The Illusions of ‘Core-Stability’ (1)
There is a very wide-spread belief in the importance and healing properties of “core stability”. It is a view that I have often heard in connection with Physiotherapy, Yoga, Pilates and gym training… all suggesting that a deliberate training of ‘core musculature’ is an essential element in good posture and relief of back-pain.
This view has been supported by studies that demonstrate that certain deep muscles of the abdomen, specifically the transverse abdominus and the lumbar multifidus undergo changes in people with chronic back-pain.
The view is that correction or rehabilitation of these muscular changes will result in improvements in posture and reductions in back-pain. While on the face of it, you can understand why people would think this, this conclusion would appear to be a classic example of “Correlation does not equal causation”1.
A recent systematic review of studies in this field has shown no support for the doctrine of training ‘core-stability’ as a means to correct lower back-pain.2 That of course, does not mean that muscular strength is not important in the abdomen, but for me points to the dangers of specific corrections for perceived specific problems. Muscular strength alone is not responsible for bodily support. While an increase in specific background muscle tone may help in some cases, it is how the person is using the body as a whole, in other words the dynamic balance of muscle tone, that determines the quality of a person’s ‘core stability’. Alexander teachers are trained to view specific aspects of actions, such as ‘core stability’ as occurring in the context of the overall coordination of the person. Alexander’s famous “Use of the Self”.