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NSA 01 2005 21.03.

2005 10:38 Uhr Seite 25

© by IAAF
20:1; 25-37, 2005

Core stabilisation training for middle-


and long-distance runners
By Michael Fredericson, Tammara Moore

A strong foundation of muscular


balance and core stability is essen-
tial for middle- and long-distance
runners. In their experience work- Dr. Michael Fredericson is an
ing with elite runners, even those Associate Professor at Stanford
at an Olympic level, the authors University School of Medicine in
have found that weakness or lack Palo Alto, California, USA. A for-
of sufficient co-ordination in core mer distance runner himself, he
musculature can lead to less effi- has worked with numerous elite
cient movements, compensatory runners as physician for the
movement patterns, strain, over- Stanford University Cross-Coun-
use, and injury. This article briefly try & Track Teams, the Nike Farm
discusses the theory behind core Team, Medical Director for the
training for injury prevention and
ABSTRACT

2002 and 2003 USA National


improving a distance runner’s effi-

AUTHOR
Track & Field Championships, and
ciency and performance. It then physician for the 2004 USA
details a systematic progression of Olympic Trials.
core exercises that can be easily
incorporated into a runner’s train-
ing programme. The programme Tammara Moore is a physical
starts with restoration of normal therapist specialising in
muscle length and mobility to cor- orthopaedic manual therapy and
rect any muscle imbalances. Next, sports rehabilitation and is
fundamental lumbo-pelvic stabili- founder of Sports & Orthopedic
ty exercises are introduced, teach- Leaders Physical Therapy in Oak-
ing the athlete to activate the land, California, USA. She is a
deeper core musculature. When Lead Instructor for Active Release
this has been mastered, advanced Therapy® and a consulting physi-
lumbo-pelvic stability exercises cal therapist for sports teams at
using the Physioball are added for the University of California at
greater challenge. As the athlete Berkeley. She is active in the care
makes the transition to the stand- of elite runners and has worked
ing position, sensory-motor train- with runners of the Nike Farm
New Studies in Athletics • no. 1/2005

ing is used to stimulate the sub- Team, at the 2004 USA Olympic
cortex and provide a basis for more Trials and at the World Champi-
advanced functional movement onship Ironman Triathlon.
exercises, which promote balance,
co-ordination, precision, and skill
acquisition.

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Core stabilisation training for middle- and long-distance runners

Introduction stiffness of the spine, and are best suited to


respond to changes in posture and extrinsic
or middle- and long-distance run- loads. The key muscles of this system include
F ners—whose events involve balanced
and powerful movements of the body
the transversus abdominus, multifidi, internal
oblique, deep transversospinalis, and pelvic
propelling itself forward and catching itself in floor muscles. Co-contraction of these mus-
complex motor patterns—a strong foundation cles produces force via the thoracolumbar
of muscular balance is essential. In many run- fascia and the intra-abdominal pressure
ners, however, even those at an Olympic level, mechanism stabilises and resists forces acting
the core musculature is not fully developed. on the lumbar spine.
Weakness or lack of sufficient coordination in
the core musculature can lead to less-effi- Fast-twitch fibres, on the other hand, pri-
cient movements, compensatory movement marily make up the global muscle system,
patterns, strain, overuse, and injury. This arti- which includes the superficial or outer-layer
cle briefly discusses the theory behind core muscles. These muscles possess long levers
training for injury prevention as well as for and large moment arms that are capable of
improving a distance runner’s efficiency and producing high outputs of torque, with an
performance. It then details a systematic pro- emphasis on speed, power, and larger arcs of
gression of core exercises that can be incor- movement.2 The main muscles in this layer are
porated easily into every runner’s training the erector spinae, external oblique, and rec-
programme. tus abdominis muscles—the muscles that are
strengthened by traditional back and abdom-
The role of the core inal exercises and that assist with gross spinal
movements.
The core musculature is composed of 29
pairs of muscles that support the lumbo- Interestingly, Hodges and Richardson3, 4
pelvic-hip complex. These muscles help to have shown that it is not simply that deep-
stabilise the spine, pelvis, and kinetic chain layer abdominal muscles are recruited during
during functional movements. When the sys- stabilisation of the spine, but it is how they
tem works efficiently, the result is appropriate are recruited that is important. The transverse
distribution of forces; optimal control and abdominus and the multifidi are considered
efficiency of movement; adequate absorption “stabilising muscles” (muscles that are con-
of ground-impact forces; and an absence of tinually modulated by the central nervous
excessive compressive, translation, or shear- system and provide feedback about joint posi-
ing forces on the joints of the kinetic chain. tion), while the global and larger torque-pro-
ducing muscles control acceleration and
The first stage in developing a stable core is deceleration. The authors found that the co-
to develop the abdominal muscles. Richard- contraction of the deeper-layer transverse
son et al1 have discovered that there are two abdominus and multifidi muscle groups
different types of muscles fibres (slow-twitch occurs prior to any movement of the limbs,
and fast-twitch) that make up the abdominal and believe that this neuromuscular pre-acti-
muscles, and that because of this different vation is critical in stabilising the spine prior
fibre composition, different exercise regimens to any movement.
are required to properly train these muscles.
New Studies in Athletics • no. 1/2005

Slow-twitch fibres primarily make up the The core programme


local muscle system—the muscles of the
deeper abdominal muscle layers. These mus- Stability work should be started only after
cles are closer to the centre of rotation of the the athlete has achieved good mobility, as
spinal segments and, with their shorter mus- adequate muscle length and extensibility are
cle lengths, are ideal for controlling inter- crucial to proper joint function and efficiency.
segmental motion, maintaining mechanical Although beyond the scope of this article, a
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Core stabilisation training for middle- and long-distance runners

thorough evaluation of the muscular system Other muscles that prove weak or inhibited on
should include an assessment of the muscles evaluation should also be strengthened on a
for over-activity, shortening, weakness, inhi- case-by-case basis.
bition, and quality of motion. This is best
accomplished by a skilled physician or thera- The purpose of basic core stabilisation exer-
pist using muscle-length tests, strength tests, cises is not only to increase stability, but more
and tests for the efficiency of basic move- importantly— it is to gain co-ordination and
ment patterns and neuromuscular control. A timing of the deep abdominal-wall muscula-
thorough postural observation and video tap- ture. It is extremely important to do these
ing of the athlete’s running gait will help in basic exercises correctly, as they are the foun-
assessing and identifying any movement dation of all other core exercises and move-
imbalances. ment patterns. These basic exercises empha-
sise maintaining the lumbar spine in a neutral
Preliminary stretches for shortened muscles position (which is the midrange position
should include proprioceptive neuromuscular between lumbar extension and flexion.),
facilitation (PNF) type or contract-relax allowing for the natural curvature of the
stretches that strive for isometric contraction, spine.
followed by end-range stretching. These are
effective techniques for maintaining muscle This first stage of core stability training
length and joint mobility. Active Release begins with the athlete learning to stabilise
Techniques® (a specialised method for soft the abdominal wall. Proper activation of these
tissue mobilisation) when used in conjunction muscles is considered crucial in the first
with stretching techniques, have shown great stages of a core stability programme, before
promise in restoring muscle length and soft- progressing to more dynamic and multi-pla-
tissue extensibility. Athletes can also do their nar activities.
own self-mobilisation with use of a foam roll.
We recommend the technique as described
Proprioceptive: Relating to stimuli that by McGill.6 This involves a sub-maximal iso-
are produced and perceived by the body, metric contraction of the three layers of the
especially those connected with position abdominal wall (rectus, obliques, and trans-
and movement. verse) producing a true muscular girdle
around the spine to buttress against buckling
Specific exercises for the runner should and shear instability.
progress from mobility to stability, to reflex-
ive motor patterning, to acquiring the skills of Fundamental lumbo-pelvic stability
fundamental movement patterns, and finally,
to progressive strengthening. These sequences The exercise programme should progress
may not be applicable to all athletes; there- sequentially through the fundamental move-
fore, the key is to analyse the individual in ments as detailed below. The following exer-
each exercise category and then to tailor an cises are to be performed three times per
exercise regimen that will best suit that run- week to maximise results. The athlete begins
ner’s needs. For example, it has been shown with one to two sets of 15 repetitions and
that runners prone to iliotibial band syndrome progresses to three sets of 15-20 reptitions.
often have weakness in their hip abductors These exercises are taught initially in either a
New Studies in Athletics • no. 1/2005

that predisposes them to increased stress on supine, hook-lying position, or all-fours


the iliotibial band.5 Thus, a preventative train- quadruped position. The athlete can progress
ing programme for runners with this syn- to the more functional standing exercises, as
drome must target the hip abductors, partic- control is developed. Important concepts
ularly the posterior aspect of the gluteus taught at this stage include not tilting the
medius that assists external rotation or in pelvis or flattening the spine. We also empha-
decelerating internal rotation of the hip. sise normal rhythmic breathing.
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Core stabilisation training for middle- and long-distance runners

described above. While maintaining a


SUPINE BENT-KNEE RAISES midrange/neutral curve of the lumbar spine,
the athlete should raise the right arm and the
This is a fundamental exercise for recruiting left leg (opposite upper and lower limbs) into
the deep abdominal muscles and for lumbo- a line with the trunk, while preventing any
pelvic control. rocking of the pelvis or spine (excessive trans-
verse- or coronal-plane motion). If it helps to
The athlete lies on her back, with knees bent maintain alignment, the athlete may use an
and feet flat on the floor. She then braces the object, such as a foam roller or wooden
abdominal wall, holding the lumbar spine in a dowel, placed along the spine, for added tac-
neutral position, and slowly raises one foot tile feedback. The leg should be raised only to
15-30cm off the ground with alternate legs. the height at which athlete can control any
Common errors when performing this exercise excessive motion of the lumbo-pelvic region.
include rocking the pelvis, abdominal protru- She then performs the exercise raising the left
sion, or an inability to maintain the neutral arm with the right leg.
(midrange) lumbar curve. If this happens, dis-
continue the exercise for a rest period. Quali- Progression: A Physioball underneath the
ty more than quantity is stressed. trunk can provide significantly more proprio-
ceptive challenge owing to its unstable sur-
Progression: The exercise can progress to face. The goal once again is for the athlete to
alternately extending the legs and lowering to maintain lumbar stability while the opposite
the ground. Once the athlete can maintain arm and leg are raised slowly.
stability with alternate leg lifts. She can add
alternate, overhead arm raises for greater
challenge. The arm raises should be performed
slowly, while maintaining lower abdominal
bracing.

Figure 1: Supine Bent-Knee Raises

Figure 2: Quadruped with Alternate Arm/Leg


QUADRUPED WITH ALTERNATE Raises
ARM/LEG RAISES

This exercise prepares the athlete for the pro- BRIDGING


New Studies in Athletics • no. 1/2005

prioceptively more challenging, more dynamic


exercises of the trunk. It specifically engages Bridging is a fundamental core-stability
the multifidi—the deep transverse spine sta- and gluteal-strengthening exercise.
biliser and extensor of the lumbar spine.
The athlete begins the exercise on her back,
The athlete should position herself on all in a hook-lying position, with arms resting at
fours. She then braces the abdominal wall as her sides. She activates the abdominals and
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Core stabilisation training for middle- and long-distance runners

squeezes the gluteal cheeks prior to initiating onds, and then repeated on the opposite side.
the movement. The athlete lifts the pelvis and Figure 4: Prone Plank
hips off the ground while maintaining neutral
lumbar alignment. There should be no rota-
tion of the pelvis. The hips should be aligned
with the knees and shoulders in a straight
line. The athlete should hold the position for
10sec and then slowly lower the pelvis to the
floor.
SIDE PLANK
Progression: In the lifted-bridge position,
while maintaining neutral lumbar and pelvic This is a fundamental, static core-stability
alignment, the athlete can lift one foot off exercise designed to challenge the athlete’s
the ground and extend the leg. By placing her body against gravity in the coronal/frontal
arms across her chest, she can increase the plane and is an ideal exercise to train the
challenge of stabilising the lumbo-pelvic quadratus lumborum.
region. To progress further, the athlete can
raise both arms up to the ceiling and then The athlete is lying on her right side with
move one arm out to the side. She should the right arm extended in a straight line up
bring the arm back to the centre and repeat from the shoulder, with the forearm resting
with the other side. on the mat. She then raises the pelvis from
the floor and holds it in a straight-line “plank”
position. The hips should not be allowed to
sag toward the floor. We suggest holding the
position for 20sec, working up to one minute
holds for two to three repetitions.

Figure 3: Bridging Progression: The top foot can be raised to


increasingly challenge the core and gluteal
musculature.
PRONE PLANK

This is a fundamental, static core-stability


exercise.

The athlete supports herself with her fore-


arms resting on the mat, elbows bent at 90º, Figure 5: Side Plank
and the toes resting on the mat. The athlete
maintains the spine in a neutral position,
recruits the gluteal muscles, and keeps the Advanced lumbo-pelvic stability
head level with the floor. She is instructed to
breath normally throughout the exercise, while Once the athlete demonstrates good stability
maintaining the abdominal brace. We suggest with all static core exercises, they can be
holding the position for 20sec, working up to replaced with more advanced exercises on the
New Studies in Athletics • no. 1/2005

one minute for two to three repetitions. No Physioball detailed below. These exercises
compensatory motion, such as increased lum- should be performed at least two times per
bar lordosis or sag, should be seen. week to maximise results. The athlete progress-
es to two sets of 10-15 repetitions. Quality is
Progression: In this position, the athlete more important than quantitiy; the athlete must
can add leg lifts for more difficulty: one leg maintain lumbar neutral and keep the spine in
can be lifted off the mat, held for five sec- perfect alignment throughout the exercises.
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Core stabilisation training for middle- and long-distance runners

Progression: The athlete holds a 2.0 to


SEATED MARCHING ON A PHYSIOBALL 4.0kg medicine ball in front of the chest with
the arms extended (see Figure 7b).
This exercise is more difficult because
the athlete positions her body against
gravity in a seated position on an unstable
surface.

The athlete begins by sitting upright on a


Physioball, with the lumbar spine in a neutral
position (midrange). She places her feet hip-
width apart. While bracing the abdominal
muscles, she lifts one leg and foot off the
ground. (The limb does not need to be lifted
very high, just enough to be off the ground—
approximately 5cm to start.) The athlete
should focus on controlling the weight shift-
ing to the weight-bearing limb while main-
taining lumbo-pelvic stability.

Progression: Once lumbo-pelvic stability


can be maintained with alternate leg lifts, the
athlete can add opposite arm lifts.

(a)

Figure 6: Seated Marching on a Physioball

SPINAL FLEXION ON PHYSIOBALL (b)

The athlete pre-activates her abdominal Figure 7: Spinal Flexion on Physioball


brace in the starting position and maintains
this as she rolls back into spinal extension.
She then slowly raises the body, focusing the ALTERNATE LEG BRIDGE WITH
New Studies in Athletics • no. 1/2005

rotation in the thoracic spine. Picture the SHOULDERS ON BALL


head and neck as a rigid block on the thoracic
spine to prevent flexing the cervical spine. The The athlete starts this exercise by sitting on
athlete concentrates on attempting to touch the Physioball and walking forward with his
the bottom of her ribs to her pelvis (ASIS). feet on the ground, slowly leaning back until
The hands can be placed over the ears to his back rests on the ball. This is called the
eliminate pulling on the neck. bridge position. The head, neck, and shoulder
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Core stabilisation training for middle- and long-distance runners

blades should be supported on the ball. Knees The goal is to keep the pelvis elevated (hip
should be bent at a 90° angle, with feet on extension) as both legs extend and flex at
the ground. While bracing the abdominal the knees. While the knees extend and flex
muscles, the athlete raises the foot and from this elevated bridge position, the ath-
extends the leg off the ground. The weight lete focuses on maintaining lumbo-pelvic
will be shifted to one side, and the athlete stability.
should focus on maintaining stability of the
lumbo-pelvic region. The athlete should strive Progression: The athlete can continue with
for stability and balance, while holding this single leg hamstring curls in the same posi-
position for 10sec and alternating lower tion (see Figure 9b).
limbs.

Progression: The athlete lifts the arms up in


the air or out to the sides.

(a)

Figure 8: Alternate Leg Bridge with Shoulders


on Ball

LEG CURLS ON A PHYSIOBALL

The purpose of this dynamic exercise is to


recruit both actions of the hamstrings—hip (b)
extension and knee flexion—while maintain-
ing dynamic stability of the lumbar spine.
Figure 9: Leg Curls on a Physioball
In a supine position on the floor, the ath-
lete places both feet on the Physioball.
(Shoes should be removed to allow increased Exteroceptor: A sensory receptor
proprioception from the exteroceptors of the that receives external stiumuli.
feet.) The athlete keeps her arms on the floor
New Studies in Athletics • no. 1/2005

at the sides of the body for balance and rais-


es the hips off the ground until the knees,
hips, and shoulders create a straight line. ABDOMINAL ROLLOUT
She should focus on holding the spine in a
neutral midrange position. In this position, The athlete kneels behind the ball, with
the athlete then pushes the ball forward both hands on the ball. Keeping the abdomi-
with the feet while maintaining the bridge. nal muscles braced and lower back in a neu-
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Core stabilisation training for middle- and long-distance runners

tral position, she then rolls the ball away from


her body a short distance until there is a
straight line from the shoulder to hips. While
maintaining alignment, she pulls the ball back
ta short distance, then pushes it away again.
The movement should occur only at the
shoulders, not the back.

Progression: The athlete can gradually


straighten the body until she is up on her
toes. There should be a straight line from
the back of the head to the knees. Now she
can again move the ball away and back
toward the body a short distance with the
arms. (a)

(b)

Figure 11: Squat Ball Thrust

Development of balance and motor


control

The following movements require reflexive


control. The athlete can establish this control
Figure 10: Abdominal Rollout using an unstable surface and taking advantage
of the numerous proprioceptors in the soles of
the feet, and by activating the neck muscles,
SQUAT BALL THRUST which contribute greatly to postural regulation.
This sensory-motor training is an attempt to
Keeping the abdominal muscles braced and provide the sub-cortex with a basis for move-
lower back and shoulder blades in a neutral ment that is progressively more challenging. It
position, he athlete uses her abdominal con- involves exercises that stimulate balance, coor-
traction to move the ball forward and back. dination, precision and skill acquisition.
Keep the spine in neutral alignment through-
New Studies in Athletics • no. 1/2005

out the movement. If the exercise shown is Various devices are useful to progressively
too challenging, start with the shins instead challenge balance, including a balance board
of the toes on the ball. with a whole sphere underneath the board
(which creates multi-planar instability) or a
Progression: The athlete can perform the rocker-board with a curved surface underneath
exercise with only one foot on the ball (see the board (which allows single-plane motion).
Figure 11b). Dynamic foam rollers are an inexpensive alter-
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Core stabilisation training for middle- and long-distance runners

native to the boards that also can be used to


challenge balance, proprioception, and stabili- SINGLE-LEG BALANCE—3 PLANES
ty. These include half-rollers and full-sized
rollers. Two other items that are invaluable to This next exercise progresses the athlete to
challenge balance and core stability and aid a single-leg stance. The rocker-board is used
proprioceptive training in the standing position in the three planes of motion. This exercise
are the Bosu Balance Trainer and the Dyna Disk also can be performed with a balance board,
(these can be used interchangeably.) The Bosu which is more demanding as it incorporates
has two functional surfaces that integrate all planes of motion simultaneously.
dynamic balance with sports-specific or func-
tional training: the domed surface is convex, The athlete takes one step forward while
the other side is flat and can be used for less maintaining alignment and balance, control-
challenge. The Dyna Disk is an air-filled plastic ling aberrant motion, mimicking a forward
disc that can be firmly inflated. It has a small- running motion. The goal is to maintain
er diameter than the Bosu and can be used like lumbo-pelvic alignment. The athlete controls
the Bosu Trainer, as it creates an increased pro- movement in the three planes of motions by
prioceptive challenge to the athlete while placing her feet in various positions on the
standing on it. The Dyna Disk is unstable and board. The athlete then alternately steps for-
does not have a base like the Bosu trainer. ward and backward onto the rocker-board.

Progression: Once the athlete achieves


FORWARD/BACKWARD ROCKING static stability and can remain stable while
standing on the rocker board, she can add an
In this exercise, a rocker-board is used to accessory motion. The athlete can swing the
challenge balance in the frontal plane of arm and the non-weight-bearing opposite leg
motion. Standing on the rocker-board with (as though mimicking running). No excessive
both feet in perfect postural alignment, the motion in the pelvis or lumbar spine should
athlete gently rocks forward and backward. occur during the swing phase.
(To maintain ideal posture, the athlete can
create an imaginary line through the joints of
the ankle, knee, hip, and shoulder. The ear
should align in a straight line with these
joints, with no excessive extension [swayback]
of the lumbar spine or anterior pelvic rota-
tion.) While rocking, there should be no excess
body movement in the coronal or transverse
planes. This exercise should be performed for
several minutes. The goal is to optimally align
the spinal curves and lower extremities.
Figure 13: Single-leg Balance—3 Planes
Progression: The athlete can
progress to a slight flexed-knee
position, with fast and slow move- WEIGHT TRANSFERS WITH
ments to stimulate the righting PROPER ALIGNMENT
New Studies in Athletics • no. 1/2005

reflexes and balance reactions.


She also can progress the stepping The preceding exercise progresses to
motion to the three axes of “falling” onto an unstable surface. Figure 14
motion. shows a rocker-board and “falling” onto a
circular balance board. Again, the emphasis is
Figure 12: Forward/Backward on spinal alignment from the head to the
Rocking sacrum. The athlete steps forward quickly
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Core stabilisation training for middle- and long-distance runners

and catches herself from falling over with a tion. The athlete raises the opposite arm
quick forward movement of the leg onto the simultaneously into flexion, while maintain-
board. ing postural alignment with an erect spine,
allowing only the extremities to move.

Progression: Once the athlete can maintain


lumbar spine stability without effort, she can
attach a pulley or resistive cord to the ankle
to increase the challenge to the hip flexors

Figure 14: Weight Transfers with Proper


Alignment

Functional Movement Training

Functional movements require acceleration,


deceleration, and dynamic stabilisation. A
functional exercise regimen specific to the Figure 15: Single-leg Balance with Hip Flexion
demands of running includes single-leg drills,
three-dimensional lunges, resistive diagonal
patterns of the upper and lower extremities, MULTI-DIRECTIONAL LUNGES
and tri-planar movement sequences. Athletes
can progress through the three planes of The athlete begins this exercise with a for-
motion by performing similar exercises on ward lunge. Again, the emphasis is on main-
balance boards, the Dyna Disk or Bosu type taining a neutral spine position and abdomi-
trainers, as static trunk and core stability nal brace throughout the entire movement.
have been mastered. Once these exercises are As the athlete steps forward, knee flexion of
performed at a high level, the coach can be the forward leg is limited to 90º. The knee
assured the athlete has the necessary core joint should be over the ankle joint and the
stability to start plyometric drills. patella aligned with the second toe. The lower
part of the leg should be perpendicular to the
ground, as shown in Figure 16.
SINGLE-LEG BALANCE WITH
HIP FLEXION Progression: Once strength and stability in
the forward (sagittal) plane have been
This exercise provides a functional move- achieved, the athlete can begin stepping out
ment pattern that is similar to running. The at oblique angles, creating a narrower lunge
exercise seeks to increase stability of the or a wider lunge in the coronal or transverse
lower abdominal muscles while using a for-
ward motion at the hip. The exercise is
designed to develop sagittal-plane control.
New Studies in Athletics • no. 1/2005

While balancing on one leg, the athlete


imitates a running motion. As the upper thigh
is lifted forward in a running motion, she con-
centrates on maintaining the abdominal
brace and lumbo-pelvic stability while avoid-
ing excessive anterior or posterior pelvic rota- Figure 16: Multi-directional Lunges
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Core stabilisation training for middle- and long-distance runners

planes. The athlete can also step out onto an achieved in the frontal plane of motion, the
unstable surface such as a Bosu Trainer or athlete can begin stepping up at a 45°.
Dyna Disk, which vastly increase the proprio-
ceptive and dynamic core-stability challenge.
STANDING PULLEY OR MEDICINE BALL
ROTATION
RESISTED ALTERNATE ARM/LEG
STEP-UPS This resistive, dynamic trunk pattern chal-
lenges the core with a rotational movement
This exercise is a continued progression of pattern while the athlete maintains stabili-
multi-directional lunges and must not be ty in the hips and pelvis. It requires strict
started until strength and stability in that bracing of the abdominal muscles and lock-
exercise has been achieved. ing the rib cage and pelvis together to avoid
unnecessary stress from torsion on the
This exercise utilises a sports cord to resist spine.
shoulder and hip flexion while doing Step-
ups. The movement pattern is similar to the The athlete stands with feet about shoul-
running gait. The athlete’s opposite arm and der-width apart and knees slightly bent. She
leg are resisted simultaneously to increase the activates the abdominal brace prior to the
strength and co-ordination of this movement movement. It is important to emphasise
pattern. postural alignment, with the scapulae
retracted and depressed. The athlete should
maintain neutral spinal angles throughout
the movement. Holding a straight-arm posi-
tion (elbows extended) while grasping the
pulley handle or medicine ball with both
hands, the athlete rotates the trunk by acti-
vating the abdominal obliques and spinal
rotators. She concentrates on keeping the
arms extended in front of the chest. It is
important that the pelvis remains stable in
Figure 17: Resisted Alternate Arm/Leg Step-ups the movement. Resistance is perpendicular
to the body.

MULTI-DIRECTIONAL RESISTED This exercise can be done in the same man-


ALTERNATE ARM/LEG STEP-UPS ner using a 2.0 to 4.0kg medicine ball.

This is a continued progression of the pre- Progression: The athlete can add diagonal
vious exercise. Once strength and stability is motions with the pulley or medicine ball.
New Studies in Athletics • no. 1/2005

Figure 18: Multi-directional Resisted Alter- Figure 19: Standing Pulley or Medicine Ball
nate Arm/Leg Step-ups Rotation
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Core stabilisation training for middle- and long-distance runners

cular to the body. She steps forward with the


FORWARD LUNGE WITH A MEDICINE medicine ball in front of her chest with the
BALL WITH TRUNK ROTATION arms extended. Once the lunge portion is
completed, she rotates the trunk by bringing
The purpose of this exercise is to challenge the ball across her body towards the same
the trunk muscles with appropriate weight side as the front leg and then returns the
shift, balance, and control on one leg. It uses ball to midline as the next step is made. It is
a resistive movement of the trunk with a important that the knee joint on the step-
lunge that demands a high level of lumbo- ping limb does not come forward past the
pelvic and lower extremity stability as the vertical angle relative to the ankle joint. The
athlete moves the ball in a diagonal pattern second toe is aligned perpendicular with the
across the body. patella.

The athlete will need approximately 30m


to complete this exercise. She stands STANDING REVERSE WOOD-CHOP
upright, holding onto a 2.0 to 4.0kg medi- WITH A MEDICINE BALL
cine ball, with arms outstretched, perpendi-
This exercise is a resistive diagonal pat-
tern of the trunk that demands a high level
of lumbo-pelvic stability and combines
upper- and lower-chain integration as the
ball is moved in a diagonal pattern across
the body.

The athlete stands, holding onto a 2.0 to


4.0kg medicine ball with both hands, with
the feet approximately shoulder-width
Figure 20: Forward Lunge with a Medicine apart. While holding the arms in front of the
Ball with Trunk Rotation body with elbows extended, the athlete

Sample Programme

Summer/Fall—Base Training/General Preparation


(3 x /week, 2 sets of 15-20 reptitions for each exercise)
Restore mobility/address any muscle imbalances
Fundamental core stability exercises
Sensory-motor stimulation

Winter—Specific Preparation
(2-3 x /week, 2 sets of 10-15 reptitions for each exercise)
Advanced core stability exercises
New Studies in Athletics • no. 1/2005

Functional movement training

Spring/Summer—Competition
(1-2 x /week. 1-2 sets of 8-12 repetitions for each exercise)
Similar to specific preparation training with the addition of plyometric exercises

36
NSA 01 2005 21.03.2005 10:38 Uhr Seite 37

Core stabilisation training for middle- and long-distance runners

moves the ball from a lower position at the Conclusion


hip, raising it across the body to the opposite
shoulder, simulating a wood-chopping This article is intended to provide an under-
motion. The motion is then reversed by start- standing of the importance of core muscula-
ing at the lower knee position and bringing ture to middle- and long-distance runners
the ball diagonally across the body, ending and to offer exercises that will help them
overhead at the opposite shoulder. This exer- achieve desired stability, balance, and neuro-
cise also can be performed with resistive muscular control. It is highly recommended,
cords or a pulley system simulating the same however, that athletes consult a skilled prac-
motions. titioner to address individual needs and max-
imise results from a programme of this
Progression: The athlete can progress to nature.
standing on one leg, using the opposite arm
to complete the motion.

Please send all correspondence to:

Figure 21: Standing Reverse Wood-chop with Michael Fredericson, MD


a Medicine Ball E-mail: MFRED2@STANFORD.EDU

REFERENCES

RICHARDSON, C.; JULL, G.; HODGES, P.; HIDE, J.: HODGES, T.W.; RICHARDSON, C.A: Altered trunk mus-
Therapeutic exercise for spinal stabilization and cle recruitment in people with low back pain with
low back pain: Scientific basis and clinical upper limb movement at different speeds. Archive
approach. Edinburgh: Churchill Livingstone, 1999. of Physical Medical Rehabilitation. 1999 Sep;
80(9): 1005-1012.
COMERFORD, M.J.; MOTTRAM, S.L.; Movement and
stability dysfunction. Contemporary developments. FREDERICSON, M.; COOKINGHAM, C.L.; CHAUDHARI,
Manual Therapy. 2001; 6(1): 15-26. A.M.; DOWDELL, B.C.; OESTREICHER, N,;
SAHRMANN, S.A.: Hip abductor weakness in dis-
New Studies in Athletics • no. 1/2005

HODGES, T.W.; RICHARDSON, C.A.: Inefficient muscu- tance runners with iliotibial band syndrome. Clin-
lar stabilization of the lumbar spine associated ical Journal of Sport Medicine. 2000 July; 10(3):
with low back pain: A motor evaluation of trans- 169-175.
verse abdominus. Spine. 1996; 21(22): 2640-
2650. McGILL, S.; Ultimate back fitness and performance.
Wabuno Publishers, 2004.

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