Redefining Core Strength
Combining Proprioceptive Specific Core Strengthening With The Benefits Of Decompression
With our sequential proprioceptive specific Muscle Pattern Re-Organization approach you will be able to give your clients the most advanced and comprehensive spinal treatment and core strengthening in our field today.
Review proper patient set up and proper use of the decompression strap prior to initiating exercises with your patients.
Section 1: Deep Core Strengthening
Section 2: Strengthening the Outer Core Muscles
Section 3: Sport Specific/Advanced Exercises
Section 4: Unloading/Decompression
Section 5: Case Study
Scoliosis Protocol Deep Core Stabilization/Disc Protocol
Section 1: Restoration of Spinal Mobility and Deep Core Strengthening
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Our system is proprioceptive specific and focuses on the deep core muscles first. Performing exercises 1-5 prior to progressing our clients to the intermediate and outer core muscles is an important concept to follow and is what sets us apart from most core strengthening programs. These muscles have 4-5 times as many mechanoreceptors than the larger outer core muscles. So not only are these small deep muscles responsible for controlling and stabilizing segmental motor control they have the major responsibility for controlling the larger more powerful outer core musculature. |
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Exercise 1: Magna Maneuver
Brian Magna a Total Spinal Fitness Clinical Affiliate and owner of Magna Physical Therapy in Avon Connecticut added this valuable exercise to our routines. We now use this regularly to initiate our protocol and this maneuver works great as a cool down following an aggressive routine.
This maneuver will initiate segmental lumbar extension in the most non invasive manner. While unloaded we are able to gently re-establish segmental lumbar extension. Utilizing the proprio-core pads you will be able to provide proprioceptive feedback to the patient ensuring the corrected movement patterns can be repeated in the same manner.
(See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
(See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
Magna Maneuver Video
Exercise 2: The Hula
This exercise will restore segmental side bending initiating deep core Intertransversarii. The resistance straps provide the proprioceptive feedback to ensure your clients are performing the movements correctly.
Hula Video
Exercise 3: Tail Bone Raise
The different size proprio-pads and resistance bands will provide your clients with a fulcrum and the proprioceptive feedback to ensure correct and repeatable movement patterns. This exercise can be progressed to isolated resisted Rectus Abdominus strengthening while the spine remains in a decompressed position. |
This exercise is extremely important as this movement performed while unloaded not only provides mobilization to the vertebrae it will safely initiate segmental extension. Restoring these natural segmental movements in a safe unloaded position helps to facilitate the disc pump mechanism which is the body's natural mechanism for providing the discs with nutrition through mechanical fluid exchange. 
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(See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
Tail Bone Raise Video
Exercise 4:
Functional Pelvic Rotation/ Unilateral Multifidus Training
The Clinical Significance of Restoring Lumbo-Pelvic Rotational Synergy.
1. Re-establishing and optimizing the mechanics of the gait cycle.
This exercise is a very powerful and important exercise as this movement pattern re-establishes the functional rotational movements associated with the oblique axis's of the sacrum. Our lumbar spine was designed to move segmentally in synergy with the sacrum and pelvis. We utilized the most functional movement of the lumbo-pelvic region and re-pattern, or re-establish, the natural biomechanics that occur during the gait cycle. This is the only system that provides resisted unilateral isolated Multifidus strengthening. With the use of the proprio-pads and resistance bands your clients will get the proprioceptive feedback to isolate these muscles. This exercise is initiated with isolated unilateral Multifidus strengthening and progressed through Muscle Pattern Re-Organization restoring the synergy of the Oblique's and TA with the deep core while performing functional rotation/de-rotation of the pelvis.
2. Reducing the loads on the lumbar discs.
Clinical studies reveal that a rhythm with high pelvic rotation and low lumbar flexion involved more global muscles and increases the role of the disc in resisting spinal loads while its counterpart, with low pelvic rotation, recruits more local muscles and engages the ligaments to lower the disc loads. On the other hand, restoring a normal rhythm that has balanced pelvic and lumbar rotations yields almost equal disc and ligament load-sharing and results in more balanced synergy between global and local muscles. This demonstrates that the spinal response during movements that involve loading the discs is highly dependent on the lumbo-pelvic rhythm.
Tao Liu, Kinda Khalaf, Samer Adeeb, Marwan El-Rich: Effects of lumbo-pelvic rhythm on trunk muscle forces and disc loads during forward flexion: A combined musculoskeletal and finite element simulation study: Journal of Biomechanics 2019 Jan 3;82:116-123
Our system is the only system in our field today that allows for isolated resisted strengthening of the Multifidus in a position of decompression. The literature is filled with research on the importance of this deep core stability. Here are just a few.
1 . Hides J, Richardson C, Jull G. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine1996;21:2763–9.
2. Richardson C, Jull G, Hodges P, et al. Therapeutic exercise for spinal segmental stabilization in low back pain. Scientific basis and clinical approach. London: Churchill Livingstone, 1999.
3. Hides J, Stokes M, Saide M, et al. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine1994;19:165–72.
(See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
This exercise is a very powerful and important exercise as this movement pattern re-establishes the functional rotational movements associated with the oblique axis's of the sacrum. Our lumbar spine was designed to move segmentally in synergy with the sacrum and pelvis. We utilized the most functional movement of the lumbo-pelvic region and re-pattern, or re-establish, the natural biomechanics that occur during the gait cycle. This is the only system that provides resisted unilateral isolated Multifidus strengthening. With the use of the proprio-pads and resistance bands your clients will get the proprioceptive feedback to isolate these muscles. This exercise is initiated with isolated unilateral Multifidus strengthening and progressed through Muscle Pattern Re-Organization restoring the synergy of the Oblique's and TA with the deep core while performing functional rotation/de-rotation of the pelvis.
2. Reducing the loads on the lumbar discs.
Clinical studies reveal that a rhythm with high pelvic rotation and low lumbar flexion involved more global muscles and increases the role of the disc in resisting spinal loads while its counterpart, with low pelvic rotation, recruits more local muscles and engages the ligaments to lower the disc loads. On the other hand, restoring a normal rhythm that has balanced pelvic and lumbar rotations yields almost equal disc and ligament load-sharing and results in more balanced synergy between global and local muscles. This demonstrates that the spinal response during movements that involve loading the discs is highly dependent on the lumbo-pelvic rhythm.
Tao Liu, Kinda Khalaf, Samer Adeeb, Marwan El-Rich: Effects of lumbo-pelvic rhythm on trunk muscle forces and disc loads during forward flexion: A combined musculoskeletal and finite element simulation study: Journal of Biomechanics 2019 Jan 3;82:116-123
Our system is the only system in our field today that allows for isolated resisted strengthening of the Multifidus in a position of decompression. The literature is filled with research on the importance of this deep core stability. Here are just a few.
1 . Hides J, Richardson C, Jull G. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine1996;21:2763–9.
2. Richardson C, Jull G, Hodges P, et al. Therapeutic exercise for spinal segmental stabilization in low back pain. Scientific basis and clinical approach. London: Churchill Livingstone, 1999.
3. Hides J, Stokes M, Saide M, et al. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine1994;19:165–72.
(See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
Functional Pelvic Rotation/ Unilateral Multifidus Video
Exercise 5: Multifidus Bilateral Strengthening
Initiating segmental lumbar extension; Multifidus
The oblique orientation of the Multifidus muscles provide deep core stability as they act as cross struts. Without this segmental cross strut stabilization we will not have true core stability.
The oblique orientation of the Multifidus muscles provide deep core stability as they act as cross struts. Without this segmental cross strut stabilization we will not have true core stability.
I use the analogy of a bridge fabricated from metal beams. Without the cross struts the bridge would collapse when any stress placed on it. When it comes to the importance of the Multifidus in stabilizing the spine this is a perfect example of their structural importance.
Strengthening the Erector Spinae and Rectus Femoris and the other outer core muscles without the structural support of active Multifidus muscles would be like building a bridge without cross struts. Although the TA and Oblique's can also act as cross struts for the trunk they have no direct control over the segmental stability therefore do not help restore optimal spinal biomechanics leading to continued dysfunction.
- (See the disc protocol below and see how we specifically incorporate these movement patterns when treating injured discs.)
Multifidus StrengtheningVideo
Section 2: Optimizing Synergy Between the Deep Core and Outer Core Muscles
We do the Sexy Muscles Second!
After re-awakening the deep core musculature we then focus on restoring the synergy between the deep core muscles and the outer core.
Exercise 6: Resisted Bridging While Decompressed
Initiating outer core Gluteals and Paraspinals
The Bridging exercise has always been a powerful, safe, and effective exercise for the outer core. By utilizing our decompression strap and core resistance bands this exercise becomes even more effective.
The Bridging exercise has always been a powerful, safe, and effective exercise for the outer core. By utilizing our decompression strap and core resistance bands this exercise becomes even more effective.
Bridging Video
Exercise 7: Advanced Bridging
Initiating advanced outer core trunk control
Single Leg Bridging initiates unilateral single leg support in a safe position of decompression and with the use of the resistance bands will help restore the synergy of the intermediate core musculature. Progressing this to a version of exercise #6 under sports specific training will challenge the intermediate core to stabilize the spine in a very functional single leg support position, restoring synergy between the Psoas, QL, and Gluteus Medius.
Single Leg Bridging initiates unilateral single leg support in a safe position of decompression and with the use of the resistance bands will help restore the synergy of the intermediate core musculature. Progressing this to a version of exercise #6 under sports specific training will challenge the intermediate core to stabilize the spine in a very functional single leg support position, restoring synergy between the Psoas, QL, and Gluteus Medius.
Advanced Bridging Video
Exercise 8: Bridging/Pelvic Rotation Synergy
Initiating synergy between the deep core and outer core musculature
Bridging /Pelvic Rotation Combo Video
Section 3: Advanced Exercises
The following exercises are examples of advanced core strengthening and sports specific training.
It is the ability of the muscle system to rapidly fire an antagonist or synergistic muscle that will protect the underlying joints and soft tissue structures from injury. When it comes to protecting against injury we must incorporate proprioceptive specific rapid transitional movements. The following exercises are a few of the many advanced exercises focusing on re-establishing and optimizing rapid transitional movements of the deep core and trunk musculature.
1. Advanced TA and Oblique Training.
2. Initiating Transitional Reaction Time Training with Lumbo-Pelvic Rotation.
3. Advancing Transitional Reaction Time Training:
Combining Multifidus for Lumbo-Pelvic De-Rotation with TA and Oblique Training.
Combining Multifidus for Lumbo-Pelvic De-Rotation with TA and Oblique Training.
4. Advancing Transitional Reaction Time Training:
Combining Multifidus for Lumbo-Pelvic De-Rotation with Thoracic Rotation and UE Plyometric Training
Combining Multifidus for Lumbo-Pelvic De-Rotation with Thoracic Rotation and UE Plyometric Training
5. Progression to Advanced Functional Closed Kinetic Chain Core Strengthening
Section 4: Unloading/Decompression
1. Unloading decreases pain improving proprioceptive input from the involved musculature leading to optimal strength gains.
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2. Unloading combined with gently segmental movement facilitates the natural spinal disc pump for nutrition and fluid exchange. This video demonstrates our systems unique ability to facilitate this fluid exchange to the discs which and is the only system that follows the body's natural blueprint for disc nutrition. |
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See the case study below and watch a video of an actual patient with disc pathology get great results with our system.
Case Story:
This patient was suffering from back pain associated with congenital Schmorl's nodes. This is a great example of how our system demonstrated results in facilitating improved disc health after all other conventional physical therapy approaches failed.
Scoliosis Protocol/Take the Torsion Out!
Scoliosis in not just a lateral curve of the spine. There is a three dimensional biomechanical component to scoliosis that must be addressed. The spine twists and torsions which can be seen in the rib hump. This torsion creates increased nerve tension further exacerbating the scoliosis and pain. We have a simple technique to reduce the torsion while exercising our scoliosis patients. This technique has proven to benefit our patients with scoliosis.
This video does not show some of the nerve gliding and nerve flossing techniques that we perform when the torsion is eliminated but we wanted to share that performing nerve glides after we de-torsion the spine has also demonstrated good results.
This video does not show some of the nerve gliding and nerve flossing techniques that we perform when the torsion is eliminated but we wanted to share that performing nerve glides after we de-torsion the spine has also demonstrated good results.
Deep Core Stabilization/Disc Protocol
This deep core stabilization/disc protocol gently re establishes segmental movement while protecting the injured disc. Conventional spinal stabilization focuses on the TA and the Oblique's in order to promote the corset affect. This corset affect will help to stabilize the lumbar spine through a conscious effort to hinge from the hips and maintain a co-contraction between these outer corset muscles and the paraspinals. But our true stability must take place at the segmental level. This protocol re-establishes motor control of the Multifidus first in order to truly control and protect the disc injuries. Through a series of gentle movements followed initially by isometric contractions of the Multifidus. This protocol will re-establish proper motor control of the deep core muscles. We then progress to dynamic segmental movements to re-establish the synergy of the TA and the Oblique's to work together with these deep core muscles.