14 Dec The Need for Regressed Core Training in Athletes – A Gymnastics Case Study
As a sports physical therapist, it never ceases to amaze me how athletes can perform at high levels despite often having huge deficits. One of the most frequent weaknesses I see in athletes is poor core control. Perhaps the two most frequent sets of athletes I see lacking core control are CrossFit athletes and gymnasts.
Many athletes would greatly benefit from actually REGRESSING their core control work, and working on more basic core movements. This “step back” can frequently lead to big improvements in sports performance.
Recently, I treated a 13-year-old high-level male gymnast with a primary complaint of right-sided abdominal pain during gymnastics. This pain was limiting him to performing only about 50% of his normal practice. The movement giving him the most problem was a back uprise (which, as you can see in the following video, requires lots of core control if performed with optimal technique).
Upon examination, the patient had pain with resisted hip flexion and passive hip extension. His hollow body was surprisingly weak, with the athlete being unable to hold a proper hollow position for >5 seconds. He could, however hold a hollow-like position with the back not held in flexion. His injury was an overuse of his psoas muscle to compensate for poor core control.
After a pain-free psoas release (TheManualTherapist.com), we began retraining his core control.
His home exercise routine began with 90/90 breathing to help him relearn the hollow spine positioning and Wall Press Abs to further challenge core control.
After he demonstrated competency with these exercises, we progressed him to Bear Crawls and Slider walks to combine core control during extremity motion.
We also challenged his ability to maintain a hollow body hold during wall walks (http://hybridperspective.com).
After three visits, the gymnast was pain-free, and his coach even reached out to say that he looked a full skill-level higher after two weeks of this regressed core training. Despite his high-skill, his lack of ability to perform basic movement patterns with integrity had not only impacted his performance but lead to an injury.
This core control exercise progression not only benefits gymnasts, but many fitness athletes would see quick improvements in their performance (and injury prevention) if they took a small step back to master fundamental movements.