Friday 15 June 2012

Core Stability-Doing the Dull Stuff...

Here goes, I am prizing the lid off a can of worms here...

Having interviewed a client earlier today with a foot problem and tracing the origin back to basic  'core instability' it got me thinking & watching some videos of cyclists to confirm I was not going mad...

This followed a rapid Internet search and there it was (research is so much easier than 20 years ago!)...

Something I have mentioned in passing to cyclists when looking at their 'fit' on the bike or their 'form' during a VO2 test, is lack of stability in the pelvic area.

A great deal of my experience here dates back to being a Basic Grade (I think they call them Staff Physios now) in a Specialist Stroke Rehabilitation Unit. One of the many challenges for the Patient is to engage the postural set of muscles on one side of the body, with reduced awareness and control without creating or increasing unhelpful patterns of movement elsewhere (or so I remember it).

How  does this relate to cycling?

Well, unless a serious recreational athlete or 'age grouper' is injured enough to seek treatment to the back very little stability work is ever done or perhaps worse still work is done but to strengthen the wrong muscles or movement patterns, the most common being to strengthen muscles whose primary function is movement in the erroneous belief this will assist postural control creating patterns of muscular recruitment that hinder rather help.

In general there is a training focus on
  • Leg Strength/Power
  • Aerobic Fitness
  • Bike Position
  • More expensive bike parts...
After all, these are all interesting and some can be measured and give instant feedback regarding results.

While I have no particular issues here, take this example for a moment.
  • When cycling, 5 points of contact are made with the bike.
    • Both hands on the bars.
    • Contact with the Saddle.
    • Both feet on the pedals.
  • The hands form a relatively fixed base of support that we rely upon for balance (this is exacerbated in the TT position due to the arm pads).
  • The pedals form a fixed base of support and serve as the main interface by which rider effort is conveyed to the bike.
  • The contact point with the saddle allows for movement both fore & aft and from side to side.
    • This is the key point, the bit in the middle is most free to movement, and is between to relatively fixed points, one of which has been trained to produce a sustained high power output alternating from side to side causing a torsional moment around the lower back and pelvis.
    • If this area has not been specifically trained to work with these stresses or has some previous injury that has not been properly dealt with, an issue is likely to result.
    • Think in the extreme of two solid objects joined by jelly, with one end needing to be still and doing as little work as possible (arms) the other driving the object forward by twisting - the result is unlikely to be efficient and at worst catastrophic.
  • The issues this can lead to could be (& there are more)
    • Asymmetrical movement on the bike leading to a functional weakness and injury.
    • Pain due to excessive movement.
    • Pain in other areas due to faulty mechanics.
      • My client today was complaining of sub-talar foot pain...
    • Reduced aerobic endurance due to respiratory restriction.
      • Respiratory muscles being recruited for stability needs.
    • Fatigue of postural muscles, leading to injury
      • A bike offers a relatively stable platform for the athlete, if a Triathlete was to pre-fatigue postural stability (core) muscles then run the likelihood of injury is even greater.
Just a few thoughts directed at Cyclists who really do need to 'Consider the Core'.

Where is the downside on this, it will assist with conditioning, is designed to make more effective use of the muscles that are being carried up hills any way so consider seeking the correct advice through the assessment of the qualified health professional and then getting some work done when you know you will not just be causing further issues.

Happy Miles
 

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