So far with the Bison we have looked at general exercises to improve core stability, last week we started to look at the Herd as individuals. We have previously looked at areas where the guys are using movement patters that are not correct. We have related these along movement pathways back to the core stabilisers.

Here is Jeff working on his core stability.

The abdominals, gluteals and shoulders are tight, the head is flexed and the shoulders extended. In this position with his level of strength and fitness he should be as rigid as a farmhouse table. This exercise continues with him transferring weight off one hand without moving anything other than that hand, then the same for a leg.

We think he looks like a Bison with the high shoulders and tight middle, just needs to work a little on the horns, but then you always suspected Jeff had horns under the helmet.

The most important areas for prevention of recurrent injuries are the core muscles, these muscle groups need to be trained not only in terms of strength but also in co-ordination and responsiveness. The muscles of the core are partly voluntary (that is to say you can use - activate - them for movement when you want to, for example to turn over in bed) and partly involuntary (they are activated automatically, for example when you slip on the ice).

If the muscles of the core are weak then simple strengthening will help, however if they are inhibited because your body does not know how to use them you need to train them to improve their responsiveness and co-ordination.

Jeff drops a ball weighing 3 kilos, (7lbs) for Michael to catch.

Not a problem, but he has to time his core stability activation with this so that he resists movement when the impact comes. He has to resist any twisting movement if the ball falls to the side. This exercise is made more difficult by coming into a slight abdominal crunch or by doing a slight hip raise.

Most people have a concept that ‘core stabilisers’ is another expression for abdominal muscles, but the core stabiliser work all around the trunk and they include all the postural muscles of the spine. The function of the core muscles is to stabilise the trunk from the shoulders to the pelvis so that it forms a stable base against which force can be applied through the arms or the legs to make movement most effective. This is as important for an elite sportsman as it is for any of our low back pain patients.

Weak or inhibited core stabilisers allow the forces applied by the arms or the legs to be absorbed by the body, which reduces the speed and power with which movement can be made. When a force is applied to the body it is also absorbed by the core, sometimes resulting in injuries.

Jeff and Michael work with a hockey stick to improve stability.

The ball will roll away if you do not stabilise in the middle of it. The only way to hold that position is to tighten the core stability muscles. Just pushing back will make the ball roll away. Michael can change direction without Jeff knowing and this will test his ability to hold firm rather than push against the force.

Session 4

Having started to look at the Herd as individuals last week we now need to work more on their understanding of their problems. As you know sadly the guys will be taking their summer break slightly sooner than expected and we are looking at their individual summer training routines now. For any of you hoping to make it to this league of Hockey, or just wanting to work on your fitness we hope to publish the training programmes over the summer.

As many of the core muscles are involuntary (automatic) they have the capacity to over react and cause spasm, this cannot be controlled by the patient. Most back injuries are not particularly traumatic but relate to an over reaction of the muscle in the area of very minor injury. Simply by improving the responsiveness of the core muscles to such forces you can reduce significantly the likelihood of the back going into spasm.

Training the responsiveness of the core stabilisers will help ‘wake up’ those areas that are not used and make the body respond in a much more organised way resulting in greater stability and more effective use of power. In a sportsman this increases their performance and reduces the chances of injury.

On working with the Herd the most obvious weakness was in side strength. This is a classic postural weakness and causes overuse of the abdominals in an effort to compensate. The result is instability in a patient who has apparently very strong abdominal muscles. The abdominals have been used as a substitute for side stability, this appears to work, but when the guys take a side hit there is no defence.

Working on the ball Jeff and Michael do some synchronised core stability working on those transverse, oblique (internal and external) and quadratus lumborum (QL) muscles.

Core stability is not just all about bad backs, having a stable core means that forces applied with the legs or arms occur in the intended direction. If the muscles of the core do not hold the body stable under load the intended force is dissipated and controlling it becomes difficult.

Injuries to large joints surrounded by powerful muscles such as the hips, knees and shoulders usually occur because of a complex combination of muscular effort most of which is in an effort to stabilise the joint while it transmits the force. This effect is significantly increased in a body which has an unstable core. The result is far greater effort used to less effect and a much higher risk of injury.

Here two guys co-ordinate abdominal, gluteal and hamstrings singly and in combination with the added complication of having to balance on the ball. The hands are not used for balance here which is and advanced position.

Basic core stability is learnt as a baby starts to become mobile, firstly lifting its head, then pushing up with the arms and hands, bringing the knees up to the sides and lifting the body into the crawling and then the standing position. If a stage of development is missed out, for example, through a period of depressed development, possibly just a few weeks of illness, the body may never learn that movement. Some very fit sportsmen may be unaware of such a weakness because they learned to compensate for it.

Identifying these fundamental weaknesses is a priority in advanced core stability work. Balance is a key factor and sense of body position is very important in balance.

Here Jeff and Michael work to improve their balance and position sense. Single leg stands with eyes open should be done by patients for 30 seconds, and with eyes closed for 10 seconds.

Dropping into a controlled squat should focus on keeping the knee pointing forward all the way down. This ensures the even use of the thigh muscles.

Controlling the joints and knowing the position of, in this case, a leg while in an extreme balance helps direct a force.

Holding a shoulder balance on the ball is OK but to then hold it with one leg extended is a lot tougher, but it need only be held long enough for the click of the shutter! Some work to do there guys.

But seriously all this ball work needs to be pushed not just to improve strength but to put both the players, and those fans who want to work on their basic fitness and keep healthy, into a position where the core muscles switch on automatically under load. Co-ordinating core stability with balance and putting a controlled force through a leg really tests the stability and strength.

Next week we will be using plyometrics to show the guys how to bounce a force back off their stable core.