PT on the Net Research

Core and Neurostabilization Training


Core training and neurostabilization training are extremely popular but as professionals we must understand the science and technology behind current trends in exercise. Core training can be just another fad or it can be a scientifically-based methodology that involves a functional and progressive approach to movement re-education and performance enhancement. It is important that you understand the necessary steps to develop a ‘core training’ program. It is also important that you understand that many variations of training and many opinions will be presented to you; however, there is a neurological framework and musculoskeletal structure that require a special sequential approach. This article will discuss the philosophy and the sequence behind building a practical model for training the core.

First, you must understand that the brain recognizes movement patterns and not simply muscle groups. Yet, many professionals are still stuck in isolation training or muscle group training. Understanding movement patterns is a little more in-depth and complicated than simply understanding muscle groups. You need to understand the role of stabilizers and the role of movers. You need to understand the most basic patterns of human movement and how they build upon each other in a neuro-developmental sequence starting in infancy and developing through childhood. You also need to understand that the most fundamental activities of the human body revolve around simple and basic movements of running and climbing.

Running demands that a spine be stable and transfer energy from one leg to the other as well as deal with the counterbalance movement of the arms as they swing, whereas climbing requires that the spine be mobile, adaptable and dynamic. These are two very fundamental movements of the human body, and yet they contrast each other in their demands of the core.

You must also understand that the core runs on a reflex base. This means that the core musculature is engaged by reflexes in response to your actions and reactions. As many of your movements involving the limbs are structured, controlled, planned out and trained, the movements of your core are reflex driven in an attempt to stabilize the spine so that more efficient movement patterns of the extremities can be produced. When the core is not functioning properly, you should first look for things that would limit this reflex behavior - significant limitations with respect to flexibility as well as asymmetries between the left and right side of the body. Imbalances in muscle groups including agonist and antagonist can all create a need for the core to compensate.

When the core must compensate, the effectiveness of the reflex with its natural sequence and timing is interrupted and the result is a less efficient core that is more susceptible to injury. Since most of us do not have high-tech equipment and EMG to check the core musculature for its efficiency in demonstrating perfect sequence and timing, we must approach training from a different aspect. If we can establish that there is minimal reason for the core to compensate, then we can assume that the appropriate amount of training will produce the desired result with respect to core stabilization and core strength.

Squat Hurdle Step Lunge

The squat movement is a double leg stance that is symmetrical. The legs perform the same tasks and the same role within the same range of motion. The hurdle step is single-leg stance requiring one leg to move freely and be a mobile segment while the other leg supports the weight of the body and is a stable segment. The lunge is almost a combination of the two above positions in that both legs remain on the floor like the squat but they are in complete opposition of each other as in a stepping motion such as the hurdle step.

These very different foot positions place different demands on the core and, when combined with diagonal movements of the upper extremity, represent a complete array of functional and athletic movements that provide opportunities for appropriate stabilization. Key equipment and communicating stabilization through proprioception include slide board, medicine ball, stability ball, cable column and core board training.

Since the core functions on a reflex base, it is necessary for initial stabilization training to be at that level. This means minimizing verbal and visual input and allowing exercise to communicate to the core what is necessary. This is a science called Reactive Neuromuscular Training and can be done by exaggerating the mistake that the individual performing the exercise is currently making. By exaggerating this mistake through weight shift or reduced control, the individual exercising has a greater proprioceptive awareness of poor timing, coordination, movement sequence, posture and joint position. If done safely and effectively, this will ultimately allow the exerciser to slowly correct the problem accelerating motor learning. Once neurostabilization training has been implemented, core strengthening can be performed through isolation or functional movements.

In closing, it is extremely important that you identify and isolate the important statements within each one of these bullet point paragraphs. They build an appropriate case for core training and will help you evaluate the many protocols and exercise techniques that will be coming your way in the future as the trends of core training and neurostabilization training are popularized. No doubt, many will jump on the bandwagon of core training but few will endure the criteria laid before them. The future of our profession lies in our credibility and attention to detail. It also relies on our creativity and openness to new concepts and philosophies. I hope this article / lecture has given you food for thought and the desire to learn.