Relationship between core stability, functional movement, and performance.

The purpose of this study was to determine the relationship between core stability, functional movement, and performance. Twenty-eight healthy individuals (age = 24.4 ± 3.9 yr, height = 168.8 ± 12.5 cm, mass = 70.2 ± 14.9 kg) performed several tests in 3 categories: core stability (flexion [FLEX], extension [EXT], right and left lateral [LATr/LATl]), functional movement screen (FMS) (deep squat [DS], trunk-stability push-up [PU], right and left hurdle step [HSr/HSl], in-line lunge [ILLr/ILLl], shoulder mobility [SMr/SMl], active straight leg raise [ASLRr/ASLRl], and rotary stability [RSr/RSl]), and performance tests (backward medicine ball throw [BOMB], T-run [TR], and single leg squat [SLS]). Statistical significance was set at p ≤ 0.05. There were significant correlations between SLS and FLEX (r = 0.500), LATr (r = 0.495), and LATl (r = 0.498). The TR correlated significantly with both LATr (r = 0.383) and LATl (r = 0.448). Of the FMS, BOMB was significantly correlated with HSr (r = 0.415), SMr (r = 0.388), PU (r = 0.407), and RSr (r = 0.391). The TR was significantly related with HSr (r = 0.518), ILLl (r = 0.462) and SMr (r = 0.392). The SLS only correlated significantly with SMr (r = 0.446). There were no significant correlations between core stability and FMS. Moderate to weak correlations identified suggest core stability and FMS are not strong predictors of performance. In addition, existent assessments do not satisfactorily confirm the importance of core stability on functional movement. Despite the emphasis fitness professionals have placed on functional movement and core training for increased performance, our results suggest otherwise. Although training for core and functional movement are important to include in a fitness program, especially for injury prevention, they should not be the primary emphasis of any training program.

Change in glenohumeral rotation and scapular position after competitive high school baseball.

CONTEXT: Pathologies such as anterior instability and impingement are common in baseball and have been linked to decreases in internal rotation (IR) and concurrent increases in external rotation (ER). In addition, alterations to scapular position have been identified in this population, but the chronology of these adaptations is uncertain. OBJECTIVES: To determine whether there is a change in range of motion and scapular position after a single baseball season. DESIGN: Prospective cohort. SETTING: High school. PARTICIPANTS: 19 high school baseball players (age 16.6 +/- 0.8 y, mass 78.6 +/- 12.0 kg, height 180.3 +/- 6.2 cm). INTERVENTIONS: Subjects were measured for all dependent variables at preseason and postseason. MAIN OUTCOME MEASURES: Participants were measured for glenohumeral (GH) IR and ER with the scapula stabilized. Total GH range of motion was calculated as the sum of IR and ER. Scapular upward rotation was measured at 0 degrees, 60 degrees, 90 degrees, and 120 degrees of GH abduction in the scapular plane, and scapular protraction, at 0 degrees, hands on hips, and 90 degrees of GH abduction. RESULTS: Overall, the dominant arm had significantly less GH IR (11.4 degrees, P = .005) and significantly more ER (4.7 degrees, P = .001) than the nondominant arm. Total motion in the dominant arm was significantly less than in the nondominant arm (6.7 degrees, P = .001). Scapular upward rotation in the dominant arm significantly increased at 0 degrees (2.4 degrees, P = .002) and significantly decreased at 90 degrees (3.2 degrees, P = .001) and 120 degrees (3.2 degrees, P < .001) of abduction from preseason to postseason. Scapular protraction in the nondominant arm significantly decreased at 45 degrees (0.32 cm, P = .017) and 90 degrees (0.33 cm, P = .006) from preseason to postseason. CONCLUSION: These data suggest that scapular adaptations may be acquired over a relatively short period (12 wk) in a competitive baseball season. Competitive high school baseball players also presented with significant GH motion differences between their dominant and nondominant arms. Total motion was also significantly less in the dominant arm than in the nondominant arm.

Threshold frequency of an electrically induced cramp increases following a repeated, localized fatiguing exercise.

Though clinical observations and laboratory data provide some support for the neuromuscular imbalance theory of the genesis of exercise-associated muscle cramps, no direct evidence has been published. The purpose of this study was to determine the effect of local muscle fatigue on the threshold frequency of an electrically induced muscle cramp. To determine baseline threshold frequency, a cramp was electrically induced in the flexor hallucis brevis of 16 apparently healthy participants (7 males, 9 females; age 25.1 +/- 4.8 years). The testing order of control and fatigue conditions was counterbalanced. In the control condition, participants rested in a supine position for 30 min followed by another cramp induction to determine post-threshold frequency. In the fatigue condition, participants performed five bouts of great toe curls at 60% one-repetition maximum to failure with 1 min rest between bouts followed immediately by a post-threshold frequency measurement. Repeated-measures analysis of variance and simple main effects testing showed post-fatigue threshold frequency (32.9 +/- 11.7 Hz) was greater (P < 0.001) than pre-fatigue threshold frequency (20.0 +/- 7.7 Hz). An increase in threshold frequency seems to demonstrate a decrease in one's propensity to cramp following the fatigue exercise regimen used. These results contradict the proposed theory that suggests cramp propensity should increase following fatigue. However, differences in laboratory versus clinical fatiguing exercise and contributions from other sources, as well as the notion of a graded response to fatiguing exercise, on exercise-associated muscle cramp and electrically induced muscle cramp should be considered.

Exercise-associated muscle cramps: causes, treatment, and prevention.

CONTEXT: Exercise-associated muscle cramps (EAMC) are a common condition experienced by recreational and competitive athletes. Despite their commonality and prevalence, their cause remains unknown. Theories for the cause of EAMC are primarily based on anecdotal and observational studies rather than sound experimental evidence. Without a clear cause, treatments and prevention strategies for EAMC are often unsuccessful. EVIDENCE ACQUISITION: A search of Medline (EBSCO), SPORTDiscus, and Silverplatter (CINHAL) was undertaken for journal articles written in English between the years 1955 and 2008. Additional references were collected by a careful analysis of the citations of others' research and textbooks. RESULTS: Dehydration/electrolyte and neuromuscular causes are the most widely discussed theories for the cause of EAMC; however, strong experimental evidence for either theory is lacking. CONCLUSIONS: EAMC are likely due to several factors coalescing to cause EAMC. The variety of treatments and prevention strategies for EAMC are evidence of the uncertainty in their cause. Acute EAMC treatment should focus on moderate static stretching of the affected muscle followed by a proper medical history to determine any predisposing conditions that may have triggered the onset of EAMC. Based on physical findings, prevention programs should be implemented to include fluid and electrolyte balance strategies and/or neuromuscular training.

Glenohumeral rotation and scapular position adaptations after a single high school female sports season.

CONTEXT: Anterior instability and impingement are common in overhead athletes and have been associated with decreases in internal rotation (IR) and increases in external rotation (ER) motion. However, the chronology and the effect of different female sports on these conditions have yet to be determined. OBJECTIVE: To measure glenohumeral IR and ER rotation, total range of motion, and scapular position in female overhead athletes over a single competitive season. DESIGN: Multiple group pretest-posttest study. SETTING: High school. PATIENTS OR OTHER PARTICIPANTS: Thirty-six female overhead athletes (age = 15.29 +/- 1.18 years, height = 164.16 +/- 7.14 cm, mass = 58.24 +/- 9.54 kg) with no history of shoulder or elbow surgery participating in high school swimming, volleyball, or tennis. INTERVENTION(S): Participants were measured for all dependent variables at preseason and postseason. MAIN OUTCOME MEASURE(S): Participants were measured for glenohumeral IR and ER with the scapula stabilized. Total glenohumeral range of motion was calculated as the sum of IR and ER. Scapular upward rotation was measured at 0 degrees , 60 degrees , 90 degrees , and 120 degrees of glenohumeral abduction in the scapular plane, and scapular protraction was measured at 0 degrees , 45 degrees (hands on hips), and 90 degrees of glenohumeral abduction. RESULTS: Internal rotation decreased from preseason to postseason (P = .012). Swimmers had less IR than both volleyball and tennis players (P = .001). External rotation also decreased in the swimmers (P = .001). Overall, preseason to postseason total motion decreased for athletes participating in swimming (P = .001) and tennis (P = .019). For all participants, preseason to postseason scapular protraction at 45 degrees glenohumeral abduction decreased (P = .007). CONCLUSIONS: Female overhead athletes demonstrated decreases in IR after only one competitive season. Clinically, our results indicate that overhead athletes should be monitored for motion changes throughout their competitive seasons.

The relationship between core stability and performance in division I football players.

The purpose of this study was to identify relationships between core stability and various strength and power variables in strength and power athletes. National Collegiate Athletic Association Division I football players (height 184.0 +/- 7.1 cm, weight 100.5 +/- 22.4 kg) completed strength and performance testing before off-season conditioning. Subjects were tested on three strength variables (one-repetition maximum [1RM] bench press, 1RM squat, and 1RM power clean), four performance variables (countermovement vertical jump [CMJ], 20- and 40-yd sprints, and a 10-yd shuttle run), and core stability (back extension, trunk flexion, and left and right bridge). Significant correlations were identified between total core strength and 20-yd sprint (r = -0.594), 40-yd sprint (r = -0.604), shuttle run (r = -0.551), CMJ (r = 0.591), power clean/body weight (BW) (r = 0.622), 1RM squat (r = -0.470), bench press/BW (r = 0.369), and combined 1RM/BW (r = 0.447); trunk flexion and 20-yd sprint (r = -0.485), 40-yd sprint (r = -0.479), shuttle run (r = -0.443), CMJ (r = 0.436), power clean/BW (r = 0.396), and 1RM squat (r = -0.416); back extension and CMJ (r = 0.536), and power clean/BW (r = 0.449); right bridge and 20-yd sprint r = -0.410) and 40-yd sprint (r = -0.435), CMJ (r = 0.403), power clean/BW (r = 0.519) and bench press/BW (r = 0.372) and combined 1RM/BW (r = 0.406); and left bridge and 20-yd sprint (r = -0.376) and 40-yd sprint (r = -0.397), shuttle run (r = -0.374), and power clean/BW (r = 0.460). The results of this study suggest that core stability is moderately related to strength and performance. Thus, increases in core strength are not going to contribute significantly to strength and power and should not be the focus of strength and conditioning.

Stiffness regulation and muscle-recruitment strategies of the shoulder in response to external rotation perturbations.

BACKGROUND: The complex interactions between capsuloligamentous structures and muscle-recruitment strategies that maintain glenohumeral stability remain unclear. The purposes of the present study were to determine whether stiffness regulation and muscle-activation strategies differed under varying joint positions and levels of contraction in the shoulder and to determine the relationship between generalized joint laxity, glenohumeral joint laxity, and joint stiffness. METHODS: Forty healthy, physically active subjects with a mean age (and standard deviation) of 25.2 +/- 4.6 years, a mean height of 174.7 +/- 6.7 cm, and a mean mass of 73.1 +/- 13.8 kg were tested. Shoulder stiffness and the activation of muscles (including the rotator cuff and the anterior deltoid) were measured at two levels of internal rotation torque (0% and 50% of maximum) and two joint positions (0 degrees and 90% of maximum external rotation) before and after a 5 degrees external rotation perturbation. Generalized laxity and glenohumeral joint laxity (in the anterior, posterior, and inferior directions) were also assessed. RESULTS: Stiffness was 77% greater at 50% of maximum internal rotation torque than at 0% of maximum internal rotation torque (p < 0.001) but was not significantly different between joint positions (p = 0.73). From 0% to 50% of maximum internal rotation torque, preparatory and reactive recruitment of the subscapularis increased significantly more (p < 0.05) than those of the other muscles. Also, subscapularis preparatory activity was 36% greater in 0 degrees of external rotation than in 90% of maximum external rotation (p < 0.01). Generalized joint laxity (as indicated by a score of >/=4) was present in 20% of the subjects. Glenohumeral joint laxity (as indicated by a grade of >/=2) was present in the anterior, posterior, and inferior directions in 13%, 15%, and 15% of the subjects, respectively. No correlation existed between passive stiffness and generalized or glenohumeral laxity (r = -0.12 to 0.29; p = 0.08 to 0.48). CONCLUSIONS: Moderate levels of muscle contraction can significantly increase glenohumeral joint stiffness and stability. Preactivation of the subscapularis appears to be the primary dynamic stabilizer with the arm in 0 degrees of external rotation. However, with the arm in 90% of maximum external rotation (the apprehension position), less subscapularis activity is observed and the maintenance of stability may shift toward other musculoskeletal structures because joint stiffness does not change. A relationship between generalized joint laxity, glenohumeral laxity, and stiffness was not observed in healthy subjects.

Compensatory mechanisms in basketball players with jumper's knee.

CONTEXT: Determining whether there are compensations in those with jumper's knee (JK) might further our understanding of the condition. OBJECTIVE: Comparing lower extremity kinematics and jump performance of basketball athletes with JK with those of healthy controls (C). DESIGN: Repeated-measures control-match design. SETTING: University laboratory. PARTICIPANTS: 24 male basketball players (12 JK, 12 C) matched by height, weight, position, experience, and frequency of play. INTERVENTIONS: Standing counter-movement and running layup jumps. MAIN OUTCOME MEASURES: Maximum vertical-jump height, footfall landing, and lower extremity sagittal-plane kinematics. RESULTS: There were no significant group differences (P > .05) in vertical-jump height (JK = 64.3 +/- 8.6 cm, C = 63.0 +/- 9.8 cm) or layup height (JK = 71.3 +/- 11.6 cm, C = 73.3 +/- 11.0 cm). JK subjects landed flat footed (50%) more than controls (8%). JK subjects showed significantly more hip flexion (JK = 105 degrees +/- 24.8 degrees, C = 89.8 degrees +/- 14.1 degrees; P = .039) with decreased hip acceleration during the countermovement (JK = -3039 +/- 1392 degrees /s2, C = -4229 +/- 1765 degrees /s2; P = .040). When landing from the countermovement jump, JK subjects had significantly less knee acceleration (JK = -4960 +/- 1512 degrees/s2, C = -6736 +/- 2009 degrees/s2, P = .023) and in the layup showed significantly less ankle dorsiflexion (JK = 106.5 degrees +/- 9.0 degrees, C = 112.5 degrees +/- 7.7 degrees; P = .048) and hip acceleration (JK = -2841 +/- 1094 degrees/s2, C = -3912 +/- 1575 degrees/s2; P = .033). CONCLUSION: Compensatory strategies observed in JK subjects might help maintain performance, because their jump height was similar to that of healthy controls.

Transient electric changes immediately after surgical trauma.

CONTEXT: Electric stimulation is frequently used to promote soft tissue healing, although we do not have a complete understanding of the tissue's electromagnetic properties. OBJECTIVE: To measure the transient electric changes in skin and muscle tissue immediately after trauma. DESIGN: 1-group time series. SETTING: Climate-controlled operating room in a public urban hospital. PATIENTS OR OTHER PARTICIPANTS: Eleven participants (8 females, 3 males) with a mean age of 65.18 +/- 11.36 years undergoing total hip arthroplasty. INTERVENTION(S): An incision approximately 10 cm distal to the posterior superior iliac spine extended distally over the greater trochanter and along the lateral limb. The incision was completed in 2 cuts: (1) skin and subcutaneous fat and (2) muscle tissue. MAIN OUTCOME MEASURE(S): Three measurement sessions were performed with an electrometer before and after a skin incision and after a muscle incision. Potential differences and current intensity were measured immediately after acute trauma to determine the transient electric changes associated with soft tissue injury. RESULTS: The electric potentials were significantly more negative after the skin incision (P = .036) and skin plus muscle incision (P = .008; preincision = 0.001 +/- 0.015 V, skin incision = -0.127 +/- 0.134 V, skin plus muscle incision = -0.192 +/- 0.153 V). Current intensity changed significantly after the skin plus muscle incision (P = .008; preincision = 0.046 +/- 0.112 pA, skin incision = -0.803 +/- 0.904 pA, skin plus muscle incision = -1.708 +/- 1.302 pA). CONCLUSIONS: Soft tissue trauma generated negative transient electric changes.

Gender comparisons of dynamic restraint and motor skill in children.

OBJECTIVES: To assess differences in neuromuscular dynamic restraint between high-skilled and low-skilled prepubescent girls and boys. To determine the contribution of sport experience and physical characteristics to motor skill. SUBJECTS: Nineteen girls and 17 boys (8.89-9.40 y) participated. INTERVENTION: Isometric hamstring and quadriceps muscle strength was assessed. Subjects performed 3 landing trials for measurement of preparatory EMG and vertical leg stiffness. Motor skill was assessed through analysis of 12 fundamental tasks. Sport experience was reported as hours per week and total years in organized and nonorganized activity. OUTCOME MEASURES: Dynamic restraint variables of isometric strength, preparatory EMG activity, and vertical leg stiffness were measured between groups. The contributions of time in sport, type of sport, and physical characteristics on skill were analyzed. RESULTS: No significant gender or skill differences were found in quadriceps strength (P = 0.73), hamstring strength (P = 0.96), hamstring-to-quadriceps ratio (P = 0.71), or vertical leg stiffness (P = 0.38). Low-skilled children exhibited significantly greater (47.8%) preparatory hamstring-quadriceps coactivation than high-skilled subjects (P = 0.03). Participation in organized and nonorganized sport accounted for 29% of the variance in motor skill. CONCLUSIONS: Neuromuscular differences between genders were not observed, but dynamic restraint EMG measures differed between skill levels. The factors predisposing females to noncontact injuries may develop prepuberty to postpuberty from a combination of variables. Greater coactivation in the low-skilled group appears consistent with immature feedforward neuromuscular control strategies. These unrefined motor skills are less economical, may compromise dynamic restraint, and appear partially determined by sport experience.