Why the term core stability needs to be reassessed

The term ‘core stability’ has no clear definition. Depending on the author(s), core stability muscles may only include extensors, flexors, lateral flexors, or rotators of the spinal column.

A more complex approach includes all muscles between the shoulders and pelvis. 

As hip position influences alignment of the spinal column and therefore modulates trunk muscle activity, a current research article favors the latter approach. 

The terms ‘stabilization’, ‘strengthening’, and ‘muscle activation’ are often used side by side as if they are independent goals in training; however, stabilization is a result of muscle forces whereas strengthening refers to improvements in force production.

Core Stability in Athletes: A Critical Analysis of Current Guidelines.
Wirth K1, Hartmann H2, Mickel C3, Szilvas E3, Keiner M4, Sander A5.
Sports Med. 2017 Mar; 47(3):401-414. doi: 10.1007/s40279-016-0597-7.


Over the last two decades, exercise of the core muscles has gained major interest in professional sports. Research has focused on injury prevention and increasing athletic performance. We analyzed the guidelines for so-called functional strength training for back pain prevention and found that programs were similar to those for back pain rehabilitation; even the arguments were identical. Surprisingly, most exercise specifications have neither been tested for their effectiveness nor compared with the load specifications normally used for strength training. Analysis of the scientific literature on core stability exercises shows that adaptations in the central nervous system (voluntary activation of trunk muscles) have been used to justify exercise guidelines. Adaptations of morphological structures, important for the stability of the trunk and therefore the athlete's health, have not been adequately addressed in experimental studies or in reviews. In this article, we explain why the guidelines created for back pain rehabilitation are insufficient for strength training in professional athletes. We critically analyse common concepts such as 'selective activation' and training on unstable surfaces.

Simon Bartold
Director of Bartold Clinical