Hi all,

this is my first post on this forum so hello :-).
Talk about opening a can of worms!! Core stability remains a very confusing subject for myself as well physiodawn, but I would like to make a couple of points:

For a nice overview see Hodges & Lorimer (2003), who work out of University of Queensland where a lot of this physio research is being pioneered.

As somasimple says the crux appears to be primarily in the motor timing of the contractions as opposed to the absolute strength (see work by Hides and/or Hodges). I would raise issue with his observation that no transversus activity was apparent in Olympic weightlifters - surely part of the difficulty in this area is the fact that it is impossible to visually assess the activity of TA!!! A well/ill defined rectus abdominus has little correlation with strength of TA.

Don't forget the role motor and somatosensory remodelling that occur with pain, particularly of a chronic nature. the implications of this upon pain and movement are massive.

Regarding real-time ultrasound I would agree that in some areas this has real benefits, particularly as an assessment and feedback tool. On a personal note, on the single occasion I have used real-time US it was fascinating to note that my "low-level" tonic contraction of TA was actually a near maximal contraction in terms of increased CSA of TA. I now tell my patients to hold the contraction at the point they first feel tension. Again, TA is a difficult muscle to directly,objectively assess.

Don't forget that Core stability involves the complicated interaction of numerous structures and processes and that it is unlikely we will improve our patients by solely activating TA.

Finally, don't forget that as with most areas we are in all likelihood looking at aheterogenous sample with our patients with a multitude of possible pathologies dysfunctions and so some may present with 'core-stability' dysfunction and others mauy not.

Hope that lies well with you all. Anything you disagree with, I'm always keen to learn.

Yours

chunkypuffin

Hodges PW and Lorimer GL (2003). Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of Electromyography and Kinesiology. Vol 13 pp361-370