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Sports Performance: Core Strength to prevent injury and support joint stability?
Enhancing core stability through exercise is common to musculoskeletal injury prevention programs. Definitive evidence demonstrating an association between core instability and injury is lacking; however, multifaceted prevention programs including core stabilization exercises appear to be effective at reducing lower extremity injury rates.
The importance of core stability for injury prevention and performance enhancement has been popularized during the past decade with minimal supporting evidence. Even though limited evidence exists, the integration of core stabilization exercises into injury prevention programs, particularly for lower extremity, is demonstrating decreased injury rates. However, a lack of consensus exists about the most effective exercises for optimizing core stability.
A universally accepted definition of core stability is lacking. Generally, core stability comprises the lumbopelvic-hip complex and is the capacity to maintain equilibrium of the vertebral column within its physiologic limits by reducing displacement from perturbations and maintaining structural integrity. Clinically and practically, this definition lacks a tangible, functional perspective that translates into principles for practical application of core stability assessment and training in active, athletic populations. Several authors have proposed a more functional perspective to describe the core as the foundation of the kinetic chain responsible for facilitating the transfer of torque and momentum between the lower and upper extremities for gross motor tasks of daily living, exercise, and sport. Core stability necessitates instantaneous changes by the central nervous system to elicit appropriate combinations and intensities of muscle recruitment for stiffness (ie, stability) as well as mobility demands of the system. It is important to know the function of the relevant anatomy when developing core stabilization training for injury prevention purposes.
Core stability exercises are implemented according to the theoretical framework that dysfunction in core musculature is related to (musculoskeletal) injury; therefore, exercises that restore and enhance core stability are related to injury prevention and rehabilitation.
Substantial evidence exists demonstrating core muscle recruitment alterations in low back pain (LBP) patients compared with healthy controls. The transversus abdominus and multifidus—local stabilizer muscles—display changes in recruitment and morphology that limit their ability to effectively stabilize the spine and provide accurate proprioceptive information. Hodges et al examined core muscle recruitment patterns during upper and lower extremity movements in LBP patients compared with healthy controls. Consistently, the transversus abdominus was the first muscle recruited, followed by the multifidus, obliques, and rectus abdominus. All local stabilizer and global mobilizer core muscles were recruited before any extremity movement, indicating that core muscles provide proximal stability for distal mobility. In the LBP patients, transversus abdominus recruitment was delayed in upper and lower extremity movements in all directions (flexion, extension, abduction). Multifidus and internal oblique recruitment in patients with sacroiliac joint pain during an active straight-leg raise maneuver was delayed until after the leg raise was initiated, indicating a lack of preparatory activation for proximal stability. The gluteus maximus activation was also delayed, suggesting an inability to compress and stabilize the sacroiliac joint and pelvis with associated lower extremity movement. Overall, these studies illustrate alterations in muscle recruitment, suggesting that deficiencies in core stabilization and load transfer muscles may be related to lower extremity function and injury.
Various progressions can be used to increase the intensity of exercises and the stability demands on the core. Recommended progressions include extremity movements during stabilization exercises, instability on devices or surfaces, and functional sport-specific training. Stabilization progressions from isometric contractions to limb movements improve muscle recruitment and may better translate to athletic activities.
Core stability focuses on maintenance of neutral spinal alignment, optimal trunk position, and the transfer of loads along the kinetic chain. A variety of assessment tools can be utilized to evaluate core stability. A multifaceted approach is recommended utilizing tests for muscle recruitment, endurance, neuromuscular control, and fundamental functional movement patterns. Core stability should be trained in a progressive fashion, beginning with local muscle recruitment, moving to core stabilization in a variety of postures, and then transitioning into total body dynamic movements.
Teach athletes to "stop before they go"? Nonsense?
Improving your ability to slow down and stop rapidly might seem totally at odds with the goal of improving sports performance; but, specific deceleration training drills will not only improve speed around the field or court, but can also reduce the risk of injury.
Speed is often the factor that separates the elite from the average athlete. But there's more to speed than running fast in a straight line. For most sports, you need to be able to cut and change direction.
The faster you can slow down, the quicker you can change direction and re-accelerate to your top speed. Yet, deceleration—the ability to slow down and control force production—is often ignored during training, which usually focuses primarily on acceleration and top speed. In fact, many athletes only work on the first of the three ways we move:
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Concentrically - to create acceleration and force production
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Isometrically - to stabilize or balance
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Eccentrically - to decelerate and decrease force production
Improving deceleration technique is critical for most sports since players rarely run in a straight line. With over 200,00 ACL injuries a year—not to mention MCL and LCL injuries—due to deceleration, this technique must be taught to keep you healthy and strong.
An important physical aspect used to aid in deceleration is the lowering of the hips or maintenance of hip height. If the athlete is going to stop, the hips must lower to create a better balance situation and to control momentum. If the athlete is going to make an oblique cut and needs to escape, the hips do not actively lower. The hips may lower due to the angle of the cutting leg being outside of the vertical axis of the body which automatically lowers the hips. By not lowering the hips too much the cut can be quick and allow the athlete to maintain speed. The last reason for lowering the hips would be if the cut is acute. In this case, the athlete will need to control speed by lowering the center of mass and slowing the body to allow the cut to be made without moving off the intended path.
The last physical aspect of decelerating is the synergistic movement of the hips and feet to make deceleration safe and effective. Below are a few deceleration exercises I teach and my athletes practice on a daily basis when decelerating from linear running.
First, set up a cone approximately 10 yards from the athlete. Begin with the athlete running at half speed to the cone. As the athlete becomes familiar with the movement, then advance to full speed. The deceleration technique used is as follows:
-The athlete will turn the hip and the foot to the right or left to avoid any torque on the knee, ankle, and hip. The planting action looks like a stopping action of a lateral shuffle. As soon as the plant has occurred, the athlete will back pedal out of it back to the start. The next time have the athlete turn the hip and foot to the opposite side. It is important to develop symmetry in planting.
The second drill resembles the first except it is now random. As the athlete approaches the 10-yard cone, the coach will point to the right or left. The athlete must react and quickly turn the hip.
*It is important to remember, an athlete will decelerate and stop in order to go backward if the ball or opponent is passing by or going over head. If the athlete was to plant the foot straight ahead with the hips and legs facing straight ahead, then the recovery back is going to be too slow and possibly dangerous if the athlete accidentally rotates the foot inward while the hips and legs are still straight.
In the last drill, have the athlete decelerate using the same technique above but now turn and run in the opposite direction. This resembles many sport situations, such as a tennis player chasing down a lob, a baseball outfielder redirecting for a pop fly or a soccer player recovering from a long kick over the head.
The final progression is forward and backward deceleration. There are many more advanced techniques and progressions I use with athletes, but I will keep it simple. This drill is performed like the first drill, however, the athlete will backpedal to the start using good backpedal techniques (nose over toes). At the starting position the athlete will decelerate on the backpedal by planting the right or left foot behind the body as the shoulders move forward to allow for an acceleration back to the end 10-yard cone. Let’s review, run forward and decelerate, then backpedal to the start and decelerates and finish back at the 10 yard cone. This is a great drill to see reversibility efforts by your athletes. Watch for high shoulders and poor planting technique. These two things will surely slow down your athletes’ movement.
Keep in mind the deceleration technique and skills mentioned above is a small percentage of the deceleration techniques that should be taught. I specifically wrote about decelerating from a linear run and back pedaling or running out of the deceleration. There are many other stances and positions an athlete must stop from. Athletes play defense in many positions directly related to the situation at hand. The quicker they can decelerate and recover or accelerate, the better athlete they will be.
Sports Nutrition: Fuel your Speed
What kind of fuel do you put in a high perfomance sports car? What about a Jet? Today, lots of athletes put things in their bodies that enhance or deminish their sport performance.
Athletes don’t just eat. They eat and drink to fuel, build, recover, and repair. And when we’re talking “athletes” -- everyone is an athlete, whether you are training for a particular sport, event or you’re simply training for life. Regardless of what a person is training for, it’s crucial to look at the overall quality of everything consumed—food and beverages. With that said, let’s take a
look at some specific guidelines and recommendations that, when coupled with a sound exercise regimen, such as that outlined with the Combine360, can cause you to lose fat, while preserving as much muscle as possible in the process.
Food Selection.....
First things, first ... it’s not just the total calories that matter, but also where these calories are coming from. First, remember that carbohydrates are not the enemy; they too can and should play a role in an overall healthy diet, whether you’re trying to lose fat, gain muscle, or even just for general health. The specific carbohydrate needs vary from person to person; an endurance athlete, for example, would need more whole grain carbohydrates to fuel their performance, while someone who’s going to the gym a handful of times each week would notneed as much.
Of course we know that protein is also crucial; it’s imperative for helping preserve as much muscle as possible during a fat loss program, assist with recovery from training, and provide essential nutrients for basic health and performance.
Finally, let’s take a look at fat. Like carbohydrates, fat has been put on a roller coaster over the last few decades. It was demonized in the early 90’s and embraced over the last few. Some avoid it like the plague and others think it’s wise to eat coconut oil by the spoonful. The fact of the matter is fat is crucial to an overall healthy diet; it provides a variety of essential fatty acids that cannot
otherwise be consumed. So how much should we eat? Well, sit tight for a bit and remember, quality is just as, if not more important, than total quantity. So let’s make this simple. Without delving into a million different equations and mapping out a food label like something used to navigate the globe, let’s take a more simple approach. When eating, I urge you to divide your plate or bowl into three sections, like that outlined below. This way you have all components covered---healthy protein, whole grain carbohydrates (think fiber, not carbs), and some healthy fats.
Nutrient Timing
Looking at some of these food “rules” a little more closely when it comes to performance here are some basic guidelines for eating around a workout.
Before Exercise
Before beginning any training session, game or competition, athletes need to be fully fueled and hydrated. When both these needs are met, muscles are energized and ready to work. Most people feel and perform best when they can eat around 2-4 hours before training. Of course this isn’t always possible for early morning workouts, but when it is the foods eaten can have more “substance” and offer more energy. The meal/drinks selected pre workout depend on timing. The closer a person is to a workout, the less they should eat. Regardless of timing, though, the meal or snack should be carbohydrate dominant since carbs provide most of the energy for the workout itself. Heading into a workout or game, aim to drink around 2 cups (16 oz) of water or sports drink. Water will help hydrate, while the sports drink will provide carbohydrates and much needed electrolytes during a workout.
During Exercise
This feeding/hydration period is particularly important for those working out longer than 60 minutes (think endurance athletes). If you fall into that category, the primary fuel during this time should be carbohydrates (think sports drinks) and some protein. Again, though, a typical workout in the gym ... there’s not much concern for this feeding/refuel period.
Post Exercise
The goal after exercise is to speed the recovery process by replenishing depleted glycogen stores (stored carbohydrate), repairing and building muscle tissue, and replacing lost fluids. A strategy for rapid recovery may be important if an athletes has a second training session or competitive event in the same day. For optimal recovery, consuming carbohydrates as soon as possible (ideally within 30 minutes) will be critical. Further, adding some protein, or including protein, is important to help rebuild and repair damaged muscles. A sports drink helps during this time because it also helps provide much needed electrolytes
that are lost with the sweat.
There you have it. Some simple nutrition tips that can apply to you,
regardless of your situation, athletic ability, or skill set.