Core
instability is the result of failure of the joint supporting structures
to maintain adequate joint congruity.
When we make any voluntary trunk movement, it is the "prime movers",
the rectus abdominus, obliques, erector spinae etc., (the large
superficial muscles) that are responsible for the gross
multijoint movement. It is beyond our conscious control that the small
multifidus, transversus abdominus and pelvic floor muscles are working
to stabilize our spinal segments to control this movement.
These stabilizing muscles work reflexively, automatically in a healthy
individual. When the back is injured either through a sprain or strain,
or disc herniation or disc degeneration, these stabilizing muscles are
weakened or inhibited and therefore don't support your spine when
demands are made upon it. When that support is not there, the
large superficial muscles take over. This can lead to excessive
stresses and shear on the joints in the spine. If these large muscles
are used regularly to perform movements, without the support of the
stabilizing muscles, these movement patterns become ingrained and can
lead to chronic pain and joint dysfunction, or instability.
When the large "prime movers" are used excessively to try to support
one's spine they fatigue quickly resulting in burning pain, aching, and
"trigger points". In order to relieve the pain in these large
superficial muscles you must re-educate and strengthen the deep
stabilizing musculature.
In simplistic terms,
you may think of most joints as a curved surface that fits inside
another curved surface, or ball and socket in a few cases. With some
injuries, the socket part of the equation essentially becomes larger,
so the ball moves around excessively. This can create damage to the
joint surfaces and put excessive strain on the ligaments that support
the joints.
Some signs of core instability are as follows:
Clinical
research has shown that injury to the spine can result in an
increased "neutral zone", resulting in core
instability. The ligaments and other passive (nonmuscular) structures
will only provide support toward the end of range of a joint. The
stabilizing muscles of the spine have the potential to compensate for
this core instability if they are strengthened, and recruited
appropriately.
Exercise
ball exercises will assist in the retraining and
strengthening of these muscles in a functional range. If you suffer from back pain, prior to starting a
lumbar stabilization program, you should be evaluated by your family
physician and physical therapist (PT). Your PT will design a program
specific to your condition and monitor your rehabilitation. If you try
an exercise that exceeds your abilities to stabilize your spine, you
may make your pain worse.
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Instability