The Myth of Core Stability
This article is posted with the written permission of the author, Professor Eyal Lederman of CPDO Ltd. in London. Thanks to Steve Turner for making me aware of the article and to Professor Lederman for allowing me to post it here.
This is important reading for anyone involved in exercise, either professionally or for their own health and fitness, and especially for those who train individuals with or have lower back pain, as it addresses many of the myths of the current core and stability training trends.
The Myth of Core Stability
Professor Eyal Lederman
CPDO Ltd.,
15 Harberton Road,
London N19 3JS,
UK,
E-mail: cpd@cpdo.net
Tel: 0044 207 263 8551
Abstract
The principle of core stability has gained wide acceptance in training for prevention of injury and as a treatment modality for rehabilitation of various musculoskeletal conditions in particular the lower back. There has been surprising little criticism of this approach up to date. This article will re-examine the original findings and the principles of core stability and how well they fare within the wider knowledge of motor control, prevention of injury and rehabilitation of neuromuscular and musculoskeletal systems following injury.
Key words: Core stability, transverse abdominis, chronic lower back and neuromuscular rehabilitation
Introduction
Core stability (CS) arrived in the latter part of the 1990’s. It was largely derived from studies that demonstrated a change in onset timing of the trunk muscles in back injury and chronic lower back pain (CLBP) patients [1, 2]. The research in trunk control has been an important contribution to the understanding of neuromuscular reorganisation in back pain and injury. As long as four decades ago it was shown that motor strategies change in injury and pain [3]. The CS studies confirmed that such changes take place in the trunk muscles of patients who suffer from back injury and pain.
However, these findings combined with general beliefs about the importance of abdominal muscles for a strong back and influences from Pilates have promoted several assumptions prevalent in CS training:
- That certain muscles are more important for stabilisation of the spine, in particular transverses abdominis (TrA).
- That weak abdominal muscles lead to back pain
- That strengthening abdominal or trunk muscles can reduce back pain
- That there is a unique group of “core” muscles working independently of other trunk muscles
- That a strong core will prevent injury.
- That there is a relationship between stability and back pain
As a consequence of these assumptions, a whole industry grew out of these studies with gyms and clinics worldwide teaching the “tummy tuck” and trunk bracing exercise to athletes for prevention of injury and to patients as a cure for lower back pain [4, 5]. At that point core stability became a cult and TrA its mantra.
In this article some of these basic assumption will be re-examined. In particular, it will examine:
- The role of TrA as a stabiliser and relation to back pain: is TrA that important for stabilisation?
- The TrA timing issue: what are the timing differences between asymptomatic individuals and patients with LBP? Can timing change by CS exercise?
- Abdominal muscle strength: what is the normal strength needed for daily activity? Can CS exercise affect strength?
- Single muscle activation: can single muscle be selected? Does it have any functional meaning during movement? Read more…










