Number Ten, December 2002    -    SPORTS MEDICINE     &     USAPL SUSPENSION LIST 
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Dr. Michael Hartle
Medical Committee Chair

Trunk Stabilization Concepts and Exercises
by Michael A. Hartle, D.C., D.A.C.B.N., C.C.N., C.C.S.P., C.S.C.S., E.M.T.



Part Six of Six

Exercises
	   

Balance/Proprioception

   Single-Leg Standing

      Progression:	Shoes - Bare Feet - Unstable Apparatus 

         (i.e. Airex pad, wobble board, sand, etc.)

         Eyes Open - Eyes Closed

         Arms Static => Arms Dynamic => Arms Dynamic Weighted

      Up to 1 minute per leg

   Wobble Board

      Front - Back; Side - Side; All Over Balance

         Can be done for sets/reps (2-3 sets x 10-20 reps) 

		 or for time limit (10 sec to 1 minute)



Bench Press

   Ball Push-ups

      Tempo:        1-1-1

         Sets/Reps: 2-3 Sets x 5-15 reps

   Forward Ball Roll

      Tempo:        3-3-3

      Sets/Reps:    2-3 sets x 10-12 reps

   Rotator Cuff Exercises

      Shoulder Horn

         Tempo:     2-0-2

         Sets/Reps: 2 sets x 15-20 reps

      Side Lying Lateral Raises

         Tempo:     2-2-2

         Sets/Reps: 2-3 sets x 10-15 reps



Squat/Deadlift/Trunk

   Supine Lateral Ball Roll

      Tempo:        1-0-1

      Sets/Repetitions: 2-3 sets x 6-8 reps

   Bridging - Floor => Ball

      Tempo:         Hold for 5 seconds, rest for 10 seconds, 

	  eventually moving to hold for 10 sec., resting for 5 sec.

      Sets/Reps:     2 sets x 10-12 reps

   TVA (Transverse Abdominis)

      4 Point TVA

         Tempo:     Hold for 5 seconds, rest for 10 seconds, 

		 eventually moving to hold for 10 sec., resting for 5 sec.

         Sets/Reps: 2 sets x 10-12 reps 



		Sample TVA Training

       Week Exercise  Rest    Intensity   Reps   Tempo   Sets	

        1	4 Point   1:00                10     10/10   1-4	

        2	BP Cuff   1:00    - 10 mm Hg  10     10/10   2-4	

        3	BP Cuff   45 sec. - 10 mm Hg  10     10/5    2-4	

        4	BP Cuff   30 sec. - 10 mm Hg  2-4    =/> 100 s.  

		

		CRAC Deadlift

            Tempo:        3-1-3

            Sets/Reps:    2-3 sets x 6-8 reps

References In addition to the above studies, material used in research for this presentation was obtained from the following sources:
  1. Liebenson C (ed) Spinal Rehabilitation: A Manual of Active Care Procedures. Williams and Wilkins, Baltimore 1996
  2. Murphy D. New concepts in spinal stability and instability, Part Two. Chiropractic OnLine 1996
  3. Chek, P. Back Strong and Beltless. Testosterone.net Magazine. Colorado Springs, CO 2000
  4. Lander J.E., Hundley J.R., Somonton R.L. The effectiveness of weight-belts during multiple repetitions of the squat exercise. Medicine and Science In Sports and Exercise 1992 May;24(5):603-9
  5. Ed by: Vleeming A., Mooney V., Snijders C.J., Dorman T.A. and Stoeckart R. Movement, Stability & Low Back Pain - The essential role of the pelvis. Churchill Livingstone, New York, Edinburgh, London, Madrid, Melbourne, San Francisco and Tokyo, 1997
  6. Lee D. The Pelvic Girdle (2nd. Ed.) - An approach to the examination and treatment of the lumbo-pelvic-hip region. Churchill Livingstone Edinburgh, London, New York, Philadelphia, Sydney, Toronto, 1999
  7. Miyamoto K., Iinuma N., Maeda M., Wada E., Shimizu K. Effects of abdominal belts on intra-abdominal pressure, intra-muscular pressure in the erector spinae muscles and myoelectrical activities of trunk muscles. Clinical Biomechanics, Feb. 1999 14(2):79-87
  8. Bauer J.A., Fry A., Carter C. The Use of Lumbar Supporting Weight Belts While Performing Squats: Erector Spinae Electromyographic Activity
  9. Lander J.E., Simonton R.L., Giacobbe J.K.F. The effectiveness of weight-belts during the squat exercise. Medicine and Science In Sports And Exercise Vol. 22, No.1 Feb. 1990 pp 117-26
  10. Chek P. Scientific Core Conditioning (correspondence course). Chek Institute, Encinitas, Ca. 1993,1999
  11. Chek P. Scientific Back Training (correspondence course). Chek Institute, Encinitas Ca. 1995
  12. Janda V. Muscles, Central Nervous Motor Regulation and Back Pain (27-41)In: Korr I.M. (Ed.) The Neurobiologic Mechanisms in Manipulative Therapy. Plenum Press New York and London 1978
  13. Richardson C., Jull G., Hodges P. and Hides J. Therapeutic Exercise For Spinal Segmental Stabilization In Low Back Pain - Scientific Basis And Clinical Approach Churchill Livingstone, London, New York, Philadelphia, Sydney and Toronto, 1999
  14. Cresswell A.G., Grundstrom H., Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 1992, 144, 409-418
  15. Norris C.M. Functional load abdominal training: part 1. Journal Of Bodywork And Movement Therapies, July 1999
  16. Kegel A.H. Progressive Resistance Exercise In The Functional Restoration Of The Perineal Muscles American Journal of Obstetrics and Gynecology August, 1948

FOR FURTHER INFORMATION:
Michael A. Hartle, D.C., D.A.C.B.N., C.C.N., C.C.S.P., C.S.C.S., E.M.T.
3835 West Jefferson Boulevard
Fort Wayne, Indiana 46804
Telephone: (219) 432-7339
Facsimile: (219) 436-4750
Website: www.chiropower.com
Email: pwrdoc@fwi.com

I would like to announce that starting December 1st, 2002, we are creating and opening a new division of our clinic. The Athletic Performance Center will offer physical therapy and rehabilitation services, one-on-one personal training and last, but certainly not least, athletic performance training. We have brought a Ball State University graduate, Michael Robertson, MS, CSCS, onboard to direct this new division. This will be the place to go in the Midwest for the aforementioned services. More to come on this in the future!!

Michael A. Hartle,
USA Powerlifting Executive Committee Board Member
Chairman, USA Powerlifting Sports Medicine Committee
Chairman, USA Powerlifting Drug Testing Committee