Core strategies

The role of the core, and the strategies used to engage and train it is a hot topic. There still does not appear to be evidence to show that core specific training has any added benefit over other exercise modalities for patients with chronic low back pain. Dr John Booth discusses two main core activation strategies: 1. Hollowing - a gentle co-contraction of transverse abdominis and multifidus - recommended in cases of known spinal instability, eg spondylolisthesis, and early - mid post back operation, eg discectomy 2. Bracing - co-contraction of all the abdominal musculature, erector spinae, glutes - recommended for heavy resistance training and manual tasks These two strategies sit on a continuum, and the approach will depend on a patient's history, condition, pain levels, function, and lifestyle. Strategies may change and they need to be included in a program of regular activity, better movement patterns and the restoration of function.

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