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NASM-CPT > Chapter 9: Core Training Concepts > Flashcards

Chapter 9: Core Training Concepts Flashcards

1
Q

core

A

the structures that make up the lumbo-pelvic-hip complex (LPHC), including the lumbar spine, the pelvic girdle, abdomen, and the hip joint

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2
Q

drawing-in maneuver

A

a maneuver used to recruit the local core stabilizers by drawing the navel in toward the spine

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3
Q

bracing

A

occurs when you have contracted both the abdominal, lower back, and buttock muscles at the same time

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4
Q

what is the objective of core training?

A

to uniformly strengthen the deep and superficial muscles that stabilize, align, and move the trunk of the body, especially the abdominals and muscles of the back

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5
Q

what does a properly designed core training program help an individual gain?

A

neuromuscular, stability, muscular endurance, strength, and power of the core

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6
Q

where is the body’s center of gravity located?

A

the core

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7
Q

where does all movement originate?

A

the core

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8
Q

what is a strong and efficient core necessary for?

A

maintaining proper muscle balance throughout the entire human movement system (kinetic chain)

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9
Q

what establishes neuromuscular efficiency throughout the entire human movement system?

A
  • optimal lengths (or length-tension relationships), recruitment patterns (or force-couple relationships), and joint motions (or arthrokinematics) in the muscles of the LPHC
  • these factors allow for efficient acceleration, deceleration, and stabilization during dynamic movements, as well as the prevention of possible injuries
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10
Q

what is the core musculature divided into?

A
  • local stabilization system
  • global stabilization system
  • movement system
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11
Q

what is required to maintain core stability?

A

neuromuscular control of the local and global stabilization systems and the movement system, ensuring sequential coordinated activation of all systems at the right time with the right amount of force

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12
Q

where do the local stabilizers attach?

A

directly to the vertebrae

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13
Q

what do the local stabilizer muscles primarily consist of?

A

type 1 (slow twitch) muscle fivers with a high density of muscle spindles

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14
Q

what are core stabilizing muscles primarily responsible for?

A

intervertebral and intersegmental stability

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15
Q

what do core stabilizing muscles work to limit?

A

excessive compressive, shear, and rotational forces between spinal segments

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16
Q

what is the function of the core stabilizing muscles

A
  • to provide support from vertebra to vertebra

- aid in proprioception and postural control because of their high density of muscle spindles

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17
Q

primary muscles of the local stabilization system?

A
  • transverses abdominis
  • internal obliques
  • multifidus
  • pelvic floor musculature
  • diaphragm
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18
Q

how to the local stabilizers contribute to segmental spinal stability?

A
  • by increasing intra-abdominal pressure (pressure within the abdominal cavity)
  • by generating tension in the thoracolumbar fascia (connective tissue of the low back), thus increasing spinal stiffness for improved intersegmental neuromuscular control
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19
Q

what does optimal neuromuscular control allow for?

A
  • normal length-tension relationships, force-couple relationships, joint arthrokinematics
  • these factors lead to optimal sensorimotor integration, optimal neuromuscular efficiency, and optimal tissue recovery
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20
Q

primary muscles of the global stabilization system

A
  • quadratus lumborum
  • psoas major
  • external oblique
  • portions of internal oblique
  • rectus abdominis
  • gluteus medius
  • adductor complex (adductor magnus, adductor longus, adductor brevis, gracilis, pectineus)
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21
Q

primary muscles of the movement system

A
  • latissimus dorsi
  • hip flexors
  • hamstring complex
  • quadriceps
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22
Q

where do the muscles of the globalization system attach?

A

from the pelvis to the spine

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23
Q

what do the global stabilization system muscles do?

A
  • transfer loads between the upper extremity and lower extremity
  • provide stability between the pelvis and the spine
  • provide eccentric control of the core during functional movements
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24
Q

where do the movement system muscles attach?

A

the spine and/or pelvis to the extremities

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25
Q

what are the movement system muscles primarily responsible for?

A

concentric force production and eccentric deceleration during dynamic activities

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26
Q

what do all of the muscles within each system provide?

A

dynamic stabilization in all planes of movement during functional activities and neuromuscular control of the entire core (LPHC)

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27
Q

what do all the muscles within each system do?

A
  • produce force (concentric contractions)

- reduce force (eccentric actions)

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28
Q

true or false: the core muscles can effectively achieve stabilization of the LPHC in isolation

A
  • in isolation these muscles do not effectively achieve stabilization of the LPHC
  • it is through their synergistic interdependent functioning that they enhance stability and neuromuscular control
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29
Q

stabilization systems from the inside out

A

local stabilization system > global stabilization system > movement system

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30
Q

true or false: training the movement system muscles before training the muscles of the global and local stabilization systems would not make sense from both a structural and biomechanical standpoint

A
  • TRUE
  • doing so would be analogous to building a house without a foundation
  • the foundation must be developed first to provide a stable platform for the remaining components of the house to be built on
  • one must be stable first to move efficiently
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31
Q

true or false: few people have properly developed the local stabilization muscles required for intervertebral stabilization

A

TRUE

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32
Q

what is required for the body to effectively use the strength, power, and endurance that has been developed in the primer movers?

A

the body’s core stabilization system has to be operating with maximal efficiency

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33
Q

what happens if the movement system musculature of the core is strong and the local stabilization system is weak?

A
  • the kinetic chain senses imbalance and forces are not transferred or used properly
  • this leads to compensation, synergist dominance, and inefficient movements
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34
Q

what does a weak core cause?

A
  • inefficient movement, which can lead to predictable patterns of injury
  • this results in lack of stabilization and unwanted motion of the individual vertebrae, thus increasing forces throughout the LPHC that may result in low-back pain and injury
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35
Q

what happens if the core is unstable during movement?

A

it does not allow for optimal stabilization, force reduction, force production, and transference to occur throughout the kinetic chain

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36
Q

individuals with chronic low-back pain have decreased activation of what muscle groups?

A
  • transverse abdominis
  • internal obliques
  • pelvic floor muscles
  • multifidus
  • diaphragm
  • deep erector spinae
  • also weaker back extensor muscles and decreased muscular endurance
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37
Q

what is an independent risk factor for developing low-back pain?

A

trunk muscle weakness

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38
Q

true or false: numerous studies support the role of core training in the prevention and rehabilitation of LBP

A

TRUE

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39
Q

what do core stabilization exercises restore in individuals with low-back pain?

A

the size, activation, and endurance of the multifidus (deep spine muscle)

40
Q

what is neuromuscular activation of the local stabilization system called?

A

drawing in

41
Q

what is neuromuscular activation of the global stabilization system called?

A

bracing

42
Q

what to traditional low-back hyperextension exercises without proper lumbo-pelvic-hip stabilization result in?

A
  • an increase of the pressure on the discs to dangerous levels
  • can cause damage to the ligaments supporting the vertebrae, which may lead to a narrowing of openings in the vertebrae that spinal nerves pass through
43
Q

electromyography (EMG)

A

a procedure that measures the electrical conducting function of nerves in the muscles

44
Q

what can an EMG identify?

A

differences in muscle or muscle group activation when performing different movements or exercises

45
Q

is EMG activity increased or decreased during pelvic stabilization and transverse abdominis activation when an abdominal drawing-in maneuver is initiated before activity?

A

increased

46
Q

when properly activated, what does the transverse abdominis create?

A

tension in the thoracolumbar fascia, contributing to spinal stiffness, and compressing the sacroiliac joint, increasing stability

47
Q

how do you perform the drawing-in maneuver?

A

pull in the region just below the navel toward the spine and maintain the cervical spine in a neutral position

48
Q

what does maintaining a neutral spine during core training help to improve?

A
  • posture
  • muscle balance
  • stabilization
49
Q

what happens if a forward protruding head is noticed during the drawing-in maneuver?

A

-the sternocleidomastoid (large neck muscle) is preferentially recruited, which increases the compressive forces in the cervical spine and can lead to pelvic instability and muscle imbalances as a result of the pelvo-ocular reflex

50
Q

why is it important to maintain the eyes level during the drawing-in maneuver?

A

not keeping the eyes level can lead to pelvic instability and muscle imbalances as a result of the pelvo-ocular reflex

51
Q

what happens if the sternocleidomastoid muscle is hyperactive and extends the upper cervical spine?

A
  • the pelvis rotates anteriorly to realign the eyes

- this can lead to muscle imbalances and decreased pelvic stabilization

52
Q

bracing is referred to the co-contraction of what muscles?

A

the global muscles, such as the rectus abdominis, external obliques, and quadratus lumborum

53
Q

what is bracing also commonly referred to as?

A

a “bearing down” or tightening of the global muscles by consciously contracting them

54
Q

true or false: muscular endurance of the global and local musculature, when contracted together, create the most benefit for those with LBP compared with traditional LBP training methods

A

TRUE

55
Q

true or false: bracing focuses on segmental vertebral stability, not global trunk stability

A

FALSE
-bracing focuses on global trunk stability, not on segmental vertebral stability, meaning that the global muscles, given the proper endurance training, will work to stabilize the spine

56
Q

what strategies can be implemented in a core training program to help retrain motor control of local and global stabilization systems and movement musculature, as well as to help retrain the strength and endurance of these muscles?

A
  • drawing-in maneuver

- bracing

57
Q

what should a comprehensive core training program be?

A
  • systematic
  • progressive
  • functional
  • should emphasize the entire muscle action spectrum focusing on force production (concentric), force reduction (eccentric), and dynamic stabilization (isometric)
58
Q

core training parameters - variables

A
  • plane of motion
  • range of motion
  • type of resistance
  • body position
  • speed of motion
  • duration
  • frequency
  • amount of feedback
59
Q

core training parameters - exercise selection

A
  • progressive
  • systematic
  • activity / goal-specific
  • integrated
  • proprioceptively challenging
  • based in current science
60
Q

why are weight belts not recommended?

A

weight belts may raise an individual’s heart rate and systolic blood pressure, and often give individuals a false sense of security and the misconception that they can lift heavier loads

61
Q

what is the goal of core training?

A

to develop optimal levels of neuromuscular efficiency, stability (intervertebral and lumbopelvic stability- local and globalization systems), and functional strength (movement system)

62
Q

what is the focus of a core training program?

A
  • neural adaptations (instead of absolute strength gains)
  • function
  • quality of movement over quantity
63
Q

true or false: increasing external resistance is more important that increasing proprioceptive demand

A

FALSE
-increasing proprioceptive demand by using a multisensory environment is more important that increasing the external resistance

64
Q

when does a client have appropriate intervertebral stability?

A

when able to maintain the drawing-in position while performing various exercises

65
Q

when does a client have appropriate lumbopelvic stability?

A

when able to perform functional movement patterns (squats, lunges, step-ups, single-leg movements, pressing, pushing, etc.) without excessive spinal motion (flexion, extension, lateral flexion, rotation, singly or in combination)

66
Q

it is critical that the core training program is designed to achieve the 3 following functional outcomes (the sequence is critical!)

A
  1. intervertebral stability
  2. lumbopelvic stability
  3. movement efficiency
67
Q

core-stabilization training (phase 1)

A

exercise involve little motion through the spine and pelvis

68
Q

what are core-stabilization exercises designed to improve?

A

neuromuscular efficiency and intervertebral stability

69
Q

what do core-stabilization exercises focus on?

A

drawing-in and then bracing during the exercise

70
Q

how long would a client typically spend at the core-stabilization level?

A

4 weeks

71
Q

examples of core-stabilization exercises

A
  • marching
  • floor bridge
  • floor prone cobra
  • prone iso-ab (plank)
72
Q

marching technique

A
  • keep abdominals drawn-in throughout the entire movement

- keep the pelvis in a neutral position

73
Q

two-leg floor bridge technique

A
  • do not raise hips too far off the floor (hyperextending the low back) - this places excessive stress to the lumbar spine
  • make sure at the end position, the knees, hips, and shoulders are in alignment and the gluteal muscles are fully contracted
74
Q

floor prone cobra technique

A

-do not come too high off the floor (hyperextending the low back)

75
Q

prone iso-abs (plank) regression options

A
  • perform in a standard push-up position
  • perform in a push-up position with knees on the floor
  • perform with the hands on a bench and feet on the floor
76
Q

core-strength training (phases 2, 3, and 4)

A

the exercises involve more dynamic eccentric and concentric movements of the spine through a full range of motion while clients perform the activation techniques learned in core-stabilization training

77
Q

what is progressed in the core-strength level?

A

specificity, speed, and neural demands

78
Q

how long would a client typically spend at the core strength level?

A

4 weeks

79
Q

what are core-strength exercises designed to improve?

A
  • dynamic stabilization
  • concentric strength (force production)
  • eccentric strength (Force reduction)
  • neuromuscular efficiency of the entire kinetic chain
80
Q

examples of core-strength exercises

A
  • ball crunch
  • back extensions
  • reverse crunch
  • cable rotations
81
Q

ball crunch technique

A

-keep the chin tucked - this will take stress off the muscles of the cervical spine

82
Q

ball crunch progression

A

perform as a long-lever exercise (arms raised overhead)

83
Q

back extension technique

A
  • make sure that at the end position, the ankle, knee, hip, shoulders, and ears are all in alignment
  • do not hyperextend the low back
84
Q

reverse crunch technique

A
  • do not swing the legs
  • once you have positioned the lower extremities during the setup, they should not move during the execution of the exercise
  • swinging the legs increases momentum, increasing the risk of injury and decreasing the effectiveness of the exercise
85
Q

cable rotation technique

A
  • to decrease stress to the low back, make sure to pivot the back leg into triple extension: hip extension, knee extension, ankle plantarflexion (extension)
  • this also ensures proper neuromuscular efficiency of the muscles that extend the lower extremities (gluteus maximus, quadriceps, gastrocnemius and soleus)
86
Q

core-power training (phase 5)

A

-exercises are designed to improve the rate of force production of the core musculature

87
Q

what to core-power exercises prepare an individual to do?

A

dynamically stabilize and generate force at more functionally applicable speeds

88
Q

examples of core-power exercises

A
  • rotation chest pass
  • ball medicine ball (MB) pullover throw
  • front MB oblique throw
  • soccer throw
89
Q

ball medicine ball pullover throw technique

A

it is important that an individual has proper extensibility of the latissimus dorsi before performing this exercise to decrease stress to the low back and shoulders

90
Q

soccer throw technique

A

-it may be easier to perform this exercise using a D-ball (a medicine ball that does not bounce back) or close to a wall for the medicine ball to bounce off of

91
Q

what happens if individuals try to perform core-power exercises without proper stabilization and strength?

A

may lead to movement compensations, muscle imbalances, and eventually injury

92
Q

true or false: it is important with all core-power exercises that you go as fast as you can while maintaining proper exercise technique

A

TRUE

93
Q

what does the core musculature help protect the spine from?

A

the harmful forces that occur during functional activities

94
Q

core stabilization acute variables

A
  • number of exercises: 1-4
  • sets: 1-4
  • reps: 12-20
  • tempo: slow (4/2/1)
  • rest: 0-90s
95
Q

core strength acute variables

A
  • number of exercises: 0-4
  • sets: 2-3
  • reps: 8-12
  • tempo: medium
  • rest: 0-60s
96
Q

core power acute variables

A
  • number of exercises: 0-2
  • sets: 2-3
  • reps: 8-12
  • tempo: as fast as can be controlled
  • rest: 0-60s
97
Q

true or false: for the goal of muscle hypertrophy and maximal strength, core training is required

A

FALSE

-for the goal of muscle hypertrophy and maximal strength, core training may be optional (although reccomended)

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