Core Stability

What is the front of the "core"

rectus abdominis and TA

What is the side of the core

obliques

What is the back of the core

erector apinae

multifidi

quadratus lumborum

What is the top of the core

diaphragmW

What is the bottom of the core

pelvic floor

What is the definition of core stability

ability or passive and active stabilizers of the lumbo-pelvic region to balange hip and trunk position with functional movements

What is core stability based off of

co-activation, coordination and sensory control of trunk muscles

What is key in core stability trunk coordination or strength and enduranc

coordination

What did Bergmark stated about core stability

-studied the lumbar spine from mechanical modeling which led him to develop the idea of global vs local muscle systems & made the term prime mover vs prime stabilizer

What are examples of global muscles

iliopsoas

rectus abd

What are examples of local muscles

multiifdi

TA

piriformis

What did Panjabi create in reference to core stability

the role of the active, passive and neural subsystems within core stability. In practice the systems provide spine stability through intersegmental stability

What is the "neutral zone" for Panjabi

the ability for the three systems to provide spine stabilize to minimze spine injury

According to Panjabi, what happens when one system is "shut-down"

another system will attempt to compensate for it

Are there clear exercises for core stability? Why or why not?

-no clear exercise regime due to differing philosophies, dosage impacts and lack of patient categorization

Do core exercises impact low back pain?

significant benefits for pain, disability and recurrent rates

Effectiveness of segmental stabiliy exercises on low back pain

better than going to general practicioner but not more effective than other PT exercises

After one year, what is more effective core stability training or general PT exercises for low back pain

no additional benefit which indicates no single muscle controls the spine

Have there been effective findings with TA activation exercises?

no

What is the role of the multifdus and what can dysfunction of it cause?

controls 2/3s of the neutral zone but can atrophy with low back pain and may not recover

atrophied mutlifidus leads to long term low back pain

What muscle do people with LBP struggle to activatie

mutlifidus but can also demonstrate delayed firing of the TA as well when perofrming extremity movements

What muscles are usually overactive with LBP

rectus abdominis and erector spinae

What needs to first be addressed with low back pain

joint dysfunction

Gait with LBP

patient have more kinesthesia of spinal position and trunk alterations during gait

What is the Capacity model

the global muscle approach made by McGill which states large muscles (glutes, erectors and hip flexors" stabilize the spine and pelvic joint)

How to treat LBP according to the capacity model?

target erector spinae, glutes and rectus abdominis while maintaining a rigid spine while loads are placed the limbs

What is the Motor control model

the local muscle approach by Hodges and Hides which states lumbopelvic health is based on the interplay of trunk muscles with the assistance from the nervous and sensory systems

What is the role of the CNS and PNS in the motor control model?

determine the requirements for stability during movement demands

What is the role of the sensory system in the motor control model?

provide spinal orientation and position during intervertebral translation and rotation

How is the spine "fined tuned" in the motor control model?

segmental control is gained

What muscles are targetted in the Motor control model

multifidi, TA and posterior gluteus medius

What are examples of capacity exercises

curls

side planks

superman

What are examples of motor control model exercises

TA activation

What is a movement impairment syndrome

injuries that occur from overuse of alignments and movements which lead to impaired pathoanatomical changes in tissues and joint structures

What is the most common spine syndrome

lumbar extension and rotation

What is lumbar extension/rotation syndrome associated with?

poor control of pelvic and lumbar movement leading to asymmetries of muscle activation

Lumbar ext-rotation movement and muscle imbalances?

-increased tendancy for lumbar spine to extend and rotation with an anterior pelvic tilt

-decreased hamstring activity and increased erector spinae activation

What activities provokes pain with lumbar ext-rotation

prone knee flexion, hip rotation and rocking in a quadruped position

What is addressed first with lumbar ext-rotation

lumbar, hip and SI restrictions

What muscles are commonly tender in LBP

erector spinae

hip flexors

TFL

hamstrings

Joint mobility findings with LBP

hypomobility of SI, hip and lumbar

What functional movements are performed for lumbar extension-rotation syndrome

postural screen

gait obersvation

single leg stance

prone knee flexion

Progression of TA exercises

prone knee flexion

bent knee fall out

heel slide

march

seated neutral spine

When to use chamsheels

LBP

hip conditions

knee

foot/ankle

What are common compensations with clamshells

TFL and hamstring substitution and lumbar rotation

What should it be progressed to after clamshells

hip hinge and SL stance exercises

What muscles would benefit from STM with a positive flick test

TFL and hamstrings

Recommended exercises with a positive flick test

METs

clamsheels

core stability with neutral spine

What should be the next step if someone has a positive sheer test

supine to long sit test then use a MET

What is a posterior innominate

PSL pumpkin spiced latta

short to long

What is an anterior innominate

ALS

long to short

Exercise to correct anterior innominate

-ALS

-patient uses their glutes

-3 reps at 10 seconds

Exercise to correct posterior innominate

-PSL

-patient pulls their leg away

3 reps and 10 seconds each