The inclusion of core stabilisation exercises in training and preventative programmes is essential to protect an individual from injury and improve athletic performance.
This is because the core represents the centre of the functional kinetic chain, playing a critical role in maintaining effective dynamic joint stability from the foot all through to the lumbar spine.
As mentioned in a study conducted by Wilkerson et al., core stability is defined as “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 terminal segment in integrated kinetic chain activities”.
While studying the prediction of core and lower extremity strains and sprains in collegiate football players, the authors established that suboptimal endurance of the core musculature and low back dysfunction are associated with impaired neuromuscular control of the body’s centre of mass.
These are also responsible for inhibiting lower extremity muscles and increasing the chances of injury leading the authors to advocate individualised core stability training regimens and pre-participation screening of injury risk as a measure to protect and prevent core and lower extremity injuries in collegiate football players.
Kellie Huxel Bliven, from the Department of Interdisciplinary Health Sciences at AT Still University in Arizona, reviewed articles with literature pertaining to core stability risk factors, assessment and training.
The author established that substantial evidence exists to correlate core muscle recruitment alterations and low back pain; the transversus abdominus recruitment was found to be delayed in the upper and lower extremity movements of patients with low back pain.
In addition to this, the gluteus maximus activation was also observed to be delayed, suggesting an inability to compress and stabilise the sacroiliac joint and pelvis with associated lower extremity movement.
The prevalence of an underlying biomechanical disturbance such as a hyperpronated foot can hamper successful outcomes in the treatment of low back pain; this is why a comprehensive management strategy should include customised foot orthotics such as MASS4D®.
Abnormal foot pronation causes an excessive internal rotation of the ipsilateral tibia and ipsilateral femur leading to a knee valgus and consequent increase in the Q-angle.
The resulting compensatory abnormality in the form of an anterior ipsilateral pelvic tilt can exert significant pressure on the muscles of the low back, further increasing the risk for lower back pain.
The role of MASS4D® orthotics in a preventative care programme for lower back pain would be to augment the efforts of individualised exercise routines by providing the greatest supportive force to the feet in order to minimise the occurrences of compensatory movements in the lower extremity and reduce stress on the lower back muscles.
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