This is the first in our multi-part series all about ‘the Core’. A term that has been used across the health and fitness world to loosely describe the muscles that stabilise the trunk. But what is it exactly? And what role does it have to play in injury and performance? Here’s Chews Health Physiotherapist Rich Saxton with some of the ‘science’ behind it.

Introduction

The central core of the body has been suggested to be important in stabilisation, production and transfer of force in all activities of daily life (Hibbs et al. 2011). The core has varying definitions within the literature and sporting contexts, with strength and stability used seemingly interchangeably.  A main role of the core is to provide proximal stability of the trunk, enabling effective and co-ordinated mobility of the arms and legs, which is required in most sports (Akuthota et al. 2008).  It has therefore been the focus of research and an area to assess, treat and train for physiotherapists and trainers in an attempt to improve sporting and athletic performance.

Due to the variety of definitions for the core, stability and strength are most commonly used in the literature.  Core stability can be defined as the ability to control the position and movement of the trunk over the pelvis and legs during movement in all planes of motion.  Core strength can be defined as the force produced by the core musculature and the ability to maintain this force (Reed et al. 2012).

In this series, the structure, role, importance and the value of training the core will be explored in relation to athletic performance and injury prevention.  Moreover, the value of assessing and the treatment or training of the core will be explored and discussed specifically in relation to field hockey.

The role of core in stability and function

The musculoskeletal core does not have a singular role and has multiple components.  A structural musculoskeletal definition of the core involves the complex interaction of non-contractile structures (the spine, ribs and pelvic bones) and contractile muscular structures, these muscle groups generate and maintain force providing both core strength and stability (Akuthota et al. 2008).  The thoracolumbar fascia connects the upper and lower extremities enabling the integration of the kinetic chain principle of force transfer.  It is also connected to the internal obliques (IO) and transverse abdominis (TrA), aiding spinal stability. Moreover the abdominal muscles, TrA, rectus abdominis (RA), IO, external obliques (EO) control the position of the spine (Sharrock et al. 2011). The diaphragm also contracts prior to limb movement to assist with spinal stability.  The muscles involved have been further divided into local, with attachments to lumbar vertebrae influencing inter-segmental control, and global with attachments to hips and pelvis influencing spinal orientation (Hibbs et al. 2008).  In addition, muscular stabilisers of the shoulder and lower limb (latissimus dorsi, pectoralis major, hamstrings and quadriceps) attach into the core of the pelvis and spine (Kibler et al. 2006).

Core stability as discussed, includes passive (skeleton, ligaments, facet joint articulations), active (muscular) structures and neuromuscular (neural) components (Akuthota et al. 2008).  The centre of gravity is located anteriorly to the sacrum and provides the basis for the musculoskeletal structures incorporated into the core (Key, 2013) and during dynamic movements segmental or local musculature maintain stability with global musculature providing force and movement (Hamlyn et al. 2007).   Thus, the core provides a stable anatomical base allowing for functional and dynamic movements to occur (Kibler et al. 2006).  For example effective reaching, grasping and lifting and other upper extremity movements require dynamic stability of the shoulder girdle on a stable trunk (Miyake et al. 2013).   In addition, an effective core enables the transfer of force production to the peripheries by minimising shearing, translational and compressive forces of the spine (Lee 1999, cited Hibbs et al. 2008, Akuthota et al. 2008). 

Therefore, the structure and location of the core is important for movement, control and the co-ordination of movement. This improvement can be measured in a variety of aspects including an improvement in running speed and acceleration, throwing distance, vertical jump height and increases in isometric strength tests (Hibbs et al. 2008).  To complete sporting tasks such as running, throwing and jumping the whole kinetic chain combines to allow the production and transfer of force generated by distal and proximal musculature.  The activation of proximal musculature, in the core, increases the activation of distal musculature therefore increasing the potential force created (Van Ingen Schenau G.J. et al. 1987, cited Kibler et al. 2006).  For example in running, the hip and pelvic floor stabilise the spine as well as aiding the power generation in the lower leg, potentially allowing the athlete to run faster. The gluteal muscles stabilise the trunk over a weight bearing leg.  This allows power for forward movements such as running (Sharrock et al. 2011).

The development of core training in the attempt to improve athletic performance can be completed by enhancing force transfer through the body by improving proprioception, muscle recruitment and muscular control (Hibbs et al. 2011).

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