Does Posture Matter? Episode 1: The Postural Menace

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There has been a recent buzz online about posture, and particularly about its importance in clinical settings for assessing, treating, and preventing pain. A growing number of physical rehabilitation specialists (physical therapists, chiropractors, etc.) are pointing to the fact that the current body of research does not definitively demonstrate a strong link between static posture and pain. Articles and debates are popping up on physical therapy and chiropractic blogs and websites suggesting that attention to static posture and treatments or preventative measures related to static posture do not have any place in therapy/rehabilitation practice [1] [2] [3]. However, as is often the case with the internet, conversations and articles over a parallel topic with a diametrically opposite viewpoint are making their rounds on everyone's Facebook feed at the same time. One in particular that has garnered its share of attention recently is the topic of "text neck" [4] [5] [6]. Given that most citizens of the Western world have a smartphone surgically attached to their hands by now, this is an eye-catching and relevant topic. As is also typical of mainstream articles on health and medicine that are desperately clamoring for your clicks, the writing is sensationalized and full of scary words and phrases like "epidemic," "permanent damage," and "wreck your spine." The text neck crusaders are out to remind the public that poor posture can cause pain and affect your health, and that it deserves attention and correction.


So, who's right? Does posture deserve your and your physical therapist's attention? Does static posture put you at risk for developing pain or dysfunction? If you have poor posture but are pain free, is there any reason to put effort into improving your posture? Is your spine going to explode if you look down at your cell phone for too long? Are the robots taking over?

Graciously, the internet's mystical and dichotomous ways have presented us with a perfect opportunity to challenge and question conventional wisdom regarding posture and pain, to ask questions that likely are not asked enough, and to ensure that we are not letting tradition supersede knowledge and thoughtfulness.

(Note: Throughout this post and further posts on this topic I will be using the term "posture" to refer just to static posture, and will specify dynamic and/or loaded posture when that distinction is needed.)


My Point Is...
Ultimately, yes, posture does matter. We can all agree that the articles on "text neck" are over the top, and that some of their tactics for gaining readership have a tinge of blatant sensationalism. However, these articles and others like them are not without their merits. No, your spine will not explode from looking down at your phone for too long to get your Twitter fix; however, day-to-day posture and accumulation of time in poor positions is something that deserves your attention and the attention of health professionals alike. It may not be the most imminent threat facing our society today, but it behooves everyone—from high level athletes to desk jockeys—to understand the how and the why of posture's effects on pain, function, and performance.

In this post and the rest in this series, I will address the major aspects of this ongoing discussion on posture and its significance in preventing pain and optimizing function and performance.


The Research
A few minutes of Googling will reveal that, to date, there really isn't much out there in the way of scientifically conducted research that definitively shows a link (causative or correlative) between posture and pain. But, on the other hand, there really isn't much out there in the way of scientifically conducted research that definitively shows there isn't a link between posture and pain. Most of what we have is research concluding that "the results are inconsistent, and therefore don't show a strong correlation." So those who argue that posture is largely irrelevant in treating pain are absolutely correct about the current standings of the body of research.

But honestly, it should not be surprising that research has yet to definitively demonstrate a link between posture and pain. Research conducted on this issue is mostly limited to cross-sectional studies, retrospective studies, and prospective studies with small groups of subjects; and, any study that sets out to examine something as variable (and often ill-defined) as posture and as mystifying as pain is bound to encounter limitations.

In cross-sectional studies, researchers take a group of people with back/neck pain and a group of people without pain and, using radiography, a flexicurve, and/or some other postural assessment tools, examine the positions/alignment of their joints (particularly in the spine) to look for patterns in posture that can be linked to the pained or pain free group. The greatest limitation of this method is that it only looks at a snapshot of the individual's posture and pain. The complexity of posture cannot accurately be captured in a snapshot. Posture is not a position at a given moment, but a series of ongoing positional patterns (it could be considered an "average") for sitting, standing, lying, etc. In addition, being aware that they are part of a study on posture, it is entirely possible (if not likely) that subjects' body positions during their examination for the study will not be true to their day-to-day posture.

In retrospective studies, groups of individuals with back/neck pain or a history of back/neck pain are asked to report, retrospectively, on their posture. These studies may also been done in combination with a cross-sectional study. The limitations on this one are rather obvious: most people can't remember what they ate for breakfast yesterday, much less how their posture has been since middle school. Additionally, much of the population is largely unaware of their posture (lacking proprioception) and general movement patterns. This does not lend itself to detailed and accurate self-reporting.

In prospective studies, researchers focus on a group (or groups) of people with a common hypothetical risk factor—in this case, poor posture—and look for the development of conditions, such as neck or back pain, over time. Of the three, this research method is the most likely to produce consistent and revealing results. However, it still has a few considerable limitations. Because prospective studies require researchers to follow subjects for long periods of time, it is generally the most costly and demanding type of study. In order to get substantial and revealing outcomes, any study on posture will require a large population to be examined; however, the cost and labor demand of prospective studies will present a limit to the number of subjects that can be followed. For this reason, long-term follow up with subjects of the study may be conducted via a mail or phone questionnaire and rely upon self-reporting rather than the more costly and impractical (but more accurate) option of assessment by a medical professional. Therefore, even in prospective studies, researchers end up with only an initial snapshot of the subject's posture; they do not collect measurements of long-term trends or changes in one's posture, and therefore face similar limitations as in a cross-sectional study. In addition, the primary strength of a prospective study—that it examines subjects over a long period of time—also presents a challenge in this type of research. Posture and posture-related habits can (and often will) change over time, and the challenge of tracking the introduction or cessation of additional risk-factors in each patient over an extended period of time mars the clarity of any results from such a study.

In addition, all of these methods fall short in that they focus almost exclusively on pain (specifically, back/neck pain). While pain is incredibly deserving of researchers' and practitioners' attention—it is our body's primary way of saying, "hey, something's not right here!"—it does not tell the whole story, and is a phenomena that follows rather inexplicable patterns. A considerable population (I've seen estimates between about 20-60%) of individuals with considerable tissue damage (think torn or frayed ligaments, bulging and degenerating spinal disks, damaged cartilaginous tissues, etc.) walk around with no pain at all [7] [8] [9]. And meanwhile, people with no signs of tissue or nerve damage find themselves in constant and severe pain [10] [11]. When health practitioners and researchers focus exclusively on pain, they ignore the relevance and importance of other factors affecting function/dysfunction, and they do themselves and their patients a disservice.

Ultimately, posture is a difficult beast to pin down and track. Life does not occur in a laboratory, and therefore something like posture which is, by nature, very dependent on and related to a massive diversity in lifestyle and individual physiology, will always challenge our research methods. Even the researchers conducting these studies and health professionals arguing against the use of posture-based practices in clinical settings punctuate their claims with qualifying terms like "probably," "inconclusive," "likely," "possibly," and "unclear," and most online articles denouncing posture-based treatment outright admit: most of these studies are poor quality and the evidence is not entirely clear one way or the other.

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It should also be noted that none of my caveats about the condition of current research really prove or suggest that posture does correlate in any way to pain or dysfunction. As with most contentious scientific matters, there is research that supports both hypotheses; but the research indicating correlations between posture and pain all face the same short-comings and challenges as the research proposing the opposite. Looking only at the research, we end up with something of a moot point.

However, some argue that because the body of research more strongly leans (by volume) to the side of "no considerable correlation," that physical therapists, trainers, and other health professionals should forego posture-related corrections and diagnoses from their practice. In other words, because our current body of research cannot not provide evidence that poor posture does cause pain, it must not cause pain. This, to me, looks like a classic case of argumentum ad ignorantiam (shout out liberal arts education). It is an appeal to ignorance.

To further support their argument, some contend that continuing to enforce the importance of "good" posture in the medical field is actually a disservice to patients, as it runs the risk of causing a nocebo effect. While this is a potential risk, I ultimately believe that the potential benefits of postural awareness and practicing good posture far outweigh the potential risks. It is the duty of any health practitioner to be familiar with up-to-date research and to understand the medical field's official (or unofficial) stance on an issue. However, I believe that it is also the duty of any health practitioner, and of any free-thinking human being with a fully functioning brain and internet access, to examine the research within a more holistic context and with a hefty dose of common sense.


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In the next post of this series, we will take a look at how and why posture can affect pain, function, and performance.

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Stay swole. 

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Photo Credits:
1 Thinker, Texter, Reader via photopin (license)^↩
2 Spine Cervical and Upper Thoracics via photopin (license)^↩

In Injury and in Health... Training Through Injury

So, you've injured yourself—hopefully nothing serious—perhaps a muscle strain or a minor sprained joint, or a minor case some sort of "-itis" brought on from overuse and/or poor movement patterns. It's not going to kill you or permanently disable you, but it's enough to piss you off and get in the way of your training; and now you're left, angry and in pain, wondering what the next step is. When will you be able to get back to training? Are there any movements you can do to keep up progress while you recover? Is there anything you can do to speed up recovery? 

I've found myself in this situation a number of times, and each time I come out of it with a little more wisdom, patience, and insight. It's one of those things that, while difficult and incredibly frustrating, gets easier with experience, and can ultimately teach some very valuable lessons.

Injury is something of an inevitability if you spend long enough training or participating in sports. Proper movement and intelligent training will aid in preventing injury and optimizing performance, but accidents do happen, and sometimes optimal training and recovery don't fit in with the demands of ordinary life, and we make a mistake and end up with a pulled muscle or strained joint. When this does happen, it's important to know how to handle it without making the injury worse and without letting all training and progress come to a screeching halt. The good news is, most injuries will not require you to completely abandon your training. And a few basic principles can help guide you through answering the above questions for yourself and help you get back to making progress and feeling happy and healthy as soon as possible. 

Sound of Mind, Sound of Body
Hopefully this is obvious, but it should probably be mentioned anyway: if your injury is serious, or you think it may be serious, or your buddy keeps telling you it looks serious, see a doctor. If your femur is sticking out of your thigh or you can't move half of your body, you should probably get your business taken care of and not worry about keeping up on your training for the moment. Having a full knee replacement at 28 years old because you're too macho to be slowed down by serious pain or injury doesn't make you a badass. Seriously, when in doubt, see a medical professional.

So, rule one: don't be stupid. 

I could probably just end the post here—this principle will take you pretty far in training (and life)—but I like to hear myself talk, so I'll press on. 

Because in the end, running on a sprained ankle is still better than being eaten.

Most of the time we know when we're about to do something really stupid; yet, fueled by hubris or stubbornness, we press on and make a mild injury worse or delay our recovery. The body does a pretty good job at letting us know when it's injured and telling us what movements are going to make things worse. So, unless you're being chased by a pack of pissed off, hungry bears, you probably shouldn't be running on the ankle you just sprained. Curiosity kills cats and cocksure stupidity kills athletes' knee joints. Don't be that guy!

Listen Up

Rule two: listen to your body. 

This one pairs closely with not being stupid. The body wants to protect itself. It does not want you to destroy your already abused tissues. Fortunately (or unfortunately), we have the pain response. Pain is a powerful mechanism that allows your body to tell you what's going on inside. While it is not always an accurate measurement of tissue damage or injury (damaged tissues can be asymptomatic and pain is sometimes not associated with injured tissues), it's wise to take heed of the pain signals your body is sending to you. There's a chance your body may be sending an "inaccurate" message, but usually (particularly with acute pain) the pain signal is being sent for a reason. And it's better to play it safe than to "tough it out" until you need of a new kneecap. 

To take this all a bit further, let's consider an example. You tweaked something in your left shoulder doing a snatch last week. There's no swelling, and no real loss of range of motion, but your shoulder feels a bit achy and swinging your arm overhead doesn't feel great; but otherwise, doesn't seem too serious. Today's workout calls for dips. You get up on the dip bars and start your first rep only to find that you get some pretty serious anterior shoulder pain in the bottom of the dip, and your left shoulder feels pretty shaky and unstable. The pain isn't excruciating, but it's enough to give you pause. 

So, should you press on (no pun intended) and impress your bros and brodettes? 

Well, is there a $30 million contract on the line? Does your life or the life of a loved one depend on getting these dips done today? If the answer to both of these is 'no,' then you should probably stop dipping, pronto. Your body is telling you, loud and clear, that this position and/or this movement is taking your damaged tissues to a place they shouldn't be. Push it too far, and there's a chance your irritated labral tissues are going to turn into completely torn labral tissues. And that's just not cool.

Know Thyself

Rule three: understand what's injured, and understand how those tissues are involved in movements. 

If you can figure out, even in a very general sense, what tissues are injured and to what degree, you can generally extrapolate what kind of movements you should avoid until you're healed up and what kinds of movements you can do to keep your training progress up and speed recovery. With minor aches, strains, and pulls, there's usually no need to see a doctor and order an MRI or CT scan to get an insider's view of the damage, so you'll have to do a bit of detective work. With an acute injury that came from some sort of trauma or mishap, it's pretty easy to get a general idea about what's injured. 

For example, if you were running, rolled your ankle, and now you have lateral swelling and bruising, it's safe to say you caused some damage to some of the ligaments on the outside of your ankle. From here, you just need to do a bit of thinking about what movements are going to put stress on those tissues and avoid those movements. On the other hand, radiating pain from nerve compression or the like can be a bit more mysterious. Shooting pains in the leg can be caused by an issue in the back, shoulder and arm pain can be traced back to neck injury, and so on. However, some Google-fu can generally shed some light on the root of the problem. Understanding what nerves run along the path of your pain, and the origin of these nerves can give you a pretty good idea of what you're dealing with. For example, shooting pains down the leg and into the foot that seem to appear out of nowhere may be caused by irritation of the sciatic nerve, which originates from the L4 to S3 vertebrae. Knowing this can help you decide what movements will be off-limits and what movements will help your recovery. 

For most minor injuries, some due diligence in educating yourself on the injury and anatomical structures and thinking about how those tissues are involved in movements should give you a pretty good blueprint for what should/should not be done while you're recovering.

Less Pain, More Gain

Rule four: figure out what you can do pain-free and with proper function.

Again, lucky for us, our bodies have provided us with a pretty simple and effective tool for assessing whether a movement is a going to make things better or worse—pain! While it may not be 100% accurate, and while there are times that painful movements actually should be done will help with recovery, these exceptions should be left to healthcare professionals. In addition to pain, injured tissues can also cause some pretty massive instability in an injured joint. If your shoulder gets shaky and feels like it's going to pop out of the socket when you try to perform a push-up, you probably aren't in any shape to being doing push-ups right now (and should probably see a doctor). The general rule for training through an injury is this: if it hurts or it feels super sketchy, don't do it. Simple stuff. 

It's important here to also recognize the difference between injury pain and soreness or some other types of pain. If you did 50 heavy back squats in your most recent workout, your legs are probably going to be sore. While soreness is painful, it is not injury. With soreness, it's actually generally a good idea to push through the pain and do some lightweight movement of the sore tissues. This will increase blood flow to the area, prevent excessive and perpetuating stiffness, and will help alleviate the soreness quicker. 

It's also important to recognize the pain involved with soft tissue work and mobilization and how this differs from injury pain. Unless you have the tissues of a young and supple demigod, rolling your quads on a lacrosse ball can be seriously painful. But this pain is not the same as that caused by doing pull-ups when you have elbow tendonitis or trying to "stretch" your back after you just pulled your lat. The difference is generally pretty evident if you're paying attention to the signals your body is sending, so listen closely. 

Know your pain! Stretchy pain is very different than torn ligament pain.

A little bit of quick trial and error can pretty clearly reveal what movements can be performed as you work around your injury. After you've completed the previous step and figured out what's injured and how those tissues are involved in movements, you can start exploring what movements you can utilize in your training as you heal up. Start with light (bodyweight or empty bar), basic movements, and go easy and slow. As you figure out what movements you can perform without pain and instability, you can establish how much of your program you can continue to perform as prescribed, and figure out what exercises you can substitute in for the exercises that would cause pain. And, as your injury heals and start getting closer to feeling 100%, you can perform movements that directly involve the injured tissues and include exercises that were previously painful with very light weights to begin to re-establish stability and strength and encourage blood flow to the recovering tissues.

Let's return to our injured shoulder example for a moment. Let's say that today's workout calls for snatches, back squats, dips, and pull-ups. You start by putting your arms overhead, in a position similar to that in a snatch (with no weight) and it brings up a dull ache in your shoulder, so no snatches today. You do some squats with just the bar, and those feel fine on your shoulder. You slowly add weight to the bar, and it doesn't seem to aggravate the shoulder, so you're good to go on squats. You establish quickly that the bottom position of the dip is painful and sketchy, so those are out of the question. Finally, you start with some light lat pull-downs to mimic the movement of a pull-up. It doesn't seem to bother your shoulder, so you move on to strict pull-ups, and can include those in your workout without issue. So, you're hunting for substitutions for snatches and dips. Snatches are an explosive hip extension exercise, so something like box jumps, standing broad jumps, or even snatch pulls (assuming those don't bother your shoulder) could provide a similar stimulus without putting stress on the injured tissues of the shoulder. For dips, given what you've figured out about the injury of your nature and how those tissues are involved in movement, you're aware that most horizontal pressing movements will be out of the question, as will overhead work. However, you could still get a somewhat similar stimulus by working the triceps. Banded tricep pushdowns, skull crushers, and cable tricep pushdowns might all be good options. You could also include some hollow rocks to mimic the midline stability demands of the dip.

It may take a bit of creativity and trial and error, but often you can find ways to stick closely to the prescribed training stimulus while allowing your injury to heal.

Patience, Young Padawan

Rule five: don't rush it. 

Healing takes time. A muscle strain, even if it doesn't seem all that major, can take months to fully heal. One of the biggest mistakes (and one that I think many athletes make) is rushing back into things. Two weeks after straining a muscle in your low back, you wake up with no more pain and are so excited to be pain-free that you jump right into a workout consisting of heavy deadlifts, pull-ups, and atlas stone loads. Probably not going to bode well for you. Being symptom free means you're symptom free, not injury free. I've made this mistake more times than I care to admit, and I've learned that it's much better to give your body a few extra days to heal than to jump back into too early. The most frustrating thing you can do is take an almost-healed injury and make it worse. What should be a three week recovery turns into a total of seven weeks of recovery when you try to get back to it too soon and make everything worse. Strength is something that is pursued over a lifetime. An extra week is not going to ruin all of your gains and make you weak, but it can keep you from hurting yourself more. 

Always Look on the Bright Side of Life

¹Cheer up bro! Bench press and pull-ups for days!

Rule six: keep a good attitude.

I hate being injured. But, I find that I always come out of injuries with a bit more knowledge and perspective. You tend to learn a lot about your body and the way it moves when you are forced to pay close attention to your movements to avoid pain and allow tissues to heal. In addition, it can be a good opportunity to focus on something that you've been wanting to add to your training or improve on. If you rolled your ankle and can't squat for a few weeks, use that time to apply extra focus and effort to increasing your bench press or your pull-ups. The worst thing you can do when you're injured is throw the baby out with the bathwater, adopt a dismal outlook on the whole ordeal, and give up on getting something positive from the whole experience. Keeping a positive outlook will help you trudge through the pain and inconvenience and can help you see the lessons that you can learn from your injury. Don't be a gloomy Gus and don't let your injuries be for naught.

Those Who Don't Know History are Doomed to Repeat It

Rule seven: figure out why you got hurt, learn from it, and don't make the same mistake again.

As I mentioned before, injuries, however inconvenient and painful, can provide us with some valuable lessons. Engaging in some self-reflection and pattern recognition can shine light on some movement deficiencies, poor postural or movement patterns, or weaknesses that you were previously unaware of. 

If it is an acute injury, think about what you were doing when the injury occurred. If you were benching and tweaked your shoulder, ask: What did my bar path look like? Where were my elbows? Is my descent slow and controlled, or herky-jerky and uncontrolled? Am I creating torque on the bar? Are my shoulders staying locked into a stable position, or are they shifting all over the place? 

If it is pain or injury that you can't trace back to an acute trauma—for example, development of sciatic nerve pain—you need to take a close look at your posture and movement patterns, and recognize what patterns may be have been gradually contributing to this injury that's now rearing its ugly head. Are you sitting, completely idle, for 15 hours every day, and then rushing into the gym to perform a 30 minute high intensity workout without any warm-up or cool down? Are you sitting, walking, running, and lifting from an overextended or flexed position? Do you perform routine mobility to maintain your body and help your tissues recover from all the abuse you throw at them? 
Figure out what went wrong, and fix your business. 

You know what's worse than getting injured? Getting injured in the same way again because you didn't correct the problem. Use your injury as an opportunity to learn from your mistakes and become a better, stronger person. 

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In future posts we will delve into specific exercise substitutions and strategies for common training injuries.
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1 photo credit: via photopin (license)^↩

"Core" Concepts, Part 2 - Best Exercises for Improving Core Strength

In a previous post, I looked at what the often-discussed but seldom-understood "core" actually is, focusing on functionality, performance, and health. I concluded that, despite common wisdom, the core's primary function is not to attract babes at the beach or to act as a washboard in the event of a malfunctioning washing machine. Rather, the core's functionality lies in its ability to position and stabilize the trunk and hip/shoulder joints and to transfer and/or generate force. In other words, if you'd like to be a good athlete or even just an adequately strong human being, you need a strong core.

So, without further ado, here are some of my favorite training methods/exercises for working towards a stronger, healthier core.

#1 - Odd object exercises

Odd object training is a no-frills, no-strings-attached, simple and effective way to get strong as heck. If someone were to come to me and ask, "hey coach, if I had to choose only one exercise to do for the rest of my life, what should it be?" I would first tell them to just do multiple exercises, because just doing one exercise is a dumb idea, and then I would tell them that if they insist on doing just one exercise, they should probably choose heavy, odd object exercises. Perhaps that way they could get wicked strong and lay the beat-down on their mysterious oppressor who is only allowing them to do one exercise.

Odd object exercises make for a great core exercise because the unevenly distributed weight of odd objects requires your core to work hard to stabilize, often in multiple planes throughout a movement, and the bulkiness of most odd object puts the center of mass farther away from your body, again requiring your core to do additional work to keep from being bent and contorted in every direction.

Odd object training is pretty intuitive, but some of my favorite odd object excercises/implements for strengthening the core are...
 - Stones
Be it a nicely molded atlas stone or a big heavy rock you found in your backyard, stones should be a go-to in odd object training. Perform stone loads, stone carries, or a barbell exercise such as a deadlift or clean & press with a stone.

- Sandbags
The nice thing about sandbags is they are a lot softer than stones, so it's easier to toss them around without some of the discomfort a heavy stone may cause. Sandbags are also particularly good for core strengthening because the load itself is dynamic--the sand tends to shift around in the bag and therefore weight distribution changes throughout the exercise. Good sandbag exercises that'll strengthen your core include sandbag shouldering, sandbag runs/carries (zercher/hugged or unilateral shouldered), sandbag getups, sandbag around-the-worlds, and countless variations of sandbag rotational exercises. As with any exercise where you have the a unilateral load or unilateral motion (i.e. load/motion on one side of your body), be sure to perform the exercise for both sides.

- Kegs
Kegs can be filled with water, sand, rocks, etc., but filling with water will yield the most challenging implement, as the sloshing water will constantly change the center of mass and require your core and other stabilizing muscles to work like hell. Regardless of what it's filled with, the bulkiness of the keg and the changing center of mass will make it a great tool for training the core. (Note that how you intend to use you keg may require different sizes and weights). Good core-strengthening keg exercises include keg carries, keg clean & press, and keg shouldering.

#2 - Medicine ball/Slam ball throws

Medicine balls/slam balls (I'll just call them med balls for the sake of brevity) are great tools to have in the gym, and lend themselves well to a number of core-strengthening exercises, particularly of the rotational and accelerative/decelerative variety. A huge number of sports movements involve high-force throwing or swinging of some kind--think about swinging a baseball bat, throwing a football, throwing a punch, grappling--and all of these movements require the body to accelerate and decelerate quickly, often under load. Med balls are a great tool for training this element of core strength.
Some of my favorite core exercises include: med ball rotational throws (front/parallel, side/perpendicular, and backwards) (all can be performed with partner or against wall), med ball slams, med ball rotational slam, and med ball roll back and throw. With all of these med ball exercises, explosiveness and speed should be priority.
(Note: when performing med ball throws against a wall, the bouncier, rubber med ball will bounce back faster and will require your core to work harder to decelerate, whereas the larger leather balls will absorb most of the force--choose your med ball according to the stimulus you are seeking; also, perform throws closer to the wall to focus on speed and quick reps, further from the wall to focus on power development and harder throws)

#3 - Plank and plank variations

Very little introduction or explanation needed here. Planks strengthen the core for stability, and that's one of the primary things we need our core to do. There are countless variations of the basic front plank, but some of my favorites are the side plank, the one-arm one-leg plank, the plank walk and the ab-wheel roll out (this can be performed from the knees or from your feet, and you can use a barbell or gymnasic rings if you don't have an ab-wheel).
Something to keep in mind with planks: prioritize quality of time. A 3 minute plank during which you're hanging your weight on your spine, arching your back, and rounding your shoulders is not making you stronger. A 20 second plank in which you maintain a neutral spine and stay as stiff as a steel beam is.

#4 - Basic gymnastic movements

Gymnasts are required to demonstrate a huge amount of core stability and positional stiffness, so it should go without saying that incorporating some basic gymnastic movements into your training can be a huge asset. A few of my favorites that should be easy to learn and perform with basic equipment are hollow rocks, v-ups, l-hangs and l-sits, and strict toes to bar. First priority with these exercises is positioning, not time or reps.

#5 - Back extensions and holds

Perhaps the most oft-forgotten part of the core is the back. The prevalence of back pain and back injury in both athletes and the general population is enough to tell us that far too many people are walking around with weak backs and crappy positioning. Some of the best exercises to strengthen the back and reinforce good positioning are back extensions and holds. My favorites are supermans, back extensions, and back extension iso holds (both can also be performed using a large exercise ball, or on a bench with a friend holding your ankles down).

By InfoGibraltar (Flickr: STRONGMEN 201373) [CC-BY-2.0], via Wikimedia Commons
It takes a lot more than crunches to build a strong core.

I'm going to leave you with a few things to keep in mind.
First and foremost, as with any exercise, proper form and resistance is the difference between getting stronger and getting injured. If you're unsure on form, seek the help of a knowledgeable trainer, and focus on form before you start throwing around big weights or doing tons of reps.

Second, most any multi-joint athletic movement is going to train your core to some extent (insofar as your core will be involved in most any multi-joint athletic movement). I've heard countless times that performing the basic barbell movements will train your core, and I agree--squat, bench, press, and deadlift and your core will get stronger. However, sometimes this is not enough. Sometimes your core is the weak link in your lifting and you need some additional core-focused work. Sometimes the demands of your sport go beyond the general bracing and isometric core strength that you can train with basic barbell lifts. And sometimes the core strength you get from the basic barbell lifts is just not strong enough. The exercises I have listed here (along with many that I did not list) help to strengthen the core to a degree or in a particular way that goes beyond what the basic barbell lifts can do. For the same reasons that you may train your triceps to increase your bench, that you may strengthen your hamstrings to help deter low back pain, or that you may perform glute exercises to improve your sprinting, you should strengthen your core.

Third, when should you include these exercises in your routine? Good question. Short answer: whenever. Just do them. I generally implement core work after the main lifts, often between sets of other accessory work, though sometimes I like to include some core in warm-ups. Other times, core work can work well as part of a conditioning workout (especially with something like sandbag work). It's up to you, and what matters most is that you actually do the work. Just be aware of the demands you're putting on your body. If your main exercise is a maximal set of heavy deadlifts and you precede that with 10 minutes of plank and 400 meters of heavy keg carries, realize that your deadlift may suffer a bit.

Finally, most of the exercises I have listed here will not give you a "burn" in your rectus abdominis or your external obliques. What is this fool's gold?! A core exercise with no burn? Yep. I don't know when or why, but at some point in the history of strength training somebody decided that core exercises must involve a "burn" if they are to be deemed sufficient and effective, and somehow that idea caught on and has stuck. I'm sure there are still top level D1 strength & conditioning coaches and six-figure personal trainers out there training top-tier athletes under the erroneous premise that core training needs to involve a "good burn." Think of it this way: when you perform a heavy set of 5 in the back squat, do your hamstrings get all burn-y? Probably not. Then do you mean to tell me that doing heavy sets of 5 in the back squat won't strengthen your hamstrings?
If you still think that you're not getting a good core workout unless your abs are on fire, then you need to change the way you think about strengthening your core.


Stay swole.