OPTM Therapy | Trunk / Core Control Programs
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Sports Therapy Programs: Trunk / Core Programs

Trunk / Core Control Programs



Our ability to generate force in our extremities is, to a large degree, dependent upon our ability to stabilize our trunk. We consider the “core” to extend from the knees to the shoulders and include the muscles of the back, front and sides. Our body works together as a whole machine and training a few muscles is insufficient for optimal results. In order for us to generate maximal rotational force, which is typically a component of sports which have arm action, running and kicking. We must coordinate the linear motion, the weight shifting, and the positioning of the lower extremities to be able to propel the rotational motion in the desired direction in order to accelerate the throwing / hitting arm or kicking leg toward the target. Sports such as volleyball and swimming, in which the feet are not in contact with the ground, create unique challenges for training.


Low back pain is common in most sports. The injuries may result from overuse, but usually back pain results from poor dynamic control of the core and the ability to transfer forces safely.


Golf requires tremendous torsion of the hips and trunk to maximize the club head speed. Muscular weakness, tightness and poor technique will place great stress on the back. The use of the reverse ‘C’ during your follow through will twist and compress your spine and lead to disc and bony injuries. As we become less flexible, these problems become more prevalent. But, there are a number of famous professionals in the prime of their careers who also have severe back conditions due to the extremely repetitive nature of practice and possibly contributing mechanics.


Running also demands excellent core control. Repetitive pounding with your back in an arched position due to weak abdominals and poor pelvic control will lead to low back pain. If you participate in a sport which requires running, like soccer, basketball, tennis, field hockey or lacrosse, the demands on the core are even greater. These sports require rapid stopping, cutting, jumping, kicking and throwing / hitting motions. Without superior core control to provide stability for the spine and pelvis, we must compensate to perform the required actions. These compensation will eventually lead to injuries.


Volleyball has much of its action with both feet off of the ground. This requires great trunk control to jump and concentrically contract the spinal extensors to arch the back, eccentrically contract the abdominals to control the amount of spine extension and a twisting back of the upper trunk and then rapidly rotate the shoulder forward and concentrically contract the abdominals to generate and impart great force to the ball. Then, the player must land and be get ready for the next shot. This landing also must be controlled by the hips as described in our program for landing.


Swimming is performed horizontally with no ground support of the lower extremities, thus the hips and trunk generate the control for the spine. Strokes such as the butterfly or breast stroke create the most amount of repetitive extension stress due to the arching of the back during the stroke. Holding a kick board out in front of you and kicking will also arch your back. Competitive divers often develop low back pain from entering the water in a spine extended position. As can be understood, many low back conditions in swimming and diving result from repetitive or sustained extension, possibly from overuse, inadequate abdominal control and / or hip weakness or poor form.


Gymnastics typically develop extension loading type of low back pain due to the repetitive back bends and the landing technique. The nature of gymnastics and the scoring requires one to ‘stick the landing.’ We have all seen the gymnasts land with their spine extended, their chest up and the arms in the air. This may be esthetically pleasing and score points, but landing in an extended position can lead to stress fractures in the spine, spondylolysis and perhaps spondylolisthesis. The gymnast begins to complain of back pain with standing, walking, leaning backward and of course during practice. The primary cause is the technique but inadequate abdominal and lower extremity shock absorption may also contribute to this condition. The gymnast must rest to recover. If they do have a bony injury, they may also need a brace to control the spine condition while healing. But they need to have specific rehabilitation to return to competition.


Our specialists at OPTM are biomechanical experts and also have an in-depth knowledge of a wide variety of sporting techniques and requirements. We will analyze your condition and your sporting form to determine any necessary adjustments and determine your range of motion, strength, coordination and deficiencies. We are not coaches but we will work closely with your coaches to ensure that they are aware of your condition and will offer guidance in practice regarding your performance during your recovery and future competitions. We will prescribe specific exercises to resolve all of the contributing issues and progress you through a complete program which will allow you to return to competing. You will receive an independent program, which will include first aid, exercises, proper rest and safety measures.


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