I was recently engaged in a conversation with Mark Young of Markyoungtrainingsystems.com about the preventablility/reduceability of low back pain, which morphed into talking about the transverse abdominis (TrA) and multifidi (M).  He sent over an article which I was vaguely familiar with titled “The Myth of Core Stability” by Professor Eyal Lederman.

I must state that the following review will probably sound like I am against what Professor Eyal Lederman has to say. This is not the case. I am only presenting my general thoughts or commenting on those ideas that I do not agree with, and the things that truly apply to us rehab/strength & conditioning professionals.

For the most part I agree with Prof. Lederman about the role of the TrA, the timing issue, and the strength issue. I start to find some problems with The single/Core muscle activation problems section.

• As health/fitness professionals we need to make sure the TrA and M are actually firing to ensure tha no dysfunction arrises between the local and global systems. Once TrA and M are firing, complex movement(s) can be added to reinforce proper coordination between the two systems
• Performing any exercises without trunk muscles is like performing a squat without the hip rotators/stabilizers in my mind. It can probably be done, but it will be very dysfunctional. I actually train a woman who has a diastatis recti from previous surgeries and her ability to perform some exercises is severely limited due to her weakened “core” muscles.
• As stated earlier in the article, “Just because in healthy subjects it [TrA] kicks off before all other anterior muscles, does not mean it is more important in any way. It just means it is the first in a sequence of events.” However, like a chain, when one link is missing, the rest of the sequence just does not work correctly. What happens when the mid and lower traps do not fire/are too weak? The upper trap becomes dominant and dysfunction arrises (neck pain, shoulder pain, etc).
• By ensuring that the TrA and M are firing, we can make sure that future dysfunctions may not arise. (I’m not even saying the dysfunction would be back pain).

CS and training in relation to motor learning and training issues

• The authors makes it seem like most trainers have most clients/pts train solely on their back. We all know this is not true.
• “Is it possible to train the trunk control to specific activity? Yes, and it is simple – just train in that activity and don’t worry about the trunk. The beauty of it all is that no matter what activity is carried out the trunk muscles are always specifically exercised.” But are they emphasized? Does this also apply to the upper and lower extremities? If to strengthen your core muscles all you have to do is your specific activity why do sprinters lift, why do pitchers lift, and why do jockies lift? Shouldn’t they just run, throw, or ride to improve their performance?
• “One wonders if David Beckham thinks about the ‘core’ before a free kick or Michael Jordan when he slam-dunks or for that matter our patient who is running after a bus, cooking or any other daily activities. How long can they maintain that thought while multitasking in complex functional activities?” I know the author must know this, but when motor learning progresses to the point where you do not need to think about the task any longer it then becomes a skill. It is known that when someone is a pro athlete they MOST LIKELY (not always) no longer have to think about their core, they just do it. When retraining a patient who has suffered a stroke, often “skills” cannot be performed without constant internal focus, and thinking about what muscle needs to be fired next. Skills such as feeding one’s self are digressed to “functional tasks”. Most patients/clients (not just post-stroke) are not considered “skilled” in their performance of CS, therefore; there does need to be much internal focus while initially training.

For the most part I actually agree with Prof. Lederman, but overall I just found this to be a strange paper. Was he writing to be controversial? Probably not, because he makes too many good points. But as Patrick Ward of Optimum Sports Performance in Tempe, AZ stated about this article, “if there is a better way to do it, then what is it?” If anything, this article will make you re-think the reasons for your training program.