Dr. Michael Hartle
Medical Committee Chair
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Trunk Stabilization Concepts and Exercises
by Michael A. Hartle, D.C., D.A.C.B.N., C.C.N., C.C.S.P., C.S.C.S., E.M.T.
Part One of Six
Introduction
Stability, balance, strength and power. What do these four words have in common? A lot more than you think. In order to succeed in any sport, you must have all of them. If you don't, you will eventually have an injury or a multitude of injuries that never seem to heal or are always nagging at you every time you train and compete. Most athletes can relate to this. When you get ready to do a particular sport or event, your body will tell you if something isn't right. For a powerlifter, it might be as simple as a small discomfort or dull ache in your right upper buttock area as you set up for a heavy squat set. A tennis player may feel a slight pain in the elbow region as they grip their racquet. My point is, if you feel these things when you workout or compete, then you don't have the aforementioned four qualities in the right quantities.
Stability
Stability is one of the most important aspects that any athlete needs to succeed. What is stability? Stability, when used in reference to the neuromusculoskeletal (nervous system, muscles/tendons/ligaments, bones) system, is a result of the interaction of three subsystems: the CNS for control; the passive osteoligamentous (bones and ligaments) structures for passive restraint and sensory feedback; and the active muscle system for production and control of movement. (Liebenson) This is the ability of a joint complex or complexes to remain stable and intact when under stress and/or physical demands and loads. Multiple joint complexes working together, such as the spine, provide the stability needed to do large movements of the body when running, squatting, etc. In order to maintain stability, the body uses the nerves and the nervous system to feed information from the area under demand to the brain and back again. It uses the muscles and tendons to contract and relax in proper sequence, with proper force and duration in order to hold the joint stable when it is being stressed. The bones along with the ligaments, provide the structural support for the joint. All of these components provide the body with stability when under stress.
All joints and joint complexes have their individual stabilizers. For example, the glenohumeral (shoulder) joint uses the infamous rotator cuff muscles as some of its stabilizers. These muscles help place the shoulder joint into the proper position before movement of the joint will occur. Then the prime movers of the shoulder joint, such as the pectoralis major, deltoid, latissimus dorsi, etc. can move the upper arm through any movement without damaging the joint itself. When these stabilizers become damaged, weak, adhered to something else because of scar tissue and adhesions or lose flexibility, they are not able to place the joint into the proper position while the prime movers move the joint. When this happens often enough, cumulative trauma begins to occur to the joint complex. It is no longer stable. All the athlete usually sees at this point is pain when using that joint, sometimes starting out as a dull ache but eventually turning into sharp pain. Down the road the athlete will not be able to use that joint because of the pain and may have to quit their particular sport.
Stability is one of the mechanisms used by the spine and the trunk to create a rigid and stable foundation against which the extremities can move and bear loads. The athlete needs to be aware of their current ability to stabilize their trunk and spine. They must work on continuing to improve their stability by fine-tuning the motor control system to the point that this system as a whole can function on a more efficient level to better ensure stability of the spine. If this stability is not achieved properly because of injury, imbalance, or chronic overuse, then the athlete cannot be as efficient in moving a load, thereby not realizing their full potential. The athlete would be wasting energy, not lifting as much as they could, and risking further injuries.
Next Issue... Proprioception and Balance
Michael A. Hartle,
USA Powerlifting Executive Committee Board Member
Chairman, USA Powerlifting Sports Medicine Committee
Chairman, USA Powerlifting Drug Testing Committee
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