I am very confused as what to teach my clients in a work safety program on safe lifting. According to Mcgills' work, we should not tell clients to hollow the lower abdominals when lifting as this decreases the stability of the spine. If this is the case, is all the information regarding TVA only appliable to supine or prone positions on the ground? Am I incorrect to advise clients to draw in the lower abdominals in performing liting tasks?
Great question, and YES this is a matter of controversy! Maybe the controversy lies in the fact that everyone is different, and each person will exhibit different levels of motor control. I have personally studied the work of Carolyn Richardson, Paul Hodges and Julie Hides (Therapeutic Exercise for Lumbopelvic Stabilization) as well as the work of Stuart McGill, and I find their research great in many ways, but I question their practical application. Being a practitioner who spends time assessing and re-assessing 35 or more hours per week, I found the best results NOT asking clients to draw in. Instead, I ask them to move their bodies in a manner that creates the right reaction at the right time in the right plane to ENHANCE the proper stabilization of the abdominal wall. If we verbally teach our clients to always contract selective muscles, we run the risk of creating a rigid system that will impede function. However, if you work with a pain-management type clientele (in pain at the moment, not to be confused with soreness or stiffness), then a cognitive drawing in cue may help improve their function at that time. This is where I think the confusion lies – what clientele is the research being done on? What clientele is the author exposed to? For example, if I teach my client who is going skiing this weekend to draw in, do you really think he will remember to draw in going down the hill? Not likely!
In all programs, we as practioners, trainers and therapists must get our clients to react in a biomechanically efficient manner. How we get there may be different client to client, trainer to trainer, therapist to therapist, but we must get there. Movement takes place subconsciously; therefore, we must condition clients to move subconsciously.
To learn more about training the core, I would strongly recommend Gary Gray's Functional Video Digest Series on Abdominals. He does a fabulous job explaining how to get the core to react.