Before offering a potentially helpful answer, we need to clarify what we mean by the ‘core’. Core (or corset and shunt) muscles are those whose main role is to maintain skeletal joints in their ideal position with various postures and when guiding the joints through their range of motion when we move – so the joint movements are smooth with no jolting. In order for them to do this job properly, these muscles need to have the maximum mechanical advantage when they contract. This typically means they are quite close to the joints so that when the more superficial muscles do the grunt work of moving us in all sorts of ways, the deeper core muscles can provide control and stability for the joints.
For example, when it comes to the core muscles that provide stability to the lumbar spine – important for protecting both joints and discs from excessive movement – current understanding is that short spinal, pelvic floor, diaphragm and abdominal muscles need to be able to work as a coordinated team. Like many things that the amazing human body does, this is indeed a complex task. While there is a requirement for a minimum degree of muscle strength, research is increasingly showing that timing, order and degree of muscle contraction are the vital ingredients.
So, for a range of injuries that can be classified as overuse or repetitive – such as types of neck/lower back pain, groin/hamstring/shoulder rotator cuff problems among others – it is important that assessment of the integrated stabilising system of the body frame is included in overall injury management. This means that the various ingredients – including muscle contraction timing, order, degree and strength – need to be evaluated by the sports care practitioner. For key faults identified in each case, customised strategies should then be provided that aim to address the faults. This would ideally involve the patient being taught a range of specific exercises where the focus is particularly on performing them with the best quality. The sports practitioner may also need to provide certain manual clinical procedures that aid this process so that the patient is able to achieve better quality postures and movements during their sport.
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