Muscular Balance, Core Stability and Injury Resilience


Most injuries of the track athlete can be classified as “overuse.” An overuse injury can be defined as any injury of the musculoskeletal system that results from the combined fatigue effect over a period of time beyond the capabilities of the body to regenerate itself. These overuse injuries  can often turn to chronic, nagging issues that can sideline an athlete for days, weeks, months, even a season or more.

So why is this an issue that can’t be ignored in the youth athlete? “As far back as 1992, an article published in the journal Sports Medicine showed that an athlete is 2.6 times more likely to suffer an injury if an imbalance in hip flexibility of 15 percent or more existed.

And it’s not just those who play sports who are at risk. “About 65 percent of injuries—both athletic and lifestyle-related—come from overuse, which is repetitive use of joints that are rendered dysfunctional by muscular imbalances,”says Mark Verstegen, president and founder of Athletes’ Performance and Core Performance”

 

What is a muscle imbalance?

“Put simply, muscle imbalance occurs when one muscle, or group of muscles, works harder than it should while other muscles don’t work hard enough. That’s it. It may not sound serious, but it can cause a wide range of problems, including sore shoulders, low energy, an aching back and even poor posture. Simply exercising harder doesn’t solve the problem!

The muscles in our bodies are designed to work in balanced symmetry, much like the wheels of a car. When some muscles get lazy and others have to take up the slack, this can’t happen. On a car, we might notice that the tires are beginning to wear unevenly, or that we’re getting poor gas mileage. But it’s different for our bodies. It may not cause obvious problems—we can run, walk, stand, sit, lift and twist without much difficulty. The truth is that very few of us have bodies without some form of muscle imbalance no matter what the age. But the good news is that with proper exercise  these can be corrected.”.

While there is no single universally accepted definition of core stability, a general definition of core is the ability to control the position and motion of the trunk over the pelvis and leg to allow optimum production, transfer and control of force and motion to the end segments of the kinetic
The core muscles are anatomically referred (in general terms) to the muscles forming around and the trunk of the body including the abdominal, oblique (sides), mid and lower back.  Although a portion of the core is visible surface muscle, most of the muscles that make up the core are deep tissue muscles layered underneath.The functional role of the core muscles are to make you stronger.    Although they are the major contributors to increasing strength, the core muscles are responsible for many of the things we take for granted in everyday living. In terms of running, a strong core helps the runner have adequate  knee lift,a balanced controlled pelvis and longer, more efficient stride length. Read more about sprinters and core strength here

Injury Resiliency training is a form of prehab/rehab training  designed to identify and address the athletes weak links (muscles imbalances) and  in some cases the resulting injury with functionally sound and progressive personally designed(in most cases by a trained sports professional) workout programs that is part of the athletes training regiment to help  him become stronger functionally more efficient and thus improved performance.

Common overuse injuries I see often are, iliotibial band pain, lateral knee pain, hamstring tightness/strain, plantar fasciosis, and Achilles tendinosis. Each condition/injury requires a specific treatment plan tailored at restoring proper function of the related musculature.

Although every athlete will require their own program based on their individual dysfunctions, one thing that remains constant in treatment and rehabilitation is that a stable core and strong foundation of muscular balance is essential for success. Weakness or lack of sufficient coordination in core musculature can lead to less efficient movements, compensatory movement patterns, strain, overuse and ultimately injury.

 

Efficient biomechanical function to maximize force generation and minimize joint loads in all types of activities ranging from running to cycling is very important to say the least. A good example of “core dysfunction” is weak hip muscles and resulting alteration of hip/trunk position at foot strike while running. This so common and often times over looked in the youth running and sprinting population.

The above  finding is often associated with knee injury. Alterations in hip muscle activity are associated with increased hip “drop” and hip flexion positions which increase knee loads in activities requiring body weight acceptance. Recent studies have looked at core stability parameters and found that weakness in hip external rotation is correlated with incidence of knee injury.

There are thousands of core exercise to choose from, so where does the athlete start? Exercise programs need to be specific for the sport and the athlete. The goal of training should be specified and the exercise prescription has to match your needs. A long-term successful outcome and prevention of injury are more likely if the focus of training is on restoration of function, rather than a specific tissue or injury. A proper gait analysis and movement screen by a health professional specializing in our sport can help point out areas of dysfunction and start the athlete on the road to recovery and prevention.

Remember, the ultimate goal of core stabilization is to train “movements” and “positions” rather than muscles. Exercises are most effective when they mirror the demands of the athlete’s sport. When the system works efficiently, the result is appropriate distribution of forces, optimal control and efficiency of movements, adequate absorption of ground reaction forces, and absence of excessive compression, translation or shearing forces on the joints of the kinetic chain.

References

·  Mark Verstegen, author, Core Performance, Core Performance Essentials, Core Performance Endurance, Core Performance Golf, (Rodale, Inc.)

  • Gray Cook, author, Athletic Body in Balance (Human Kinetics Publishers)  (I have worn this book out and purchased again after I lost it. It’s that good)
  • Lyle Micheli, MD, author, The Sports Medicine Bible for Young Athletes, Sourcebooks, Inc.
  • Muscle Balance Lecture Notes, Department of Physical Education, Health, Dance, & Athletics, Los Angeles Trade-Tech

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