Written by: Lana Johnson, Sydney, AU based POLESTAR mentor and Physiotherapist
I have had many interesting and valid questions of late from a variety of health professionals and patients, centred around the question of core stability and its role in Pilates and musculoskeletal rehabilitation. Many of them have been brought to light by Eyal Lederman’s recent article, ‘The Myth of Core Stability’ in The Journal of Bodywork and Movement Therapies 2010.
I feel obliged to mention that my point of view is shaped by my various lenses; Physiotherapist, Pilates Instructor, ConnectTherapy Practitioner (formerly known as ISM Practitioner), dancer and human movement enthusiast! Given this blending of manual and movement therapy, as well as the intermingling of evidence based practice, it is little wonder at times that I feel stretched between different paradigms and constantly evolving evidence and beliefs.
I appreciate Dr Lederman’s work in shining the evidence-based torch on ‘Core Stability’. It helps to keep us as health professionals honest when making evidence based decisions for our patients and acts as a guide to highlight where the ‘Marketing Health Machine’ has extrapolated research findings for use in its own purpose. However catchy, his title, ‘The Myth of Core Stability’, does little to help clarify the inconsistencies of language and understanding which currently surround the manual and movement therapy worlds. I believe the only myth here, lies in our definition of the term “core stability”, rather than in the actual practice of it!
If you define core stability purely in terms of ‘strength’ and limit it to being region specific (ie trunk musculature only), then the myth of core stability is rampant. Tighten all of your ‘trunk’ muscles and notice how you feel and how your movement is. For most people it feels limiting and stiff. Any good movement therapist will tell you that the body works as an integrated whole and practising only chest lifts on the mat, or holding a plank for 5 minutes will not cure nor prevent back pain brought on by 1 hour of sitting!
If you however define core stability in terms of the whole organism (physical body, both peripheral and central as well as the mind) then there is no myth at all. Hundreds of manual and movement therapists understand that a well-constructed movement session helps a body recovering from injury or from poor movement strategies to regain options for movement both from a peripheral and central point of view. In fact what is happening in these sessions is not ‘core stability’ training as defined above but rather ‘integration’, whereby bodies are reminded how to ‘problem solve’ movement deficits through various central and peripheral paths.
Thus I think it is about time that we throw away the tarnished phrase ‘core stability’ and define a new term, like Polestar Pilates’ ‘Movement Integration.’ That helps build bridges between manual and movement therapists, aid communication and get back to improving the lives of our patients!