Core Stability and Injuries Plus a Tennis Elbow Exercise

I know when I talk about core stability, some people will roll their eyes.

There is always a discussion in the fitness world on what the core is and if we should be focusing in on it.

Well when it comes to injuries, I focus on the core.

It is looking like core stability is playing more of a role when it comes to injuries.

I know in previous Injuries of the Month (patellofemoral pain syndrome, sacroiliac joint pain and piriformis syndrome), core stability has been a component of the exercise program that I have recommended.

I wanted to highlight some research that talked about injuries and core stability.

What They Looked At

They looked at 80 female and 60 male intercollegiate basketball and track athletes.

This was very interesting. They measured core stability by testing:

  • Isometric hip abduction strength
  • Isometric hip external rotation strength
  • Back extensor endurance (modified Beiring-Sorensen test)
  • Quadratus lumborum endurance (side bridge test)

Interesting Points in the Introduction

What They Found

These were the main results from the study:

  • Males produced greater hip abduction, hip external rotation and quadratus lumborum measures
  • Athletes who did not sustain an injury were significantly stronger in hip abduction and external rotation
  • Hip external rotation strength was the only useful predictor of injury status

Rick’s Comments

Often times when we focus on working on the core we think of crunches or bridge variations. It is interesting how this research expands on things further and looks at core function in different planes of movement and different movements. I like the fact that it highlights the importance of looking at hip abduction and hip external rotation strength. Many times this is not mentioned or covered in an exercise program.

Here is an exercise that I give to work on hip movement and strength:

A few comments on the exercise.  The exercise can be used for:

  • Educating the movement of hip movement from the rest of the body.
  • A dynamic stretching of the hip rotators.
  • A body weight active hip rotator exercise.

The directions given and the cueing can change the function of the exercise.

Where to get more information – Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34.

If you are looking for exercises to strengthen the external rotators of the hip, these are what I use:

Easy and Effective Exercises for Tennis Elbow

I am working on this month’s Injury of the Month. It is Tennis Elbow.

I was doing my research on the injury and came across this article, which was interesting. It talks about isometrics for an injury and really highlights the new trend in exercise rehabilitation.

What They Looked At

They wanted to see if isometric exercises were as effective as medication for pain relief in those with lateral epicondylitis (tennis elbow).

They had two groups:

  • Group 1 – Were shown the exercise and then they did it at home
  • Group 2 – Began the exercise after 4 weeks of medication

Interesting Points in the Introduction

  • An increase in symptoms from exercise will decrease the compliance rate to the exercise program
  • Performing the exercises too aggressively can increase the risk of irritation or injury
  • The above two points are obvious but nice to see them highlighted in an article

Tennis Elbow Exercise Performed

The researchers only gave one exercise.  Here are the details of the exercise:

  • The subjects did the exercise in a sitting or standing position with the arms flexed to just below shoulder height.  Then the wrists were moved in a slow controlled manner into extension with the fingers relaxed. The focus was on moving the middle finger towards the elbow in order to target extensor carpi radialis brevis.
  • The exercise was performed without pain and in a controlled manner.
  • Four sets of 50 repetitions with each repetition being held for 10 seconds, done daily.

What they Found

  • After one month, group 1 had a greater decrease in their pain levels compared to group 2
  • At 3, 6 and 12 month follow up there was no difference between the groups
  • Those that did not feel any benefit from the exercise program after one month were referred on to shock wave therapy

Rick’s Comment

Interesting to see the benefits of isometric strengthening on an injury, specifically with lateral epicondylitis. Isometric exercises are not exciting but effective when it is comes to an injury and the safest of the three types of contractions.

A lot of the research out there focuses on eccentric exercises for tennis elbow. This article highlighted the benefits of an isometric exercise which is less stressful on an injured area.

The number of repetitions was a surprise to me. Over a day performing 200 repetitions or about 33 minutes of exercise sounds like a lot. This is a trend that is occurring in exercise rehabilitation. The standard used to be 1 set of 10 repetition but this is fading away and does not correlate well with what many people do during the day (number of movement cycles performed in a day). Performing low load (isometrics) more frequently transfers more over to what one does on a daily basis and assists in recovery.

Just so you know, the tennis elbow exercise program will be coming out at the end of the month.

Where to get more details – Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. (2011). Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3.

That is it for another edition of the research review.  I hope this helps you out when it comes to core stability and injuries, plus a great little tennis elbow exercise.

Rick Kaselj, MS