Deep Abdominal Muscles

This is a comment I got from a reader after my post on Saturday. I am going to do my best to put this one to rest once and for all “Having read your comment about the recruitment of the TrA and deep abdominal musculature, I can see your point if you are coming from the standpoint of treating a healthy athlete, but in one who has a history of back pain, it has been shown that deep abdominal musculature does not get recruited properly and that the spine is not stabilized appropriately in these athletes...so a process of encouraging the athlete to retrain the nervous system to recruit would be appropriate and beneficial.”

Let’s stop and think for a minute. Just because it is a high level athlete will the deep abdominal muscles respond differently? No way! There are three movement constants that dictate movement they are the same for the 83 year old lady living next door who has back problems and the other neighbor who is a 26 year major league pitcher. The movement constants are the body, gravity and the ground. They are constants because they are always there. It is the interplay between all three that insure efficient quality movements in the athletic arena and everyday life. If there is low back pain then research has shown that the deep abdominal are not recruited properly – is that a fact or another myth that has been perpetuated by “experts’? Robert B. Cialdini in his landmark book Influence – The Science and Practice States the situation quite clearly: “… there is an unsettling tendency in our society to accept unthinkingly the statements and directions of individuals who appear to be authorities on the topic. That is rather than thinking about an expert’s arguments and being convinced (or not), we frequently ignore the arguments and allow ourselves just by the expert’s status as “expert.” (Cialdini, Page 8) As best I can tell all of this dates back to around 1997 when several experts that eventually morphed into the NASM began to quote copious resources to support this deep abdominal recruitment shutdown. They cited numerous sources, but did anyone bother to go back and read the citations? I think people were just impressed by the volume of the references, I know I was. I maintain that very few did, because you would have drawn some different conclusions.

I think we all need to go back and read the research and look at the research critically in light of the conclusions that have been drawn. Most of the original research in this area that talks about the necessity of the drawing in maneuver and abdominal hollowing was done by the so called Queensland group. This has been interpreted so many different ways that I have resolved in the next week or two to go back and reread the book Therapeutic Exercise For Spinal Segmental Stabilization In Low Back Pain. London, England: Churchill Livingstone, 1999.

I am also going to revisit the work of Dr Stuart McGill as presented in his book Low Back Disorders. Champaign, Illinois: Human Kinetics, 2002. McGill summarizes the whole stability issue: “In summary, achieving stability is not just a matter of activating a few targeted muscles, be they the multifidus, transverse abdominis, or any other. Sufficient stability is a moving target that continually changes as a function of the three dimensional torques needed to support postures. It involves achieving the stiffness needed to endure unexpected loads, preparing for moving quickly, and insuring sufficient stiffness in any degree of freedom of the joint that may be compromised from injury. Motor control fitness is essential for achieving the stability target under all possible conditions for performance and injury avoidance.” (McGill p 146)

There are some things that I am sure of. Neurologically the brain does not recognize individual muscles, it recognizes patterns of movement. This is true for the deep abdominal muscles as well as the VMO or any other muscle. I do know that the body is smart, it can compensate and it does. Perhaps it is the word compensation that scares people. Think of it this way. If you are coaching a basketball team you want your best five players out on the floor as often as possible to give you the best chance of winning, however inevitably someone is going to get tired so you put in a substitute in order to maintain the effort, intensity and cohesion. That is exactly what the body does. It goes out and gets help, it looks for a substitute and it looks for the best substitute available. Thos deep abdominal muscle may not work as efficiently when the back in a painful state, but they will find help. We will not get them back into the game by taking gravity and the ground out of the equation. That is the court they have to play on. Therefore too much prone and supine work will create an artificial environment that will not get them ready to get back into the game.

Also let’s debunk this myth of firing sequence or order. That is great if you think you can get muscles to fire in a preferred sequence. It works on the treatment table, maybe? In real life there is no set firing pattern. Think about it logically, a fundamental reflex is flight or fright. When the caveman had to escape the saber tooth tiger he wasn’t too worried about recruiting the glute before the hamstring, he just ran to escape. That is the way the body works.

I am going to go back through the literature gain to see if I missed something. Meanwhile I encourage all of you to think critically, just because someone is an expert does not mean they are right.