// Perfect Practice - Cutting edge core control part 2: the core crash
by Lisa Champion and Anna-Louise Bouvier
The right response for the right loadIn Part 1 of ‘Cutting Edge Core Control’, it was established that in order to have perfect core control you need to recruit the right response for the right load. This principle rests on a foundation of efficient, well-established core control.
Low level control involves the local muscle system (LMS) working at a low level without getting tired; it usually requires little general movement of the skeleton so global muscle system (GMS) recruitment is minimal and it has a low cardio response. In contrast, high level core control requires the LMS to maintain neutral spine while the GMS drives and controls the direction and force of the movement. With high level control, there is normally a high cardio load as working muscles demand peak volume circulation. Part 1 was summed up with the important concept that low level core control must be the foundation for higher level core control. This will establish the optimal brain-to-muscle connections to provide on-going, reliable,
dynamic control which minimises risk of injury and helps to maximise performance.
Having established that low level core control must be the foundation of all movement, Part 2 of Cutting Edge Core Control takes you on the journey of understanding what influences low level control and how the body’s ‘operating system’ can break down, leading to a core crash.
The operating system crashCanadian physiotherapist Rick Jemmett, describes an acute episode of back pain as ‘a software crash’ and essentially this is exactly what happens when your brain/LMS system gets into trouble. Like any operating system, you are not really aware of its existence until something goes wrong. Back pain is the single most obvious symptom of a ‘core crash’, but there are many other signs, some more subtle than the existence of pain. We have developed the 1234 core and more system to help you and your clients understand their risk factors for crashing, and also to help them be aware that they may need to ‘re-boot’ their core many times a day.
1234 core and more system
Step oneTake into consideration the factors that can influence the integrity of the deep core. These key postural muscles interlace and wrap around the spine like a corset and work as a unit (see diagram 1). The unit comprises four main elements:
1. lid (diaphragm)
2. seam (spine)
3. walls (deep abdominal muscles)
4. floor (pelvic floor muscles)
Each element can be compromised in some way:
1. The lid (diaphragm) can be affected by stress and anxiety (think how shallowly you breathe when you are stressed), asthma, allergies, sinus problems, respiratory illnesses or a lack of fitness.
2. At the back, the seam (spine) can be affected by poor posture and any type of spinal pathology (disc bulges or degeneration, for example).
3. At the front, the walls (deep abdominal muscles) can be affected by abdominal surgery, gastric or digestive problems or hernias.
4. The floor (pelvic floor) can be affected by childbirth, menstruation, menopause or chronic constipation. Getting correct activation of the pelvic floor muscles is equally important in men and women.
As these are only some of the physical factors that come into play, you can see how easy it is not to have the deep core working efficiently.
Step twoIdentify whether genetics is a factor in how well the deep core controls the spine. For this you have to determine if your client may be a ‘Floppy’. Tell your client to think back to their childhood, and ask them:
• Have you always found stretching easy?
• Could you do (or almost do) the splits as a child?
• Could you do backbends?
• Have you always thought, or been told, you were double-jointed?
• Do your joints click a lot?
If they answer ‘yes’ to two or more of these questions they are likely to be a Floppy. This term (coined after many years of dealing with very mobile clients!) means their ligament system is really loose, so their LMS and GMS have to work harder and more efficiently to control their ‘cooked spaghetti spine’ against gravity. In a nutshell, they will find it harder to stabilise their spine than someone who has always been naturally stiff. Consequently, they will need more concentrated effort in this area.
Step threeThe final step is to determine if your client is symptomatic. This can often be determined by sharp skills of observation (including posture, breathing patterns and stress or fatigue levels).
You can also ask him or her:
• Do you have back pain at the moment?
• Do you have groin pain, hamstring pain or sciatica?
Pain means crashes. It inhibits the normal neural pathways between the brain and the muscles and tends to make the body move differently.
The more questions to which a client replies yes, the more likely he or she is to have subtle crashes in the operating system. Some of the factors tend to have been present for a long time and, as a result, are often really subtle. You have to be aware of how much these issues can affect the system.
Something else to bear in mind is that the condition of a client’s core system can alter from session to session. For example, consider a fit client you already know to be a Floppy, who comes in for her normal workout sneezing and coughing with hayfever. She also happens to have her period.
Load her up with a heavy lifting session, and there is an increased possibility she will end up with a sore back or some other injury.
Re-booting and testing for low level core controlOnce you have identified that the operating system may not be working properly, get your client to ‘re-boot the core’ in order to stimulate the brain to reactivate low level control. To do this, he or she has to focus on turning on the bits that have shut down (a bit like installing a live update) and then… voilà, he or she is online and ready to go again (see diagram 2)!
Here are two fantastic re-booting exercises.
Exercise Basic re-boot with Breathe and Sit• Sit on the edge of a chair with neutral spine.
• Take a slow breath in, widening the ribs and keeping the shoulders relaxed.
• Breathe out, imagining slowly drawing up on the pelvic floor muscles.
• Do not suck in or harden the stomach.
• Do not change the position of the torso.
• Repeat for 5 SLOW breaths.
Exercise Re-boot with Leg-in/Leg-out
This exercise can be used both to test for low level core control and to re-boot. While it may look like a Pilates exercise and can certainly be used in a Pilates class, it is a valuable general tool for every trainer (see diagram 3).
• Lie on your back with the knees bent up.
• Establish balanced spine position. Arch too far, press the spine into the mat, then find the midpoint between these two positions.
• Place the left hand under the small of the back and the right hand on your abdomen just below the navel.
• Breathe in slowly to the count of 4.
• Breathe out slowly, letting the left leg open slightly while visualising drawing up the pelvic floor muscles.
• Breathe in and return the leg to the starting position.
• Repeat 5 times on one leg, then repeat on the other side.
There are several important focus points for this exercise.
Make sure the client uses the out-breath to activate the core, which in turn stabilises the pelvis. Ensure the knee drops and returns to the centre with the rhythm of his breathing and the movement remains smooth and continuous. Remind him to focus throughout on the image of drawing up the pelvic floor muscles into the body. It takes strong visual imagery to get the breathing and muscle activation coordinated.
The hand under the spine helps to check it is staying stable. If the client feels pressure on the hand it means the pelvis is rolling and he has gone too far. If his shoulder aches, he can remove it from behind the back and place it on top of the abdomen. He can use this hand to check he is activating the deep corset. He should feel the hand dropping towards the spine if it is activating correctly. He is trying too hard, and probably holding his breath, if his abdomen pushes up and out against the hand.
What does a core crash look like?If your client has poor low level core control, or has had a crash in their LMS, you may see:
• poor breathing pattern, i.e. inability to activate the diaphragm correctly, shoulders raising or the abdominal wall protruding while inhaling
• bracing or doming of the abdominal wall
• rolling of the pelvis to the side as the leg moves out
• shaking and excessive moving of the opposite leg
When you see these responses, be aware there is a heightened chance of injury if the client performs a more demanding exercise.
The answer is to work on re-booting frequently.
Teach your clients to use these exercises as often as they can during the day. The ‘Breathe and Sit’ reboot can be done anywhere – in the car, in front of the computer or during a meeting. Leg in/Leg out is a more advanced re-boot and can be done before or during a workout or whenever they get the chance to lie down. Either can be used before a session to re-establish a connection between the deep core and the brain. With this in place, they will have a much better chance of maintaining perfect alignment and control in higher level exercises.
Upgrading the softwareThe understanding that good low level control is the foundation for high level control applies to every single aspect of training, not just for exercises that are specifically designed to train the core. The two most important things to remember are:
1. Without good low level control, you cannot have good high level control.
2. To enhance low level control you need a strong brain connection. This means lowering the pace and the load, and giving your client time to think.
Low level exercises should:
• be performed on stable surfaces
• be very slow and controlled
• not involve extra weight
• be cued to allow for maximum re-booting value.
Exercises that involve unstable surfaces, weight, speed and long levers require high level control. They are only valuable when the foundation for them is perfect low level control. A PERFECT PRACTICE™ trainer uses this foundation to make exercise safer and understands how it ultimately enhances all exercise performance.
And if you don’t re-boot?
The deep core and global muscle activation will be out of synch when performing high level exercises without a good connection between the brain and the deep core. You’ll find your client holding his breath or breathing very shallowly. You may see the thoracic cage splinting to the pelvis in an effort to stiffen the spine, but the client will not be able to maintain neutral spine.
You may see alignment problems both above and below the centre of the body. He may feel pain when exercising (low back, neck and shoulders being the most common areas) or afterwards and he may be susceptible to other injuries such as muscle tears.
It’s also important to realise that even elite athletes who lift heavy weights and regularly perform high skill level exercises can have poor low level control (see box on next page).
So, if you want to be a perfect trainer you need to get your clients thinking about PERFECT PRACTICE ™ all day, every day. It’s all about identifying risk and making sure you increase loads only according to ability to cope with various levels. It’s also about ensuring that alignment and core control are vital components of every training session. Practice does not make perfect – perfect practice does. To quote Michael Leunig, ‘it’s as simple and as difficult, as that.’
If you are interested in learning more about Cutting Edge Core Control you can order the audio CD of Anna-Louise’s FILEX session of the same name from Conference Capture, telephone 0408 001 818 or attend a PERFECT PRACTICE™ workshop.
PERFECT PRACTICE™ is based on the framework of the Physiocise program developed by Anna-Louise Bouvier. The terms ‘Floppy’, ‘Re-boot your core’, ‘1234 Core’ used in this article are copyrighted by Anna-Louise Bouvier and should be acknowledged as such, particularly in presentations and written materials. More information on the Physiocise program can be found in Fix Your Back by Anna-Louise Bouvier available from all ABC shops and centres, good book shops or online at www.abc.net.au
Anna-Louise Bouvier, BAppSc (Physio)
Named Australian Fitness Network's 2004 Presenter of the Year, Anna-Louise is an accomplished author and creator of audio resources addressing back pain. The developer of a back specialist program called Physiocise, she runs a private physiotherapy practice and is an injury prevention consultant to the NSW Rugby Union team.
Lisa Champion, MSc (ExSc)
Lisa is a multi-talented exercise specialist. In her role as a director of the Australian Fitness Network, she has had a positive influence on the development of the fitness industry in Australia for nearly 20 years. Lisa has shared her expertise and knowledge as an instructor trainer, program developer, convention presenter and author. She works as a personal trainer, teaches pilates and children’s movement classes and inspires equestrian athletes through her book Riding from the Inside Out. With Anna-Louise she is the co-creator of the PERFECT PRACTICE(TM) training system.
NETWORK MAGAZINE • WINTER 2006 • PP17-23