Nick

Tumminellos

Core Training:
Facts, Fallacies
& Top Techniques

Workshop Objectives
- Discover the Performance U approach to

core-training.

- Demonstrate the technique and application

of the top core training methods used in the

Performance U approach.

- Separate Facts from Fallacy about the TvA,

Psoas, Posture, Performance and Low Back

Pain.

Who the heck is Nick Tumminello?

Live in South Florida
Owner of Performance University

International

Consultant to several training equipment

and clothing manufactures

Writer / Contributor for over 20 major tness

magazines

Featured in 2 NY Times Best Sellers

Featured in ACE PT Manual, 4th Edition
Produced 12+ DVDs
International Fitness Presenter
Trained Pro / Amateur Bodybuilders, Pro /

Amateur Figure Athletes, MMA Fighters, NFL

Players, and lots of exercise enthusiasts!
Teach professional mentorships

The BIG Question

What is
the
Core?

The Core Made Simple!

The core is your entire

torso! (w/o arms & legs)

All the muscles that
surround your spine: Neck,
Glutes, Abs, Back,
Scapular, Pecs, Obliques,
etc.
The term The Corewas
rst published in 1982 by
Gajda & Dominquez in
their book Total Body
Training

What is Core Training?

The foundation of Total Body
Training is the core, which
compromises the muscles in the
center of the body. These muscles
stabilize the body while in upright,
antigravity position or while using
the arms and legs to throw or kick.
These muscle maintain the bodys
structure during vigorous
exercises such as running,
jumping, shoveling and lifting
weights. These muscles also also
control the head, neck, ribs, spine
and pelvis

What
does
the Core
do?

3 Primary functions of the Core

Respiratory (during active

expiration)

To transfer force from the

hips to the shoulders. The

Core X-Factor.
Ex: Overhead Press

To help produce force:
Force summation (of all
your levers) = Power.
Ex: Swinging a Baseball Bat.

How we train to enhance the Cores

function:
We use the SAID principle to design exercises that require

the core to do its job: Transfer force or Help in Force

Summation.

An organism makes specic adaptations to imposed demands (1)

(Mathew & Fox, 1976)
The simplest and most straightforward way to implement the principle of
specificity is to select exercise similar to the target activity with regard to
the joints about which movement occur and the direction of the
movements.(2)
Dr. Everett Harman, "Essentials of Strength & Conditioning.

We use the principle of overload to progress these

exercises for continued strength.

The Performance U Approach to

CORE POWER
TRAINING

The Summation of ALL Your Levers

It our belief that the core has an active role, not ( just) a
passive role in force production during swinging (a Bat ,
Racquet, Club, etc.) to throwing and striking.

Sports Involve Speed!

Fighters need to activate muscles
extremely quickly and then be able to
relax them to allow the middle section
(speed generation of the foot) of the
double pulse of activation to happen.
Dr. Stuart McGill
This is also applied when Dr. McGill
measured the muscle activities of
great distance hitters in golf. They
are not necessarily the strongest, but
long distance golf hitters have this
wonderful gift of creating a pulse at
the instant the club hits the golf
ball.(3)

Research: Tri-Phasic EMG

-Elbow extension movements at speeds

ranging from ballistic (FAST) to very slow.

-The results showed that triphasic EMG patterns
developed systematically.
-Slow elbow extension movements were
produced by a single continuous activation of
the agonist triceps brachii muscle.
-Agonist activation became predominantly burst-
like and other components of the triphasic EMG
pattern [activation of the antagonist (Ant) and
second agonist activation (Ag2)] began to
appear.
-At the fastest movement speeds, triphasic
EMG patterns (Ag1-Ant-Ag2, Ag1 being rst
activation of agonist muscle) were always
present. (4,5,6)

The Take Away

Slow (heavy) exercises or isometrics dont rene

the tri-phasic muscle-ring pattern.

Our Specic exercise applications for force

summation involve fast speed and Momentum

- Especially Rotary actions!

Our Top Fast (MET) Exercises:

THROW STUFF!
MB OH Throw / Step (We dont do Slams)
MB Chest Throw w/ Step
MB Rotary Throws (Punch, Front & Side
Scoop)
MB Reverse Scoop
HIT SHI#
- Punching, Elbows, Kicks, Knee Strikes
- Gladiator Twist
- Hammers

Our Top Fast (MET) Exercises

Cont.
Tight Rotations (MB,ABB, BW)
Gladiator Twist (w/o bag)
DB Punches
KB Rotary swing
Sprinting

Quick review!
We use the exercise applications just discussed
to:
Enhance to bodys ability to summate force using
all of its levers: the Legs, Core and Arms.
To match the force production patterns of fast,
sporting-type actions.

Direction-specic properties of power and agility: Training should
match the force production patterns of how athletes move in
competition (7) (Homan et al., 2007).

To rene the tri-phasic EMG ring pattern.

Science!
Because sequential kinetic linking
plays such a vital role in rotational
power, fundamental exercises that
enhance trunk and core strength are
essential for success. Furthermore,
ground reaction forces generated by
the large muscles of the lower body
provide a base of support to transfer
kinetic energy through the core,
resulting in a more powerful kinetic
link. (8)
Frank J. Spaniol, EdD.
Developing Power to Turn,

Core strength does

have a significant effect
on an athlete's ability to
create and transfer
forces to the
extremities (9)
(Shinkle, Nesser, et al.
2012.)

The Performance U Approach to

CORE STRENGTH

TRAINING

We use 2 types of Core

Strength Training:
Integrated: Compound Core (CCT) &

Core Limited (CLT)

Targeted (focusing on specic

muscles of the core)

One of the MANY Common Fitness

Training CONTRADICTIONS:
- I train movements, not muscles
- Integrated (complex) exercises before isolated
(simpler) exercises
- We start each workout with specic core exercises
because the core is the most important part of the
body.

The Performance U training approach applies the
SAME training logic to everything we do!

Full Spectrum Core Strength

Training:
- FSCT approach prioritizes Core Limited

Strength (CLT) and Compound Core exercise

applications.
-It does NOT prioritize the Bench Press (1 of

the 3 big lifts), but it is still used because its a

great pushing exercise.
- Can your core control the force you can create?

(the muscle imbalance no one talks about!)

- The TRUTH About the Bench Press

The Truth About the Bench Press:

- This study compared the standing cable press (SCP) and the traditional bench press (BP) to

better understand the biomechanical limitations of pushing from a standing position

together with the activation amplitudes of trunk and shoulder muscles.

- In addition, the model predicted that pushing forces from a standing position

under ideal mechanical conditions are limited to 40.8% of the subject's body
weight.

- For the 1RM BP, anterior deltoid and pectoralis major were more activated than most of the

trunk muscles. In contrast, for the 1RM single-arm SP, the left internal oblique and left
latissimus dorsi activities were similar to those of the anterior deltoid and pectoralis major.

- Our EMG ndings show that SCP performance is limited by the activation and

neuromuscular coordination of torso muscles, not maximal muscle activation

of the chest and shoulder muscles. (10)

Santana JC, Vera-Garcia FJ, McGill SM.

J Strength Cond Res. 2007.

The Take Away!

- Unless youre a powerlifter or

training for a Bench Press (combine)

test; the bench press is just another
compound exercise application its
not magic - to strengthen your chest,
shoulders and triceps.
- Squats & Deadlifts are awesome

because they are CLT!

- We feel the best core training is

infused with pushing, pulling,

squatting, etc. movements. (The
SAID Principle)

One-Arm Push ups

(Done Better than Rocky Displayed)

Our Top CCT & CLT Exercises

PUSHING
- Push Ups
-1A Push Ups

PULLING
- BO rows
-1A Free Standing Rows

-1A Cable Presses

-1A Cable Rows

-OH Presses (DB or BB)

-1A Compound Rows

-DB Uppercuts

-1A Motorcycle Rows

-Angled Barbell Presses

(Split Stances)

Our Top CCT & CLT Exercises

ROTATION

LOWER BODY (R&LCOM)

- Cable Chops

- BB Squats

-Plate Corkscrew

-1A Lunges

-DB Plank Row

-Deadlifts (DB,BB, Trap Bar)

-DB Uppercuts

-Front Squats

-1A Cable Press

-Zercher Squats & Lunges

-1A Farmers Walks (lateral)

Our Top 3 Hybrid CCT

Exercises:
TGUs (partials)

Cable Tight Chops

(High, Mid, Low)

Animal Patterns

SCIENCE!
The activation of the abdominal and lumbar
muscles was the greatest during the exercises
that required deltoid and gluteal
recruitment
An integrated routine that incorporates the
activation of distal trunk musculature would
be optimal. (11)

Gottschall JS et al. J Strength Cond Res. 2013

The Performance U approach to

TARGETED ABS
EXERCISES

We Use Targeted Abs Exercises

to gives us what the other
stuff didnt!
Build up the hardware! (To better Dissipate

Force)

CCT Work is mostly (anti) Rotary and

Lateral. We integrate in some targeted

work (mainly) for the anterior core (i.e. the
Abs).

TOO
DAMN
EASY!

Heres what we do instead:

For Upper-Abs: SB Plate Crunches (w/

stretch)

For Lower-Abs: Reverse Crunches

Your abs work together as a unit, but the upper
and lower abs are separately innervated and
you can be maximally load from the bottom up,
or from the top down.

Your Abs dont Flex your

spine when standing?

SCIENCE!!!

The Swiss ball roll-out and Swiss ball pike were the
most eective exercises in activating upper and lower
rectus abdominis, external and internal obliques, and
latissimus dorsi muscles, while minimizing lumbar
paraspinals and rectus femoris activity. (12)
Escamilla et al. J Orthop Sports Phys Ther 2010.

- Dont forget about the research on core exercises
that involve the hips and shoulders.

Our Top 10 (Targeted) Abs moves:

Medicine Ball Roll out
Swiss Ball knee tuck (modify for disc issues) OR

Swiss Ball Pike (+ Roll Back)

Stir the Pot
Pallof Press (2.0,Linear, lateral)
BB Rainbow
Leg Lowering
Posterior Reaches
Ab Snails
MB Side Lean
MB Around the World

Coaching Tips on using Abs

Exercises
For Increased Lordodic Individuals we use:

Swiss Ball Pike, Leg lowering, Linear Pallor

Press (Rev crunch; if using exion)

For Decreased Lordodic individuals, we

use: Roll outs, Bodysaw, Posterior Reach (SB

Sit up; if using exion)

REMEMBER! YOUR CORE IS YOUR

ENTIRE TORSO!
If you want a truly strong core - Dont forget
to

Strengthen Those Lats

Works with the glutes

to squeeze on the
spine. (Portereld &
Serosa)
Only muscle to
connect shoulders and
pelvis.
Biggest/Strongest
muscle in the upper-
torso.
Do your Chin ups, Lat
pull downs, Rows,
etc.:

Strengthen
Your Upper/
Mid-back!
Mid/Lower Traps,

Rhomboids, Serratus
Your shoulders work
with your hips The
serape eect Do your
Horizontal rows
(seated, BO, etc.)
Ys,Ts, etc.

Strengthen Your Pecs and Serratus!

Your Pecs and Serratus

are linked (through

facial connections) to
your obliques.
(Portereld & DeRosa)
Do your Pushing
exercises!
Great abdominal
exercises are the ones
that involve some
shoulder movement
Carl DeRosa

Strengthen your Lower-Back and

Glutes!
Do your Deadlifts, Hip

Thrusts, Good-Mornings,
etc.
Shout out to Bret
Contreras!

Strengthen Your Neck!

Neck Supports Your Head (Brain talks to

body through the neck)

Injury Prevention/ (Concussion protection -

Football, Rugby, etc.)

Combat Sports (Boxing, MMA, wrestling,

etc.)

Pain Reduction: "Specic strength training

exercises led to signicant prolonged relief

of neck muscle pain, while general tness
training resulted in only a small amount of
pain reduction. (13) Arthritis Care &
Research, January 2008; 59:1; pp. 84-91.

Upper-Traps, Focus on Neutral Neck/Head

Position

Do your shrugs and neck work (Athletes)

Sample Neck Exercises

- Use band at neck for planks

- Shoulder Shrugs

The TRUTH About the TvA!

Slides Adapted from Mark Comerford!

KineticControl.com
PerformanceStability.com

Transversus Abdominis

Two General Types of Core Muscles

Classifications

Local Muscles
(Inner-Unit)

Global Muscles
(Outer-Unit)

Global Mobility Muscles (Outer Core)

Function
generates force to produce

range of movement
concentric acceleration of
movement ( sagittal plane:
power)
High load shock absorption and
stability
activity is especially phasic
(on:o pattern)
direction dependent

(review: Comerford & Mottram 2001) (14)

Primal
Pictures

Local (Inner Core) Stability Muscles

Function
muscle stiness to control

segmental translation
no or minimal length
change in function
movements
anticipatory recruitment in
all directions prior to
functional loading provides
protective stiness
activity is continuous and
independent of the
direction of movement
(review: Comerford & Mottram 2001) (14)

Lumbar Local Cylinder

Local Inner Core
Transversus
abdominis
Segmental
multidus
Posterior psoas
Diaphragm
Pelvic oor

Core Cylinder expanded concept

Local (inner) Core

transversus abdominis
segmental multifidus
posterior psoas
pelvic floor
diaphragm

Global (outer) Shell

global stabilisers
oblique abdominals & anterior psoas
superficial multifidus & semispinalis
trapezius & serratus anterior

global mobilisers
Pelvis & Scapula (girdles)
link the limbs to the core
Gluteals, iliacus, stab adductors
G-H rotator cuff, deltoids

Local Muscle System

Deepest, 1 joint
Minimal force, stiness
No/min length change
Does not produce or limit
range of motion
Controls translation
Maintains control in all
ranges, all directions, all
functional activities
Tonic recruitment with
low load and high load
activities
No antagonists (NOT
Inhibited) (adapted Rood)

Global Muscle System

Deep 1-joint (stabilisers) or

supercial multi-joint
(mobilisers)
Force ecient
Concentric shortening to
produce range (mobilisers)
Eccentric lengthening or
isometric holding to control
range (stabilisers)
No translation control
Direction specic
antagonist inuenced
(adapted Bergmark)

The TRUTH About Presetting the

TVA in the gym
If movements are planned, slow and the CNS
can predict potential displacement, there is no
need to consciously pre-contract TVA. Even in
the presence of back pain when TVA is delayed,
it automatically activates within 50-90ms of
starting to move the arm, leg or spine. There are
almost no situations in the gym when load will
be taken faster than this.

Comerford (2006) (15)

The Take Away!

TVA is NEVER o
unless you are dead
or paralyzed!

Recruitment Threshold differences

Local Muscles

Low Threshold
SMU dominant
Slow / Static
and
Sustained
(low load, non-
fatiguing)

Global Muscles

High Threshold
FMU dominant
Fast
or
Fatiguing
(high load)

The Facts Dont Lie!

1-3% increase in muscle tension in the deep local
muscles can signicantly increase stiness about a
motion segment.
McGill & Cholewicki (1996) (16)

As little as 25% of the max voluntary contraction of
the muscle around a joint is needed to provide
optimal stiness (and stability) around that joint.
Hoer & Andreassen (1981) (17)

Core Muscle Activation During Normal

Activities
During standing and walking the trunk muscles are minimally
activated [42]. In standing the deep erector spinal, psoas and
quadratus lumborum are virtually silent! In some subjects there is no
detectable EMG activity in these muscles. During walking rectus
abdominis has a average activity of 2% maximal voluntary
contraction (MVC) and external oblique 5% MVC [43]. During
standing active stabilization is achieved by very low levels of co-
contraction of trunk exors and extensor, estimated at less than 1%
MVC rising up to 3% MVC when a 32 Kg weight is added to the torso.
With a back injury it is estimated to raise these values by only 2.5%
MVC for the unloaded and loaded models [44]. During bending and
lifting a weight of about 15 kg co-contraction increases by only 1.5%
MVC [45].

Dr. Eyal Lederman, The Myth of Core Stability (18)

The Take Away!!!

It is not possible to maintain a transversus

dominant recruitment pattern and move!

As soon as you move - (even if you maintain

a hollowing contraction of the lower

abdominal wall ) ... you have global (oblique
abdominal) dominant recruitment pattern
Mark Comerford

Non-functional specific recruitment Motor

control training
(Hodges & Richardson 1996 1997, Hodges et al 1999, Hides et al

1996 2001,OSullivan 2000, Jull 2000, Hodges & Tsao 2007 2008)
(19-26)

The above have all demonstrated :

that specic, non-functional, cognitive low load, motor control

training (low abdominal wall hollowing) can correct the timing

delay in TrA that is consistently associated with LBP.

that functional strength movements do not improve the TrA

timing delay in the short term

that core stability & core strengthening exercises do not improve

the TrA timing delay in the short term

Core Stability vs. Strength

Stability = Prevent

unwanted motion.
Stability does NOT mean
dont move.
Static holds just build
isometric
strength. (SAID
principle)
The way we teach joint
stability during
movement is by using
movement.

TvA Review

TvA is never o!
TvA is never weak, its late! Only w/LBP
No need for NLBP to Draw in, ever!
Posture does not change TvA function.
Its impossible to move (exercise) and stay

TvA Dominant
You cannot strengthen TvA Its timing
issue.
Use Abdominal Brace (or let your body
handle it) in the gym, not a draw in!

Is Changing Timing the LBP

Solution? Rolling?
No study to date has shown that back pain is due to timing
dierences in specic muscle such as transversus abdominis. These
control changes have been observed only in individuals who
already have back pain. They probably represent the outcome
rather than the cause of back pain . (27)
Lederman, Fall of the PSB Model

Measurement studies have demonstrated that cognitive, non-
functional, low threshold motor control retraining, can more
eectively recover the timing delay in the short term Specic
motor control retraining can reduce symptoms and recurrence of
low back pain. (28)
Mark Comerford

The TRUTH About

the PSOAS

Psoas Major

Psoas major segmentally connects the lumbar

spine, pelvis (sacro-iliac joints) and femur (hip
joint)

Psoas Major: Myths & Misconceptions

Function based on theory & assumption
(very little direct measurement)
Very few papers are of high quality
Many have been misinterpreted
Anatomy texts are 25yrs out or date

Mark Comerford (29)

Psoas - Fascial Relationships

Psoas fascia is

continuous with the

diaphragm fascia

Psoas fascia is

continuous with the

pelvic oor fascia
Gibbons (1999) (30)

Psoas is a part of
the Inner-Unit!

Posterior Fascicles Psoas

Major
Local Inner Core
transversus
abdominis
segmental
multidus
posterior psoas
pelvic oor
diaphragm

Lumbar Local Cylinder

Local Inner Core
transversus
abdominis
segmental
multidus
posterior psoas
pelvic oor
diaphragm

Psaos Myth vs. Reality

MYTH

Psoas can get short/tight and cause

LBP or Your Psoas is too strong/
overactive!
REALITY
Psoas is a local, low load muscle
(minimal length change and force, etc.)

See chart for review of Local vs. global

Local Muscle System

Deepest, 1 joint
Minimal force, stiness
No/min length change
Does not produce or limit
range of motion
Controls translation
Maintains control in all
ranges, all directions, all
functional activities
Tonic recruitment with
low load and high load
activities
No antagonists (NOT
Inhibited) (adapted Rood)

Global Muscle System

Deep 1-joint (stabilisers) or

supercial multi-joint
(mobilisers)
Force ecient
Concentric shortening to
produce range (mobilisers)
Eccentric lengthening or
isometric holding to control
range (stabilisers)
No translation control
Direction specic
antagonist inuenced
(adapted Bergmark)

The Take away!!!

The Psoas works with your Inner-Unit,

not against it!

The Psoas is a part of the inner-unit! It
mirrors your Multidus
The Psaos is primarily a spinal stabilizer,
not a mobilizer!
Psoas does NOT get short or tight due to
its design/role as a low load, local
stability muscle!

Lines of Action of Psoas Major

Line of pull is too close to axis of
rotation to contribute to
exion, extension or lateral
exion. (31)
More suited for eccentric

control of spinal movements

PSOAS

EMG activity does not mean

muscle provides movement

(Adapted Bogduk, 1997)

Nobody questions psoas as a hip

exor

Psoas Major: Fiber Orientation

Fascicle Length
10 - 15 cm
similar within individuals

Fiber length:


Anterior fascicles: 3-8cm

Posterior fascicles: 3-5cm

Psoas can shorten between

1cm - 1.5cm (posterior)
1 - 2.25cm (anterior)

Unable to produce sucient

L5

Anterior L3

range or force to be an eective

hip exor

The TRUTH!!!

Psoas is NOT a
Hip Flexor!

The proof is in the Bursa!

Muscles that act like pulleys have

a bursa (underneath) to deal
with the pulley action/friction.

Who has a bursa under it:
illiacus or psoas?

Relationship to Iliopectineal
Bursa

Relationship to Iliopectineal
Bursa

Psoas Major: Biomechanical Function - Research

Support
Lumbar Spine
Minimal movement function on

the lumbar spine

Primary force on lumbar spine is
axial compression
(Bogduk et al, 1992) (32)

SIJ
Resultant force of posterior

rotation of the innominate

+ axial compression
(Gibbons et al, 2001) (33)

Hip

Primary force on hip joint is axial

acetabular compression

(Adapted: Bogduk et al, 1992) (32)

Psoas: Compression & Shear

Forces
It is claimed that Psoas produces too much anterior

shear
Compression & shear are consistent ndings
But: Compression is always > shear
3: 2 or >

3:1 or > with Internal Ab Pressure (IAP) estimates

(Rab et al, 1977; Bogduk et al, 1992; Santaguida and

McGill, 1995) (34,32,35)

The Take Away

Psoas does NOT place

anterior shear forces
on the Lumbar spine!

Psoas Conclusion
Psoas is your friend!
Psoas (along with Multidus) is the only muscle

in the body that mechanically stabilizes the disc

because it attaches to the disc (anterior aspect).

Anything that causes you to pull your femur up

into the pelvis is psoas training. Its a spine and

Hip stabilizer!

Core Strength & Stability as it

Relates to Posture & Low Back
Pain: Claims vs. Evidence

Spinal Curvatures & LBP:

A 2008 systematic review of more than 50 studies
found no association between measurements of
spinal curves and pain.

Dierences in regional lumbar spine angles or range
of motion between the segments failed to show an
association with the future development of LBP

(Hellsing,1988b;Burton&Tillotson,1989; Hamberg-
van Reenen, 2007, syst. rev.; Mitchell et al., 2008)


The spinal neutral zone & LBP: No study exists
to show a correlation between mechanical changes in
the neutral zone changes and LBP (Leone et al.,
2007, review)

Taken from Lederman, Fall of the PSB Model. (27)

Pelvic Position, Lumbar Curve, Abdominal

Strength, Psoas Tightness & LBP
No relationship to exist between pelvic angle, lumbar
lordosis, and abdominal strength Orthop Sports
Phys Ther. 1995 May;21(5):287-95 & Phys Med
Rehabil, 1997; 78:1215-23.

The researchers (in another study) urge physical
therapists to avoid prescribing therapeutic exercise
programs of abdominal muscle strengthening in
patients with low back pain based solely on
assessment of standing posture. Phys Ther.1987;
67:512516

Hamstrings and Psoas tightness & LBP:
Prospective studies of inexibility of the lower
extremities and hamstrings and psoas tightness also
fail to predict future episodes of LBP (Hellsing,
1988c; Nadler, 1998)

Summary of (research) correlations between low

back pain and pelvic tilt or related spinal curves
No dierence in lumbar curvature between people with and

without low back pain;1

No dierence in lumbar lordosis between people of dierent
ages or in people with and without pain;2
No dierence in thoracic kyphosis, lumbar lordosis and sacral
inclination between people with acute low back pain and
chronic low back pain;3
Low back pain is not associated with the degree of lumbar
lordosis or pelvic tilt;4
2008 systematic review of 56 studies nds no strong
evidence of an association between measurements of spinal
curves and pain.5

Taken from Does Anterior Pelvic Tilt Cause Low Back Pain? by Todd Hargrove
(36)

4 Most Common
Arguments against the
Research findings

Cherry Picking - (a few studies vs. the

majority)

Sub-groups (Generalizations. The need

for special assessment.)

Dr.McGills Work (Spine Sparring Ex vs.

the Fix: Removing specic painful

positions and movements while
emphasizing pain-free exercises and
activities).

Ive seen it work! (Regression to the

mean: statistics show that most acute

LBP begins to improve after 2 to 5 days
and typically resolves itself in less than 1
month with non-steroidal anti-
inammatories (NSAIDs) and (tolerable)
activities.

A common explanation for this

discrepancy is the perceived heterogeneity
(difference) of patients with chronic nonspecific low back pain. It is felt that the
effects of treatment may be diluted by the
application of a single intervention to a
complex, heterogeneous group with
diverse treatment needs. This argument
presupposes that current treatment is
effective when applied to the correct
patientAn alternative perspective is that
the clinical trials are correct and current
treatments have limited efficacy. This
paper argues that there are numerous
problems with the sub-grouping approach
and that it may not be an important reason
for the disappointing results of clinical
trials. (37)
Wand & OConnel, BMC Musculoskeletal
Disord. 2008

Conclusion:
We dont get caught up with trying to use core

(strength or stability) training as corrective

therapy for lack of evidence that we should.
We dont make claims that core (strength or
stability) training is a x for posture or LBP.
We use integrated (CLT & CCT) and targeted core
exercises that each individual can do with control
and comfort.
Instead of worrying about the it sounds pretty
good (but highly debated and often anecdotal or
pseudoscientic) stu, we focus on the proven
principles of training: SAID and Overload.

Thank You!!!

PerformanceU.net

References:
1. Mathew, D.K. and Fox, E.L. Physiological basis of Physical Education and

Athletics, W.B.. Saunders Co., Philadelphia, 1976)

2. Essentials of Strength & Conditioning, 3rd Edition. . Edited by Thomas R. Baechle

and Roger W. Earle. NSCA -National Strength & Conditioning Association. Human
Kinetics. Copyright 2008
3. Interview with Dr. Stuart McGill: Back Health, Core Exercises and More.
1/12/2010, By Mark Kennedy. http://www.healthynomics.com/2010/11/dr-stuart-mcgill-
interview-back-health-core-exercise/
4. W. Gilleard , European journal of applied physiology and occupational physiology,
volume 63, number 5, 381-386)
5. Motor Control. 1999 Oct;3(4):346-71. Natural goal-directed movements and the

triphasic EMG. Morrison S, Anson JG.

6. Movement-related phasic muscle activation. I. Relations with temporal prole of

movement. S. H. Brown and J. D. Cooke, J Neurophysiol 63: 455-464, 1990;

7. Research in Sports Medicine: An International Journal. Volume 15, Issue 2, 2007. Do

Bilateral Power Decits Inuence Direction-Specic Movement Patterns?
Jay R. Homan, Nicholas A. Ratamess, Marc Klatt, Avery D. Faigenbauma & Jie Kang.

References:
8. Developing Power to Turn. Frank J. Spaniol, EdD. NSCA Strength & Condtioning Journal. Vol.
34, #6. Dec 2012.
9. J Strength Cond Res. 2012 Feb;26(2):373-80. Eect of core strength on the measure of
power in the extremities. Shinkle J, Nesser TW, Demchak TJ, McMannus DM.
10. J Strength Cond Res. 2007 Nov;21(4):1271-7. A kinetic and electromyographic comparison
of the standing cable press and bench press. Santana JC, Vera-Garcia FJ, McGill SM.
11. Integration core exercises elicit greater muscle activation than isolation exercises.
Gottschall JS, Mills J, Hastings B. J Strength Cond Res. 2013.
12. J Orthop Sports Phys Ther. 2010 May;40(5):265-76. Core muscle activation during Swiss
ball and traditional abdominal exercises.
Escamilla RF, Lewis C, Bell D, Bramblet G, Daron J, Lambert S, Pecson A, Imamura R, Paulos L,
Andrews JR.
13. Eect of Two Contrasting Types of Physical Exercise on Chronic Neck Muscle Pain. Lars L.
Andersen, Michael Kjaer, Karen Sogaard, Lone Hansen, Ann I. Kryger, Gisela Sjogaard, Arthritis
Care & Research, January 2008; 59:1; pp. 84-91.

NOTE: Go to this link to read the rebuttal papers to Eyal Ledermans Fall of the PSB
Model - http://www.sigurdmikkelsen.no/admin/dokumenter/JBMT%20debate%20-
%202011%20-%20Is%20a%20postural-structural-biomechanical%20model,%20within
%20manual%20therapies,%20viable%3F.pdf

References
14. Man Ther. 2001 Feb;6(1):3-14. Functional stability re-training: principles and
strategies for managing mechanical dysfunction. Comerford MJ, Mottram SL.
15. Scott M, Comerford MJ, Mottram SL 2006. Transversus Training - A Waste of Time
in the Gym? FitPro Network (Apr-May).
http://www.performance-stability.com/document/Publication/
31_33backpain_tranversusFitProSpring06.pdf
16. Cholewicki J and McGill S (1996), Mechanical stability in the vivo lumbar spine:
implications for injury and chronic low back pain, Clinical Biomechanics, 11(1): 1-15.
17. Hoer J, Andreassen S (1981), Regulation of soleus muscle stiness in premamillary
cats, J Neurophysiology, 45: 267-285
18. Journal of Bodywork & Movement Therapies (2010) 14. The myth of core stability.
Eyal Lederman.
19. Hodges PW, Richardson CA (1996) Inecient muscular stabilisation of the lumbar
spine associated with low back pain: a motor control evaluation of transversus
abdominis. Spine 21(22): 2640-2650
20. Hodges PW and Richardson CA (1997) Contraction of the abdominal muscles
associated with movement of the lower limb. Physical Therapy. 77: 132-143

References
21. Hodges PW, Richardson CA. Transversus abdominis and the supercial abdominal
muscles are controlled independently in a postural task. Neurosci Lett 1999;265(2):
91-94
22.Hides JA, Richardson CA, Jull GA (1996) Multidus muscle recovery is not automatic
after resolution of acute, rst-episode low back pain. Spine 21(23): 2763-2769.
23. OSullivan PB. Lumbar segmental instability clinical presentation and specic
stabilizing exercise management. Manual Therapy 2000;5(1): 2-12
24. Jull GA. Deep cervical exor muscle dysfunction in whiplash. Journal of
Musculoskeletal Pain 2000;8(1/2):143-154.
25. Exp Brain Res. 2007 Aug;181(4):537-46. Epub 2007 May 3. Immediate changes in
feedforward postural adjustments following voluntary motor training.
Tsao H, Hodges PW.
26. Brain. 2008 Aug;131(Pt 8):2161-71. Reorganization of the motor cortex is associated
with postural control decits in recurrent low back pain. Tsao H, Galea MP, Hodges PW.
27. CPDO Online Journal (2010), March. The fall of the posturalstructural
biomechanical model in manual and physical therapies: Exemplied by lower back
pain. Eyal Lederman.
28. Thoughts about Transversus Abdominis. 21st November 2011. http://
www.kineticcontrol.com/page.php?Plv=1&P1=16&Blog=46

References
29. Gibbons SGT, Comerford MJ and Emerson PL 2002. Rehabilitation of the stability
function of Psoas Major. Orthopaedic Division Review. Jan/Feb. 7-16.
http://www.kineticcontrol.com/document/Publication/FunctionofPsoasMajor.pdf
30. Gibbons SGT (1999) A review of the anatomy, physiology and function of psoas major: A
new model of stability. Proceedings of: The Tragic Hip: Trouble in the Lower Quadrant. 11th
Annual National Orthopaedic Symposium. Halifax, Canada. Nov 6-7.
31. Bogduk N (1997) Clinical Anatomy of the Lumbar Spine and Sacrum 3rd Ed. Churchill
Livingstone, New York
32. Bogduk N, Pearcy M and Hadeld G (1992) Anatomy and biomechanics of psoas major.
Clinical Biomechanics. 7: 109-119
33. Gibbons SGT (2001) The model of psoas major stability function. Proceedings of: 1st
International Conference on Movement Dysfunction. Edinburgh, Scotland. Sept 21-23
34. Rab GT, Chao EYS, Stauer RN 1977 Muscle force analysis of the lumbar spine.
Orthopaedic Clinics of North America 8(1):193-199
35. J Biomech. 1995 Mar;28(3):339-45.The psoas major muscle: a three-dimensional
geometric study. Santaguida PL, McGill SM.
36. Posted on March 12, 2012 by Todd Hargrove.
http://www.bettermovement.org/2012/does-anterior-pelvic-tilt-cause-low-back-pain/
37. BMC Musculoskeletal Disorders 2008, 9:11. Chronic non-specic low back pain sub-groups
or a single mechanism?