Rehabilitation and Support Methods

Sub-Core Training: A Little Known Method for Stability:

[An Excerpt from the Article Originally presented on the Fox 59 News WebSite]

You have heard of Core Training principles but you may not have heard of Sub-Core training. This method of rehabilitation and correction stems from the inside out method of correcting deficits in both the extremities and the spine. In my experience over the years, I have seen numerous athletes and average people alike, present with excessive motion and dysfunctional placement of their vertebral alignment. This mal-position of the spinal segments can lead to a wide variety of disease processes such as arthritic change, neurological disorders, vascular compression, muscular strain / sprain, coordination deficits, etc. There are many forms of postural exercise such as Egoscue and Yoga which aid successfully is stabilizing a person’s posture. These are however limited to the familiar core strengthening principles.

Sub-core training on the other hand, focuses on the small, typically ignored muscles that initiate the motion of the spine. Muscular stability is created through activation of the nervous system via ligament stimulation. Every time the bones move in your spine, the ligaments send back information to the spinal cord and control reactivity of the surrounding Sub-core musculature of the spine. Without freedom of this information transfer, there is wasting of these structures leading to slippage called listhesis, and is visible on radiographic films (x-rays). Long term effects of this slippage such as accelerated degeneration of the associated joint structures and micro-damage of the discs may lead to deterioration of these structures to a point of potential failure.

The same can be true in areas such as the ankle. Stimulation of the ligaments sends information to the spinal cord which passes information to the cerebellum via a specific tract to create an organization called balance or proprioception.

Correction of a malposition of the bones of the ankle or the spinal segments followed by reinforcement can aid in development of a new habit of neurological function which decreases the risk of future injuries via proprioception. This reinforcement can only be effectively altered and maintained by a high velocity thrust (adjustment) as opposed to a slow movement through range of motion often called mobilization.

Mobilization is performed often by Physical Therapists and Athletic Trainers as well as Chiropractors on athletes of all kinds. Only the Chiropractic Doctor however, may be able to do the adjustment and activate the nervous system component correctly. This can be like the switch on a breaker panel being flipped back on for power. Once this task has been accomplished, exercises which I call Sub-core Muscular Facilitation may begin and the muscles may begin to function as they were meant to.

There are many simple exercises that can be performed and most involve a very unsuspecting device called a balance board. Wobbling back and for the from side to side without bending your knees is one method. This will increase the stress on the multifidi and spinal Sub-core musculature to help it regain tone with the adjustment. Tilting the board from back to front activates the ankles, knees, and pelvic components (called a kinetic chain) to reinforce proprioception and enhance coordination. For those who have pelvic deficiencies that cause them to throw their hip sideways when doing a squat, I offer the Wobble Board Squat. These exercises are very effective when correctly accomplished and have made significant gains for many of my patients over the years. The use of an exercise ball will also significantly stimulate the ligaments as well as imbibe the discs allowing an increase in fluid exchange creating a healthier environment for the disc. All you do is sit and bounce. These are the same exercises that I discussed with the Trainer for UCLA gymnasts.

I hope that you’ll enjoy the challenges that these exercises offer you as well, now that you know some of the science behind them. Have a great day!   Dr. Todd McDougle   Dr.McDougle@Comcast.Net

More discussion can be expected to ensue regarding this simplistic approach to reduction of spinal listhesis through proprioceptive rehabilitation and sub-core muscular facilitation in order to maximize results. Science does support this fact so we will not review this in this piece.