problem in modern life, so we need to help people to move better and more freely.” There is a clinical assumption that exercise should aim to increase the stability of the spine, and exercise interventions have been around for 100 years.

There’s been a huge amount of research performed around if your muscles are better then that helps the spine. But is it our goal to make people move less or make them move more? Is it about stability or about too much stability? Or is it that they’re too rigid and we need to make them move more? And what about about functional training?

“The big problem is that all of these controversies are based on models that are too simplistic. We need to look at the system in more detail,” said Paul.

“Performance has to be dynamic and you have to co-ordinate exercise with your breathing, so simply learning how to use your trunk muscles won’t be any good.”

To be optimal in spinal function you need many things, and not just muscle. You need to be able to cope with unpredictability, high quality sensation, high forces, variability, pain and injury, and you need to have appropriate strength and endurance.

So what do you actually need to control? You need to make sure the spine doesn’t buckle and collapse when you put a load on it, so there’s no question that you need to have muscle, but what we need to question, is that there’s got to be more to it than that.

One of those things is controlling translations between vertebrates, but there’s one more thing – it’s movement. It is good for your spine to move. There are times when you don’t want your spine to move, like when you’re picking something up off the floor, but when you’re exercising and twisting and turning, you do, and there are a lot of studies that show this.

It’s not just about making your trunk rigid. It is about optimal ‘control’. We use our spine to get from one place to another, so someone with back pain may need to be told how to move effectively. Your spine is a shock absorber, so it’s very important that it works with optimal function. What your spine does influences your whole body as it is 70% of your body mass, so isn’t it time you questioned the controversies of the core?

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