The Core: Testing and Training for the hockey player. · • Core strength does not contribute significantly to strength and power and should not be the focus of any strength and

©2013 MFMER | slide-1

The Core: Testing and Training for the hockey player.

Joe Eischen PT, ATC, SCS, CSCS Mayo Clinic Sports Medicine Center


What is the Core?

• Passive subsystem:

• Spinal ligaments.

• Facet articulations.

• Limited load=10 kg.

• Muscular subsystem:

• Local group.

• Global group.

• Guy wires.

• No one important muscle.

• Contribution is dependent upon the magnitude and direction of trunk loading.

• Cholewicki and Van Vliet: No single muscle group contributed more than 30% to lumbar stability no matter what the task.

• Neural subsystem:

• Continuous monitoring from muscle spindles, Golgi tendon organs and spinal ligaments.

• Requirements for stability can change instantaneously.

• Directs tensioning of guy wires.


What is the Core? Muscular subsystem

• Local Muscular Stabilizers:

• Primary:

• Transversus abdominis

• Multifidus.

• Secondary:

• Internal oblique.

• Medial fibers of the External oblique.

• Quadratus lumborum.

• Diaphragm.

• Pelvic floor muscles.

• Illiocostalis and longissimus (lumbar portions).


What is the Core? Muscular Subsystem

• Global Muscular Stabilizers:

• Rectus abdominus.

• Lateral fibers of the external oblique.

• Psoas major.

• Erector spinae.

• Illiocostalis (thoracic portions).

• Some say we should not divide core muscles into local and global stabilizers. They all work together.


How are we put together?

• Mobility stacked upon stability:

• Mobile GH joint.

• Stable scapula.

• Mobile thoracic spine.

• Stable lumbar spine.

• Mobile hips.

• Stable knees.

• Mobile ankles.

• Extensive MSK evaluation:

• Look for limits or stressors above and below the spine.

• What is throwing gas on the fire???


How do we test it?

• Sahrmann:

• 5 levels of progression.


Testing

• McGill

• Plank testing.


Testing: McGill

• Nesser, Lee. The Relationship Between Core Strength and Performance in Division 1 Female Soccer Players. Journal of Exercise Physiology. Vol. 12, No. 2, April 2009.

• 16 female soccer players.

• Tests: • Counter movement vertical jump.

• Shuttle run.

• 40 yard sprint.

• 1RM squat and bench press.

• McGill plank testing.

• No significant correlations were identified between core strength and strength and power.

• Core strength does not contribute significantly to strength and power and should not be the focus of any strength and conditioning program with the intent to improve sports performance.

• Discussion:

• McGill’s tests specifically look at muscle endurance utilizing slow twitch muscle fibers.

• The tests involved 1 repetition explosive drills or exercises utilizing fast twitch muscle fibers.

• Static measurement versus dynamic movement.

• N is very small.


Testing:

• Gray Cook:

• FMS (Healthy)/SFMA (Injured):

• 7 tests.

• 0-3 grading system.

• 0=pain with movement pattern.

• 3= perfect movement pattern.

• Mobility and stability issues?

• 46 NFL football players of a single team.

• Score of 14 or less on the FMS was predictive of serious injury during that season.

• Specificity of 0.91

• Sensitivity of 0.54


How do we test it?

• Prone instability test:

• Part of clinical prediction rule for lumbar stabilization:

• <40 years old.

• SLR > 91 degrees.

• Aberrant spine movement pattern.

• + prone instability test.

• Bridging with knee extension test:

• Test of proper gluteal activation.


Continuum of Training -Injury to performance….

• Train 3 planes of motion: • Sagittal plane flexion and extension.

• Frontal plane.

• Transverse plane.

• Mat-based training.

• Physio ball training.

• Unilateral training.

• Weight bearing training. • Base of support.

• Unilateral drills/exercises.

• Performance. • Development of power and explosiveness while maintaining core control.


Core Training and Injury…

• Core endurance is more important in injury prevention and rehab.

• Type 1 muscle fibers which require only low loads to improve performance.

• Performing trunk exercises on a physio ball results in significantly increased activation of the lower abdominal region.

• But, there are studies showing it does not change activation….

• Unilateral use of upper extremities while on a ball or bench results in even greater activation of core musculature.

• However….

• When performing exercises on a ball, force production in the upper and lower extremities is significantly reduced.


Common presentation in the hockey player:

• Lower cross syndrome:

• Huge issue with many hockey players:

• Tight hip flexor.

• Weak glutes.

• Tight low back.

• Weak abdominal muscles.

• Remember the paper on the need for hip rotation and rotational sports…..

• Increased thoracic kyphosis (upper cross syndrome):

• Lack of thoracic extension.

• Tight pectorals and Lats.

• May focus stress on lumbar spine.

• Remember our wall Lat test…..


Core Training and Performance….

• Can we improve performance by training the Core?

• 24 Elite high school Norwegian handball players.

• 14 performed sling exercise training.

• Similar to TRX training.

• 10 players in control group

• Both groups performed regular handball training x 6 weeks.

• Maximum throwing velocity improved by 5% in the SET group.


Core Training and Performance….

• Can we improve it?

• Purpose:

• Is there any difference in hip strength among golfers with different proficiency levels.

• What is the relationship between hip strength and golf handicap.

• What is the relationship between hip strength and self-reported driving distance.

• 82 golfers.

• 10-19 handicap.

• 0-9 handicap.

• Scratch or better.

• Measured isometric hip abduction and adduction in side lying using a hand-held dynamometer.

• Scratch or better group was found to be significantly stronger in left hip strength as well as all hip movements tested.


Training the Core:

• Educate the Athlete:

• Understand the task.

• Feel the proper pattern.

• Train the proper pattern.

• Own the proper pattern.

• See it, Feel it, Do it!


Training Progression:


Bibliography • Willardson. Core Stability Training: Applications to Sport

Conditioning Programs. Journal of Strength and Conditioning Research. 2007, 21 (3), 979-985

• Parchmann, McBride. Relationship Between Functional Movement Screen and Athletic Performance. Journal of Strength and Conditioning Research. Dec 2011. Vol. 25, No. 12

• Kibler, Press, Sciascia. The Role of Core Stability in Athletic Function. Sports Med 2006/ 36 (3):189-198

• Behm, Drinkwater, Willardson, Cowley. Strength and Conditioning Journal. Vol. 33, No. 3, June 2011.

• McGill. Core Training: Evidence Translating to Better Performance and Injury Prevention. Strength and Conditioning Journal. Vol. 32, No.3, June 2010.

• Shinkle, Nesser, Demchak, McMannus. Effect Of Core Strength On The Measure Of Power In The Extremities. Journal of Strength and Conditioning Research. Vol. 26, No. 2, February 2012.

• Faries, Greenwood. Core Training: Stabilizing the Confusion. Strength and Conditioning Journal. Vol. 29, No. 2, April 2007.

• Willardson. Core Stability Training for Healthy Athletes: A Different Paradigm for Fitness Professionals. Strength and Conditioning Journal. Vol. 29, No. 6, Dec 2007.

• Yung-Shen, Myers, McCrory, Laudner, Pasquale, Lephart. The Relationship between Hip Muscle Strength and Golf Performance. Medicine and Science in Sports and Exercise. Vol. 36(5) Supplement, May 2004.

• Saeterbakken, Tillaar, Seiler. Effect of Core Stability Training on Throwing Velocity in Female Handball Players. Journal of Strength and Conditioning Research. Vol. 25, No. 3, March 2011.

• Van Dillen, Bloom, Gombatto, Susco. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Physical Therapy in Sport 9 (2008).

• Lust, Sandrey, Bulger, Wilder. The Effects of 6-Week Training Programs on Throwing Accuracy, Proprioception, and Core Endurance in Baseball. Journal of Sport Rehabilitation, 2009, 18, 407-426.

• Aroskoski, Valta, Airaksinen, Kankaanpaa. Arch Phys Med Rehabil Vol 82, August 2001.Ekstrom, Donatelli, Carp. Electromyographic Analysis of Core Trunk, Hip, and Thigh Muscles During 9 Rehabilitation Exercises. JOSPT, Vol 37, No. 12 Dec 2007.

• Parenteau-G, Gaudreault, Chambers, Boisvert, Grenier, Gagne, Balg. Functional movment screen test: A reliable screening test for young elite ice hockey players. Physical therapy in Sport. 15 (2014) 169-175.


Bibliography • Peate, Bates, Lunda, Francis and Bellamy. Core strength: A

new model for injury prediction and prevention. Journal of Occupational Medicine and Toxicology 2007, 2:3.

• Kiesel, Plisky, Voight. Can Serious Injury In Professional Football Be Predicted By A Preseason Functional Movement Screen. North American Journal Of Sports Physical Therapy. August 2007, Vol. 2, No. 3.

• Parchmann, McBride. Relationship Between Functional Movement Screen And Athletic Performance. Journal of Strength and Conditioning Research. Vol. 25, No. 12, Dec 2011.

• Okada, Huxel, Nesser. Relationship Between Core Stability, Functional Movement, and Performance. Journal of Strength and Conditioning Research. Vol. 25, No. 1, January 2011.

• Stuart McGill. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Champaign, IL: Human Kinetics, 2002.

• Nesser, Lee. The Relationship Between Core Strength and Performance in Division 1 Female Soccer Players. Journal of Exercise Physiology. Vol. 12, No. 2, April 2009.

• Lehman, Gordon, Langley, Pemrose and Tregaskis. Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises. Dynamic Medicine 2005, 4:6.

• Anderson and Behm. Maintenance of EMG Activity and Loss of Force Output with Instability. Journal of Strength and Conditioning Research. 2004, 18 (3). 637-640.

• Mori. Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball. Electromyography and Clinical Neurophysiology. 2004, 44(1): 57-64.

• Cholewicki, Van Vliet. Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions. Clinical Biomechanics 17 (2002) 99-105.

• Tarnanen, Ylinen, Kiekkinen, Malkia, Kautiainen, Hakkinen. Effect of Isometric Upper-Extremity Exercises on the Activation of Core Stabilizing Muscles. Arch Pys Med Rehabil Vol 89, March, 2008.


Thank you

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The Core: Testing and Training for the hockey player. · • Core strength does not contribute significantly to strength and power and should not be the focus of any strength and