In part one of this post I very simple reviewed some of the ideas behind core stability and how I questioned their relevance to a patient’s pain presentation. In this follow up post I will briefly review how people with pain have different function than those without pain and give an opinion on how core ‘stability” exercises may help with patients in pain in a manner that has nothing to do with stabilizing the spine.
Nutshell summary: People in pain have spines that function differently than those not in pain. Many treatments can influence pain. The spine stability model of low back pain does not explain how people have pain and takes an overly mechanical view of the pain experience. No test has ever shown that a spine is unstable or how “increasing stability” would lead to a decrease in pain. Thinking that our spines need more stability or control may be the completely wrong path in explaining how people have pain or how our exercises help them. Our treatment “corrections” occur not via one specific “corrective” mechanism (e.g. improving stability) but rather through global non-specific mechanisms that our better explained by our understanding of pain neuroscience. Making the shift from believing that “stability” is the issue with pain can thus free up to choose completely different exercise programs. Exercise and treatment prescription thus become simpler. We have preliminary evidence to support this view with the clinical studies that show benefits with the various exercise conditioning programs that train different schools of thought on stability or the just as effective programs that completely ignore any concepts of stability.
Purpose: To provide a very selective review of Charlie Weingroff’s course and how it actually fits with a neurocentric view of pain and function.
Audience: Therapists and strength coaches. Patients who have trouble sleeping.
1. Jeff Cubos discusses SFMA, DNS and Lorimer Moseley and they inform his practice style
I took 2 days out of Charlie Weingroff’s course, Training = Rehab, Rehab = Training course here in Toronto from MSK-Plus. MSK-Plus is a continuing education company run by Dr. Glen Harris. Dr. Harris has brought in a lot of great educators over the years and this course was not an exception. (more…)
Quick Background: The joint-by-joint (JBJ) approach, popularized by Mike Boyle and Gray Cook (link here), is a method of categorizing how each joint should ideally function and what tendencies a joint might have toward dysfunction. It also suggests how joints interact with each other and might provide shortcuts to identifying shortcomings in a joint’s or system’s functioning in the cause or persistence of pain, injury or less than ideal performance. The assumption of the theory is best illustrated with this quote from its original description:
Injuries relate closely to proper joint function, or more appropriately, to joint dysfunction. Problems at one joint usually show up as pain in the joint above or below.
Audience: Therapists and Strength Coaches
Purpose: To justify the use of a variety of exercises (even general exercises) for training, rehabilitation and injury prevention and question the application of movement specificity principles.
The Gist of this Post: Specificity of training is an important component of rehabilitation and strength and conditioning but I think the application of specificity can be taken too far when we attempt to mold our posture. (more…)