Sports Medicine

, Volume 38, Issue 12, pp 995–1008 | Cite as

Optimizing Performance by Improving Core Stability and Core Strength

  • Angela E. Hibbs
  • Kevin G. Thompson
  • Duncan French
  • Allan Wrigley
  • Iain Spears
Review Article


Core stability and core strength have been subject to research since the early 1980s. Research has highlighted benefits of training these processes for people with back pain and for carrying out everyday activities. However, less research has been performed on the benefits of core training for elite athletes and how this training should be carried out to optimize sporting performance. Many elite athletes undertake core stability and core strength training as part of their training programme, despite contradictory findings and conclusions as to their efficacy. This is mainly due to the lack of a gold standard method for measuring core stability and strength when performing everyday tasks and sporting movements. A further confounding factor is that because of the differing demands on the core musculature during everyday activities (low load, slow movements) and sporting activities (high load, resisted, dynamic movements), research performed in the rehabilitation sector cannot be applied to the sporting environment and, subsequently, data regarding core training programmes and their effectiveness on sporting performance are lacking.

There are many articles in the literature that promote core training programmes and exercises for performance enhancement without providing a strong scientific rationale of their effectiveness, especially in the sporting sector. In the rehabilitation sector, improvements in lower back injuries have been reported by improving core stability. Few studies have observed any performance enhancement in sporting activities despite observing improvements in core stability and core strength following a core training programme. A clearer understanding of the roles that specific muscles have during core stability and core strength exercises would enable more functional training programmes to be implemented, which may result in a more effective transfer of these skills to actual sporting activities.


Lower Back Pain Maximal Voluntary Contraction Rectus Abdominis Core Stability Core Strength 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to thank the English Institute of Sport and University of Teesside for their support. No sources of funding were received in the preparation of this article and the authors have no conflicts of interest directly relevant to its contents.


  1. 1.
    Stanton R, Reaburn PR, Humphries B. The effect of shortterm Swiss ball training on core stability and runningeconomy. J Strength Cond Res 2004; 18 (3): 522–8PubMedGoogle Scholar
  2. 2.
    McGill SM. Low back stability: from formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev 2001; 29 (1): 26–31PubMedCrossRefGoogle Scholar
  3. 3.
    Axler CT, McGill SM. Low back loads over a variety of abdominal exercises: searching for the safest abdominalchallenge. Med Sci Sports Exerc 1997; 29 (6): 804–11PubMedCrossRefGoogle Scholar
  4. 4.
    Myer GD, Ford KR, Palumbo JP, et al. Neuromuscular training improves performance and lower-extremity biomechanicsin female athletes. J Strength Cond Res 2005; 19 (1): 51–60PubMedGoogle Scholar
  5. 5.
    Nadler SF, Malanga GA, Bartoli LA, et al. Hip muscle imbalance and low back pain in athletes: influence ofcore strengthening. Med Sci Sports Exerc 2002; 34 (1):9–16PubMedCrossRefGoogle Scholar
  6. 6.
    Cosio-Lima LM, Reynolds KL, Winter C, et al. Effects of physio ball and conventional floor exercises on early phase adaptations in back and abdominal core stability and balance in women. J Strength Cond Res 2003; 17: 721–5PubMedGoogle Scholar
  7. 7.
    Fig G. Sport-specific conditioning: strength training for swimmers — training the core. Strength Cond J 2005; 27 (2): 40–2Google Scholar
  8. 8.
    Lehman GJ. Resistance training for performance and injury prevention in golf. JCCA J Can Chiropr Assoc 2006; 50 (1):27–42Google Scholar
  9. 9.
    McGill S. Low back disorders: evidence-based prevention and rehabilitation. Champaign (IL): Human Kinetics, 2002Google Scholar
  10. 10.
    Santana J. Sport-specific conditioning: the serape effect — a kinesiological model for core training. Strength Cond J 2003; 25 (2): 73–4Google Scholar
  11. 11.
    Elphinston J. Getting to the bottom of things. Sportex Dynam 2004; 2: 12–6Google Scholar
  12. 12.
    Leetun DT, Ireland ML, Willson JD, et al. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc 2004; 36 (6): 926–34PubMedCrossRefGoogle Scholar
  13. 13.
    Panjabi M. The stabilising system of the spine, part I: function, dysfunction, adaptation and enhancement. J SpinalDisord 1992; 5: 383–9PubMedCrossRefGoogle Scholar
  14. 14.
    Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006; 36 (3): 189–98PubMedCrossRefGoogle Scholar
  15. 15.
    Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 2004; 85 (3 Suppl. 1): 86–92CrossRefGoogle Scholar
  16. 16.
    Faries MD, Greenwood M. Core training: stabilising the confusion. Strength Cond J 2007; 29 (2): 10–25Google Scholar
  17. 17.
    Comerford MJ. Performance stability, module 1: stability for performance. Course 1: core stability concepts. Ludlow: Comerford & Performance Stability; 2007Google Scholar
  18. 18.
    Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 2001; 26 (11): 243–8CrossRefGoogle Scholar
  19. 19.
    National Collegiate Athletic Association. NCAA injury surveillance system. Overland Park (KS): NCAA, 1998Google Scholar
  20. 20.
    National Collegiate Athletic Association. NCAA injury surveillance system. Overland Park (KS): NCAA, 1999Google Scholar
  21. 21.
    Arokoski JP, Kankaanpaa M, Valta T, et al. Back and hip extensor muscle function during therapeutic exercises. Arch Phys Med Rehabil 1999; 80 (7): 842–50PubMedCrossRefGoogle Scholar
  22. 22.
    Brown T. Getting to the core of the matter. Strength Cond J 2006; 28 (2): 552–61CrossRefGoogle Scholar
  23. 23.
    Cholewicki J, Van Vliet JJT. Relative contribution of trunk muscles to the stability of the lumbar spine during isometricexertions. Clin Biomech (Bristol, Avon) 2002; 17 (2): 99–105CrossRefGoogle Scholar
  24. 24.
    Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999; 4 (2): 74–86PubMedCrossRefGoogle Scholar
  25. 25.
    Hubley-Kozey CL, Vezina MJ. Muscle activation during exercises to improve trunk stability in men with low backpain. Arch Phys Med Rehabil 2002; 83 (8): 1100–8PubMedCrossRefGoogle Scholar
  26. 26.
    Stephenson J, Swank AM. Core training: designing a program for anyone. Strength Cond J 2004; 26 (6): 34–7Google Scholar
  27. 27.
  28. 28.
    Richardson C, Jull G, Hodges P, et al. Therapeutic exercise for spinal segmental stabilisation in low back pain:scientific basis and clinical approach. London: ChurchillLivingstone, 1999Google Scholar
  29. 29.
    Gracovetsky S, Farfan HF, Lamy C. The mechanism of the lumbar spine. Spine 1981; 6 (3): 249–62PubMedCrossRefGoogle Scholar
  30. 30.
    Tse MA, McManus AM, Masters RS. Development and validation of a core endurance intervention program: implications for performance in college-age rowers. J Strength Cond Res 2005; 19 (3): 547–52PubMedGoogle Scholar
  31. 31.
    Bobbert MF, van Zandwijk JP. Dynamics of force and muscle stimulation in human vertical jumping. Med SciSports Exerc 1999; 31 (2): 303–10PubMedCrossRefGoogle Scholar
  32. 32.
    Wilson E. Rehab tips: core stability: assessment and functional strengthening of the hip abductors. Strength Cond J 2005; 27 (2): 21–3Google Scholar
  33. 33.
    Bergmark A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orthop Scand Suppl 1989; 230:1–54PubMedGoogle Scholar
  34. 34.
    Lee D. The pelvic girdle. 2nd ed. London: Churchill Livingstone, 1999Google Scholar
  35. 35.
    McGill SM. A revised anatomical model of the abdominal musculature for torso flexion efforts. J Biomech 1996; 29(7): 973–7PubMedCrossRefGoogle Scholar
  36. 36.
    Comerford S, Mottram S. Transverse training: a waste of time in the gym? Fit Pro Network (Apr-May) [online].Available from URL: [Accessed 2008 Oct 29]
  37. 37.
    Gibbons SGT. A review of the anatomy, physiology and function of psoas major: a new model of stability. Proceedingsof the 11th Annual Orthopedic Symposium; 1999 nov 6-7; Halifax (NS)Google Scholar
  38. 38.
    Behm DG, Anderson K, Curnew RS. Muscle force and activation under stable and unstable conditions. J StrengthCond Res 2002; 16 (3): 416–22PubMedGoogle Scholar
  39. 39.
    Pollock ML, Leggett SH, Graves JE, et al. Effect of resistance training on lumbar extension strength. Am JSports Med 1989; 17 (5): 624–9CrossRefGoogle Scholar
  40. 40.
    Lewis FM, Hawke JR. Orthopaedic treatments — 1: the spine. Physiotherapy 1983; 69 (3): 76–7PubMedGoogle Scholar
  41. 41.
    Scott JJ, Pruce SP, Wilson DJ. Orthopaedic treatments — 2: the upper and lower limbs. Physiotherapy 1983; 69 (3): 78–80PubMedGoogle Scholar
  42. 42.
    Carriere B. The Swiss ball: theory, basic exercises and clinical applications. Berlin: Springer, 1998Google Scholar
  43. 43.
    Carriere B. The Swiss ball. Physiotherapy 1999; 83 (10): 552–61CrossRefGoogle Scholar
  44. 44.
    Cotton T. Low back pain: does its management differ between athletes and non-athletes? Zurich: SchweizerischerSportmedizin Kongress, 2005Google Scholar
  45. 45.
    Vezina MJ, Hubley-Kozey CL. Muscle activation in therapeutic exercises to improve trunk stability. Arch PhysMed Rehabil 2000; 81 (10): 1370–9PubMedCrossRefGoogle Scholar
  46. 46.
    Andersson EA, Ma Z, Thorstensson A. Relative EMG levels in training exercises for abdominal and hip flexor muscles. Scand J Rehabil Med 1998; 30 (3): 175–83PubMedCrossRefGoogle Scholar
  47. 47.
    Sahrmann S. The Shirley Sahrmann exercise series 1. St Louis (MO): Videoscope, 1991Google Scholar
  48. 48.
    Davidson KL, Hubley-Kozey CL. Trunk muscle responses to demands of an exercise progression to improve dynamicspinal stability. Arch Phys Med Rehabil 2005; 86 (2): 216–23PubMedCrossRefGoogle Scholar
  49. 49.
    Jackson CP, Brown MD. Analysis of current approaches and a practical guide to prescription of exercise. Clin Orthop Relat Res 1983; (179): 46–54PubMedGoogle Scholar
  50. 50.
    McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther 1998; 78 (7): 754–65PubMedGoogle Scholar
  51. 51.
    Cresswell AG. Responses of intra-abdominal pressure and abdominal muscle activity during dynamic trunkloading in man.Eur J Appl Physiol Occup Physiol 1993; 66 (4): 315–20PubMedCrossRefGoogle Scholar
  52. 52.
    Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. PhysTher 1997; 77 (2): 132–42PubMedGoogle Scholar
  53. 53.
    Hodges PW, Richardson CA. Feedforward contraction of transversus abdominis is not influenced by the directionof arm movement. Exp Brain Res 1997; 114 (2): 362–70PubMedCrossRefGoogle Scholar
  54. 54.
    Cordo PJ, Nashner LM. Properties of postural adjustments associated with rapid arm movements. J Neurophysiol 1982; 47 (2): 287–302PubMedGoogle Scholar
  55. 55.
    Zattara M, Bouisset S. Chronometric analysis of the posturo- kinetic programming of voluntary movement. J MotBehav 1986; 18 (2): 215–23PubMedGoogle Scholar
  56. 56.
    Morrissey MC, Harman EA, Johnson MJ. Resistance training modes: specificity and effectiveness. Med SciSports Exerc 1995; 27 (5): 648–60Google Scholar
  57. 57.
    Behm DG, Sale DG. Velocity specificity of resistance training. Sports Med 1993; 15 (6): 374–88PubMedCrossRefGoogle Scholar
  58. 58.
    Willardson J. Regarding ‘The effectiveness of resistance exercises performed on unstable equipment’. Response.Strength Cond J 2005; 27 (4): 11–3CrossRefGoogle Scholar
  59. 59.
    Staron RS, Karapondo DL, Kraemer WJ, et al. Skeletal muscle adaptations during early phase of heavy-resistancetraining inmen and women. J Appl Physiol 1994; 76: 1247–55PubMedGoogle Scholar
  60. 60.
    Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol 2003; 13 (4): 371–9PubMedCrossRefGoogle Scholar
  61. 61.
    Kankaanpaa M, Taimela S, Laaksonen D, et al. Back and hip extensor fatigability in chronic low back pain patients and controls. Arch Phys Med Rehabil 1998; 79 (4): 412–7PubMedCrossRefGoogle Scholar
  62. 62.
    Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: amotor control evaluation of transversus abdominis. Spine 1996; 21 (22): 2640–50PubMedCrossRefGoogle Scholar
  63. 63.
    Fritz J, Whitman JM, Flynn TW, et al. Clinical factors related to the failure of individuals with low back pain toimprove with a spinal manipulation. Phys Ther 2004; 84(Feb): 173–90PubMedGoogle Scholar
  64. 64.
    Robinson R. The new back school prescription: stabilisation training, part I: occupational medicine. State Art Rev 1992;7: 17–31Google Scholar
  65. 65.
    Jeng S. Lumbar spine stabilisation exercise. Hong Kong J Sport Med Sports Sci 1999; 8: 59–64Google Scholar
  66. 66.
    Beckman SM, Buchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyographyonset latency. Arch Phys Med Rehabil 1995; 76(12): 1138–43PubMedCrossRefGoogle Scholar
  67. 67.
    Devita P, Hunter PB, Skelly WA. Effects of a functional knee brace on the biomechanics of running. Med Sci SportsExerc 1992; 24 (7): 797–806PubMedGoogle Scholar
  68. 68.
    Marshall P, Murphy B. The validity and reliability of surface EMG to assess the neuromuscular response of the abdominalmuscles to rapid limb movement. J ElectromyogrKinesiol 2003; 13 (5): 477–89PubMedCrossRefGoogle Scholar
  69. 69.
    Hodges PW, Richardson CA. Relationship between limb movement speed and associated contraction of the trunkmuscles. Ergonomics 1997; 40 (11): 1220–30PubMedCrossRefGoogle Scholar
  70. 70.
    Check P. Swissball exercises for swimming, soccer and basketball. Sports Coach 1999; 21: 12–3Google Scholar
  71. 71.
    Fuller T. A ball of fun: programs using ‘Swiss balls’ can help junior participation at your facility. Tennis Industry 2002;30: 48–9Google Scholar
  72. 72.
    Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy: an outcomestudy. Spine 1989; 14 (4): 431–7PubMedCrossRefGoogle Scholar
  73. 73.
    Comerford MJ, Mottram SL. Movement and stability dysfunction: contemporary developments. Man Ther 2001; 6 (1): 15–26PubMedCrossRefGoogle Scholar
  74. 74.
    Koes BW, Bouter LM, Beckerman H, et al. Physiotherapy exercises and back pain: a blinded review. BMJ 1991; 302 (6792): 1572–6PubMedCrossRefGoogle Scholar
  75. 75.
    Liemohn P, Baumgartner TA, Gagnon LH. Measuring core stability. J Strength Cond Res 2005; v19 (3): 583–6Google Scholar
  76. 76.
    Urqhart DM, Hodges PW. Differential activity of regions of transversus abdominis during trunk rotation. Eur Spin J 2005; 14 (4): 393–400CrossRefGoogle Scholar
  77. 77.
    Cholewicki J, McGill SM. Mechanical stability of the in vivo lumbar spine: implications for injury and chroniclow back pain. Clin Biomech (Bristol, Avon) 1996; 11 (1):1–15CrossRefGoogle Scholar
  78. 78.
    McGill SM. Electromyographic activity of the abdominal and low back musculature during the generationof isometric and dynamic axial trunk torque: implicationsfor lumbar mechanics. J Orthop Res 1991; 9 (1): 91–103PubMedCrossRefGoogle Scholar
  79. 79.
    Roetert PE. 3D balance and core stability. In: Foran B, editor. High-performance sports conditioning: moderntraining for ultimate athletic development. Champaign(IL): Human Kinetics, 2001Google Scholar
  80. 80.
    Jeffreys I. Developing a progressive core stability program. Strength Cond J 2002; 24 (5): 65–6CrossRefGoogle Scholar
  81. 81.
    Johnson H. Stressful motion: golfers at risk for low back pain. Sports Med Update 1999; 14: 4–5Google Scholar
  82. 82.
    Kerrigan DC, Todd MK, Della Croce U. Gender differences in joint biomechanics during walking: normativestudy in young adults. AmJ Phys Med Rehabil 1998; 77 (1):2–7CrossRefGoogle Scholar
  83. 83.
    Nadler SF, Malanga GA, DePrince M, et al. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med 2000; 10 (2): 89–97PubMedCrossRefGoogle Scholar
  84. 84.
    Nadler SF, WuK D, Galski T, et al. Low back pain in college athletes: a prospective study correlating lower extremityoveruse or acquired ligamentous laxity with low back pain. Spine 1998; 23 (7): 828–33PubMedCrossRefGoogle Scholar
  85. 85.
    McGill S. Stability: from biomechanical concept to chiropractic practice. J Can Chiropr Assoc 1999; 43: 75–88Google Scholar
  86. 86.
    Ball T, Comerford MJ, Mottram SL. Performance stability: a new system for providing stability and control for movement and performance [online]. Available from URL: [Accessed 2008 Sep 19]
  87. 87.
    Hasegawa I. Using the overhead squat for core development. NSCA Perform Train J 2004; 3 (6): 19–21Google Scholar
  88. 88.
    Scibek J, Guskiewicz KM, Prentice WE, et al. The effects of core stabilisation training on functional performance in swimming [abstract]. NATA Annual Meeting — Free Communications; 1999 Jun 17-18;Kansas City (MO)Google Scholar
  89. 89.
    Cusi M, Juska-Butel CJ, Garlick D, et al. Lumbopelvic stability and injury profile in rugby union players. NZ J Sports Med 2001; 29: 14–8Google Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Angela E. Hibbs
    • 1
    • 3
  • Kevin G. Thompson
    • 1
    • 4
  • Duncan French
    • 1
  • Allan Wrigley
    • 2
  • Iain Spears
    • 3
  1. 1.English Institute of SportGateshead International StadiumUK
  2. 2.Canadian Sport Centre PacificVancouverCanada
  3. 3.University of TeessideUK
  4. 4.School of Psychology and Sports ScienceNorthumbria UniversityUK

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