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Core Training: Drawing-in vs. Abdominal Bracing

Could you give me your intake on this assignment, including the articles? I am looking forward for your observations on the articles below. Regards.

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Your position on this topic has likely shaped your entire clinical application model for performance enhancement, injury prevention, reconditioning and rehabilitation training.

Based on some of your experiences and the articles posted below.

What training model is most effective? Drawing- In OR abdominal Bracing? Should you do one without the other?

I have more experience w/ the Drawing maneuver. However I think that the other method is valid too.

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Please review the following articles.

1.Barr_2005_Core Stability Review_Part I

2.Barr 2007_Lumbar stabilization_Part 2

3.McGill 2001_Low Back Stability

4.Willardson 2007_Core stability training applications to sporst conditioning programs (BRief Review)

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Hi,

Interesting set of articles. Have you read them yet? One approach to helping you with an assignment like this one is to review the articles and point out where the two techniques are found to be beneficial in exercise programs. This is the approach this response takes. I attached a description of one type of 'abdominal bracing' that is beneficial, although there are others as well.

RESPONSE:

1. What training model is most effective? Drawing- In or abdominal Bracing? Should you do one without the other? I have more experience w/ the Drawing maneuver; however I think that the other method is valid too. I am looking forward for your observations

I have never practiced or preached 'drawing in' as it DOES not seem useful or even practical. However, after reading the articles, both methods have been supported in the literature as being beneficial, although trainers most often use abdominal bracing today. Both techniques are intended to increase lumbar stabilization through strengthening the muscles that support the spine and increase muscle control.

For example, 'bracing' the abdominal/stomach muscles ready for effort does seem intuitive. It is the newer technique used by most trainers. A person only has to do a pull-up or chin-up on a bar to feel how these muscles automatically brace themselves for effort. Developed 'abs' provides 'core' stability to the spine. Most trainers agree that this procedure of bracing e.g. a pretend punch in the stomach (as opposed to hollowing or drawing in) is a fundamental tool of the exercise trainer and a basic procedure from which every person involved in exercise or physical activity of any sort can benefit. Research suggests that strengthening this 'core' of muscle - at back and front of the torso - is paramount to performance and injury prevention (Barr et al, 2005, 2007). It's important to understand the distinction between 'bracing' and 'drawing in' or 'hollowing'.

Muscles worked: rectus abdominis (six-pack) with some activation of the external obliques (muscles at the sides of the abdomen) to increase motor control and modest stability of deep muscles - TA. There are compelling theoretical reasons to prescribe LSPs to treat patients with LBP. Multiple studies have found they decrease pain and improve function. Certain features on the history and physical exam may help determine who will benefit most from this type of exercise and assist the physician/trainer in determining the correct starting point. An appropriate exercise prescription, education regarding why the exercises should help and realistic expectations should increase compliance with this treatment (Barr et al, 2007).

It is important to understand what 'abdominal bracing' is not. Abdominal Bracing is not holding the breath, pushing the stomach out or trying to push your belly button through your tailbone (coccyx). When a person gets used to the bracing idea, you can do it almost anywhere, even running. Many endurance runners have poor core strength and abdominal posture because under fatigue they get very slack in the stomach area. Another group that can benefit from braced abdominals are office workers and people sitting at work or home most of the day. One of the basic exercises for strengthening the abdominal muscles is the crunch. The 'crunch' has replaced the 'situp' for most purposes because of concerns about lower back injury and that sit-ups may be less effective than crunches for abdominal strengthening, although this is not accepted by every authority. With the crunch, the lower back stays on the ground and you raise the shoulders while contracting the abdominals muscles. Crunches (e..g, abdominal bracing) take many forms including the standard supine floor crunch, reverse crunch, crunch with weights and on a fit ball, combined crunch and twist crunch. The attached example features the standard floor crunch (From http://weighttraining.about.com/od/toptenexercises/ss/crunch_3.htm).

However, a solid foundation and muscles are associated with the segmental stability of the lumbar spine, so an exercise such as abdominal hollowing (e.g. the drawing-in technique) has also been found beneficial to increase segmental stability of the lumbar spine. As mentioned above, though, 'abdominal bracing' has often replaced this method today (but not always). However, both methods also enhance motor control and create modest stability using the deeper abdominal wall (transverse abdominis and internal oblique (see Richardson et al p. 15, as cited in Willardson, 2007, p. 30).

Now, let's look closer at the two training models in relation to the reviews of the articles attached.

2. Please review the following articles.

A. Barr, Griggs and Cadby, T. (2005 June; 2007, August)

Barr, Griggs and Cadby, T. (2005 June), in the article "Lumbar stabilization: Core concepts and current literature, Part 1. Invited review", review the key concepts and factors effecting lumbar stabilization. It also discusses how people with low back pain (LBP) differ in terms of their ability to stabilize their spine from those who do not have LBP and explains how these two populations differ biochemically. Research also suggests that instabilization of the spine leads to increased pain and injury. Since 'Abdominal Bracing' training increases spine stability through the strengthening of the TA deep muscles, it is beneficial and valid to incorporate into exercise programs. In Part 1, the authors also review the effectiveness of lumbar stabilization programs for reducing LBP. In the second review article, Lumbar stabilization: a review of core concepts and current literature Part 2, Barr et al (2007) outline an evidence-based medicine approach to evaluating patients for a lumbar-stabilization program (LSP) and discuss typical clinical components of this type of program and the rationale for including these particular features based on the medical literature.

In Part 1, Barr et al (2005) discuss the Lumbar Stabilization Theory, which posited that the following three components work together, which inform LSP. The 'abdominal bracing' techniques are linked mostly to the second component of this model; however, they are interrelated.

(1) The bone and ligament structure (provide the most stability by passive restraint toward the end of the range of motion; but do not provide much support in neutral position - muscles provide the support and stiffness at the intervertabral level to ...

Solution Summary

Based on evidence from the articles, this solution discusses the type of training model that is most effective: Drawing- in and Abdominal Bracing. It also discusses if a trainer should do one technique without the other. It then provides an overview of each article as well, in relation to the questions. Supplemented with a step-by-step guide for doing crunches and the references are in APA format.

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