Myths, by their very nature, are very hard to dispel once they've taken hold. Despite the core stability myth being exposed nearly ten years ago, and journalist Peta Bee writing about it in The Times in 2010, from conversations I have with people I'd say its hold is as strong as ever.
The myth is that by having a stronger "core" (a poorly defined term anyway) you will have better posture, less back pain, and will perform better in your sporting activities. There's an elephant in the room regarding this too and I'll come back to it later.
From personal experience I have never met anyone with a core so weak that they can't achieve good posture and less back pain without having to strengthen it. If you can walk into my Alexander Technique studio, your core is strong enough. And if it is technically a little “weak”, well-coordinated functional movement (the ability to perform normal daily tasks efficiently) will soon give it the tone it needs. Muscle tone, not strength; there's a world of difference! Balanced poise doesn't require "strength", and "stability" invariably translates into rigidity at the expense of mobility.
What isn’t weak are the habits that pull you away from your natural poise and freedom of movement. Millions of years of evolution have given you postural reflexes that work just fine if you don't interfere with them. You don't need to "do" good posture, simply stop doing bad posture. Stop thinking of posture as a correct position and instead as a dynamic and fluid balancing act.
So that elephant I mentioned: it (he) has a name, Joseph Pilates. If you haven't read his book Your Health, you'll probably find it quite amusing by modern marketing standards. He states quite clearly that what is required is "the simultaneous drawing in of the stomach and throwing out of the chest". The photos of Pilates demonstrating the “correct” way to stand look extremely tiring, I can't imagine anyone could keep that up for long. And it's clearly an affectation, it’s not natural at all. Why after millions of years of evolution would you need to do this? Why don't we instinctively do this as children? Ever see indigenous communities do this? They're not typically known for the postural abnormalities so prevalent in "civilised" culture. To be honest I found Pilates contradicts himself quite a bit in Your Health. I'd often find myself nodding in agreement with his principles only to not see it evidenced in practice. I guess it's very much a book of its time.
Not having read his other books I've not had a chance to see if he developed or changed his ideas over time. But I have spoken to a number of Pilates instructors (and had great feedback from my own clients about their Pilates instructors) who now place much less emphasis on this "drawing in of the stomach", working instead on the quality of movement in general, strengthening movement rather than muscle, which I can get on board with. It's all relative. I have been challenged that some people can't do the plank because their core is so weak. But that's not normal functional movement. Who needs to do the plank in their daily lives? And I have nothing against being generally strong. I just challenge whether it's medically necessary for the "core" to be specifically so to overcome back pain and improve posture.
Ironically, Stuart McGill, professor of spine biomechanics at the University of Waterloo in Canada, has shown that drawing in the stomach during movement can actually destabilise the spine. “In studies we have done, the amount of load the spine could bear was greatly reduced when subjects sucked in their belly buttons,” he says. “What happens is that the muscles are brought closer to the spine, which reduces the stability in the back. It becomes weak and wobbly as you try to move.”
The idea of core strength may have stayed within the Pilates community but for Professor Paul Hodges, head of human neurosciences at Queensland University. He performed experiments by attaching electrodes to two groups of people, one with healthy backs and another with chronic back pain. His results showed that the healthy group engaged a deeply embedded muscle called the transversus abdominis, causing it to contract and support the spine just before movement. In those with back pain, no such engagement took place, leaving the spine less supported. Hodges then claimed that this muscle could be strengthened by “drawing in” the stomach during exercises and this provided some protection against back pain. What he failed to see was that this wasn't an issue of poor strength, but poor coordination. Despite no clear link to core strength, the concept quickly spread spawning a huge rise in exercise classes based on Hodges work. And before you knew it, a stable core was lauded as a prerequisite in the fight against back pain and postural problems.
Thomas Nesser, assistant professor of physical education at Indiana State University, later tried to establish a positive link between core stability and the ability to perform ordinary daily tasks, but failed! He says that “despite the emphasis fitness professionals have placed on functional movement and core training for increased performance, our results suggest otherwise”. When he looked at top football players he found that those with a strong core played no better than those without. He concluded that “the fitness industry took a piece of information and ran with it. The assumption of ‘if a little is good, then more must be better’ was applied to core training and it was completely blown out of proportion.”
For an indepth look in to all of this there’s Professor Eyal Lederman’s paper The Myth of Core Stability - he’s an osteopath with a PhD in physiotherapy. Thankfully Jeff Cubos, who works in sports injury rehabilitation, has already reviewed it and I recommend you read his summary here.
My two favourite take home points from Jeff’s summary are:
- Focusing internally to concentrate on contracting stomach muscles is counter-intuitive to motor learning principles. Focusing on tasks external to the body is more conducive to performance improvement.
I’m telling my clients this all the time: you don’t hit a tennis ball by focusing on your muscles, but with spatial awareness, and:
- Chronic and recurrent back pain has been shown to be associated more with psychological and psychosocial factors.
This is Alexander to a T, in other words, it’s how you react to your environment.
I’ve also recently stumbled on this YouTube interview with physiotherapist Peter O’Sullivan on core stability:
He now calls his work Cognitive Functional Therapy, which wouldn’t be a bad name to describe the Alexander Technique, although as a profession we’d prefer Cognitive Functional Education. I don’t know what his methods are for achieving change in his clients, but he’s certainly taking the principles in the right direction. Maybe a collaboration is in order.
P.S. Since I first posted this, Lederman has done an interview that's really worth checking out, it makes his academic paper more accessible.
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Write a comment
Adrian Farrell MSTAT (Wednesday, 02 December 2015 20:34)
The day before I published this blog two well known newspapers printed articles recommending core stability training, showing just how entrenched this idea still is. Here are the articles:
Stacey (Friday, 04 December 2015 18:20)
I read your blog on the core stability myth and it has made me laugh (in fairness not much to laugh about as I am still very unwell)
But your post takes me back to four years ago when I was sent to a core stability physio class. Picture the scene there was one physio, me, someone who needed a translator and another who had narcolepsy and kept falling a sleep ( l kid you not) So essentially the physio was only effectively communicating with one of us - me.
The core stability sessions caused my muscle tone in my right foot to become so high, I had difficulty getting my shoes on. When I got up the next morning I could not even sit up in bed to drink a cup of tea!. I told the physio the next week (same happened) and she said I should take Baclofen to lower my muscle tone, so that I could build up my core. I decided not to do the core stability exercises instead of being put on medication :)
Lucy (Saturday, 05 December 2015 14:24)
My experience of pilates classes was that you engage the pelvic floor muscles and lightly zip up but no pulling in, contracting or tightening going on. That would be daft imo. The breath is key as well as in dance. I think the pilates industry is way out of control and lately entirely unregulated as far as l can tell. unfortunately it's become a bit of a scam to benefit gyms and not the gym goers. I was lucky l had very good teachers at virgin active when l started about 10 years ago living with a chronically repetitive strain injured ready to fall apart no muscle tone hypermobile jointed previous ballet body that had been stuck at a desk job for too long. It worked well for me and with 2 or 3 classes a week a year later l was better than new. It works for those who are used to using their bodies and already have mobility. I had not been taught these core strengthening techniques which would have protected my spine when l was doing all that silly hypermobile stuff. Athletes and dancers don't realise they are knackering their joints til its too late. Core strength seems to me really necessary for these people. You can't transpose this to the averagely mobile body. That's where pilates has gone a bit wrong. Pilates should stretch the muscles that need it and strengthen the ones that are underused. Any one size fits all idea is just not going to work.
Keith Silvester (Saturday, 05 December 2015 14:36)
I've often said that what the Alexander Technique offers is 'core freedom' rather than 'core strength'. But the problem of core strength is possibly elsewhere. From a psychotherapy perspective, what is important is a secure 'sense of self', which is an emotional-psychological-sensate experience. Some people have this quite naturally in spades , some people need the help of another to acquire it. The principal psychotherapeutic avenues of work are (a) building secure attachment, and (b) opening to 'what is me and what is not me'. A further aspect of building this sense of core freedom is the ability to 'disidentify' from those psychological and emotional patterns which have served a 'survival self' up till now, but which have now become self-limiting. With what we know of psychophysical unity, there are many ways into addressing what constitutes core strength.
Adrian Farrell MSTAT (Saturday, 20 February 2016 22:20)
Lederman has just done an interview that's really worth checking out, it makes his academic paper more accessible:
Adrian Farrell MSTAT (Monday, 22 August 2016 17:50)
Here's another article on the matter adding more weight to the idea:
Adrian Farrell MSTAT (Friday, 16 September 2016 10:55)
More on the core stability myth, I look forward to the day we can put this one to bed.
OBSESSIVE STRENGTHENING OF TRANSVERSE ABDOMINIS CAUSES PROBLEMS IN SEVERAL WAYS:
1. Raises the resting level of compression between the lumbar vertebrae = stiffness
2. Causes a loss of lumbar hollowing (lordosis) and stooping of the upper back
3. Causes ballooning and weakening of the pelvic floor
4. A permanently cinched-in abdomen reduces breathing efficiency of the diaphragm
5. Breathing difficulties (asthma, sleep apnoea) and panic attacks may be related
6. Over-awareness of 'switching on' TrA reduces spontaneous spinal movement = stiffness
Adrian Farrell MSTAT (Friday, 16 September 2016 10:59)
This one is from a cyclists perspective in relation to sporting performance.
Lavenia Aguinaga (Wednesday, 01 February 2017 20:47)
Wow, this piece of writing is pleasant, my younger sister is analyzing these kinds of things, therefore I am going to tell her.
Charleen Stainbrook (Monday, 06 February 2017 10:00)
Having read this I thought it was extremely informative. I appreciate you finding the time and effort to put this short article together. I once again find myself spending a lot of time both reading and commenting. But so what, it was still worthwhile!
Claudia (Sunday, 30 April 2017 17:38)
Hello, I am a Pilates & movement teacher and I totally agree with you. Contemporary Pilates & movement teacher do focus on movement and the harmonious relationships among the muscles and fascia. Posture has become "dynamic posture" and stability is now often replaced "dynamic stability". the point is we are designed to move, and nowadays we need to re-learn to move in a free and and pain free way. One of the biggest problem in the Pilates & fitness industry though, was created by a misinterpretation of Stuart McGill original study, that created too much emphasis on "core strength" that as often happens spirelled out of control. I only notice that this fixation on core strength still persist in physio's and gyms environment and not very qualified Pilates instructors. I would love to point you out in the direction of modern Pilates bio-mechanical research, should you be interested...
Malcolm (Sunday, 22 August 2021 19:01)
Wow! This was a really good read. I have been feeling for a while that something is off with all of this attention (or paranoia) over having a strong core. I kept asking myself…”why don’t I see people in non western societies doing planks all day every day? What is unique about the bodies of those in the west that makes us have innately weak cores? Of course the answer is nothing. This article provides me with fact to go along with my intuition. Thanks