Critical review of the impact of core stability on upper extremity athletic injury and performance.

Courtney M Butowicz,Marisa Pontillo,David Ebaugh,Sheri P Silfies

doi:10.1590/bjpt-rbf.2014.0108

Abstract

BACKGROUND: Programs designed to prevent or rehabilitate athletic injuries or improve athletic performance frequently focus on core stability. This approach is based upon the theory that poor core stability increases the risk of poor performance and/or injury. Despite the widespread use of core stability training amongst athletes, the question of whether or not sufficient evidence exists to support this practice remains to be answered. OBJECTIVES: 1) Open a dialogue on the definition and components of core stability. 2) Provide an overview of current science linking core stability to musculoskeletal injuries of the upper extremity. 3) Provide an overview of evidence for the association between core stability and athletic performance. DISCUSSION: Core stability is the ability to control the position and movement of the trunk for optimal production, transfer, and control of forces to and from the upper and lower extremities during functional activities. Muscle capacity and neuromuscular control are critical components of core stability. A limited body of evidence provides some support for a link between core stability and upper extremity injuries amongst athletes who participate in baseball, football, or swimming. Likewise, few studies exist to support a relationship between core stability and athletic performance. CONCLUSIONS: A limited body of evidence exists to support the use of core stability training in injury prevention or performance enhancement programs for athletes. Clearly more research is needed to inform decision making when it comes to inclusion or emphasis of core training when designing injury prevention and rehabilitation programs for athletes.

Highlights

Prevention and treatment of musculoskeletal injuries in athletes is a principal concern of coaches, medical and fitness professionals, and athletes themselves
Where a contribution has been demonstrated, the amount of risk potentially posed by poor core stability has not been systematically evaluated in conjunction with other identified injury risk factors
Other factors associated with upper extremity injury, specific to the joint or region and those factors associated with environment or exposure related to the sports activity itself, have not been investigated in conjunction with core stability

Summary

Introduction

Prevention and treatment of musculoskeletal injuries in athletes is a principal concern of coaches, medical and fitness professionals, and athletes themselves. Their study included 30 male athletes with an UCL tear and 30 non-injured, age-, arm dominance-, experience-, and position‐matched controls These studies do not directly support decreased standing balance control as a cause for shoulder injury/pain or UCL tears, they do support the hypothesis of a potential relationship between poor core control, as measured by clinical tests (SLBT, Y-balance), and upper extremity injury. Dynamic balance impairment as measured by the Star Excursion Balance Test, Single-leg Hop for Distance, and Lower Extremity Functional Test have been associated with back, knee, and ankle injuries[24,33,34] Work in this area has advanced to include studies that suggest core stability training can reduce the risk of LE injuries[35,36,37]. Given the study designs, a true causal relationship cannot be strongly inferred and further research is warranted to expand upon this premise

Limitations and gaps in the literature

Findings

Conclusions