Answers (9)
1
Hi Joanne,
as I have never been afraid of the devil, I'll give it a try.
I believe that crunches are neither a 'no no' nor a 'oh yeah'. Ultimately, we want our clients to healthy and pain-free through a proper choice of exercises for them.
When I train clients, I regularly move them through all possible movements of the spine, spinal flexion included (such as seated circles on a ball). When I want to strengthen the core abdominal muscles, I tend to gravitate towards exercises that do that in a neutral spine position. This is based on the observation that just about all people I deal with are true experts at spinal flexion as they assume that position all day long. They would love to do crunches in that position but I do not want to reinforce strength in a locked-short position.
As far as the person you are describing: healthy but an excessive anterior pelvic tilt. Yes, I probably would do spinal flexion in an effort to move the pelvis into better alignment.
as I have never been afraid of the devil, I'll give it a try.
I believe that crunches are neither a 'no no' nor a 'oh yeah'. Ultimately, we want our clients to healthy and pain-free through a proper choice of exercises for them.
When I train clients, I regularly move them through all possible movements of the spine, spinal flexion included (such as seated circles on a ball). When I want to strengthen the core abdominal muscles, I tend to gravitate towards exercises that do that in a neutral spine position. This is based on the observation that just about all people I deal with are true experts at spinal flexion as they assume that position all day long. They would love to do crunches in that position but I do not want to reinforce strength in a locked-short position.
As far as the person you are describing: healthy but an excessive anterior pelvic tilt. Yes, I probably would do spinal flexion in an effort to move the pelvis into better alignment.
1
Just received my ACE Certified News in my inbox... very interesting article
When Pigs Crunch - A Commonsense Approach to Abdominal Training... perhaps all we need in this area is a bit more of that, commonsense!
http://www.acefitness.org/certifiednewsarticle/1884/when-pigs-crunch-a-c...
When Pigs Crunch - A Commonsense Approach to Abdominal Training... perhaps all we need in this area is a bit more of that, commonsense!
http://www.acefitness.org/certifiednewsarticle/1884/when-pigs-crunch-a-c...
0
Karin, thank you so much for indulging me. 8))
I echo your position on the importance of choosing the correct exercises for our clients.
As always thank you for the stimulating interchange.
I echo your position on the importance of choosing the correct exercises for our clients.
As always thank you for the stimulating interchange.
0
Trixy but here I go. With an increased lumbar curve on an individual that presents as healthy, I wouldn't shy away from crunches or crunching motions, (as Karin already stated) in an effort to improve their pelvic alignment. (unless aggrevation occured) I actually have seen more anterior pelvic tilt amongst women, and more posterior pelvic tilt amongst men (*strange, huh?)
Personally I prefer to utilize planks and lateral leans with most (apparently healthy, w/o sports specific needs) clientele. And, as always, a good dose of transverse abdominal holds, timed and with convergence. (Gotta make sure they aren't holding their breath ;} )
Personally I prefer to utilize planks and lateral leans with most (apparently healthy, w/o sports specific needs) clientele. And, as always, a good dose of transverse abdominal holds, timed and with convergence. (Gotta make sure they aren't holding their breath ;} )
0
Well Joanne,
Honestly, I don't see a point in favoring crunches in the traditional sense as an exercise for this client. I don't have a problem with crunches. I don't have a problem with how many or how often people want to do them (within reason, obviously). The important thing to me is that you're balancing out any movement or combination of movements with a proportionally appropriate amount of opposing movements.
Depending on the muscular endurance and to a lesser extent, mucular strength, of the abdominals, hip flexors, erector spinae, and multifidi muscle groups, I may or may not wish to favor a certain group of exercises over others. I might even go so far as to consider what role, if any, the Psoas Major and Psoas Minor muscles might have to play here. In this instance, it's important to determine whether the client's anterior pelvic tilt is a result of structural damage to the spinal column or if the problem results from tight muscles or a muscular imbalance. A referral might be necessary.
In order to answer the question, let's say the problem is tight muscles that are acting on the lumbar spine, the posterior iliac crest, and the sacrum. We'll go with the Multifidi and the Erector Spinae. My common sense as a trainer tells me to design a program for this client that focuses on developing the endurance of the abdominal muscles with emphasis on the LOWER rectus abdominus. I'm a firm believer in balance. I recognize that too much encouragement of muscle growth in the opposing mucsles (mainly the rectus abdominus) has the potential to result in another muscular imbalance. Proper stretching needs to be emphasized for the tight muscles in the back acting at the lumbar spine, the posterior iliac crest and the sacrum. For sample stretches, I would begin with ones that the client could refer to when they leave the gym. See LIVESTRONG:
http://www.livestrong.com/article/349868-stretches-for-spine-lengthening...
In the end, sure, crunches could be included in the routine to correct the anterior pelvic tilt. Crunches, in my opinion, tend be effective and are associated with a low risk of injury. However, I think that one of the best exercises I could include in this client's routine would be the following:
http://www.youtube.com/watch?v=F3h79ud1Y9g&feature=related
An additional note on the ^^^reverse crunch inclusion: For this client, I would elevate the pelvis in the starting position. This could be done by having the client simply rest the top of the tailbone on his/her hands to give a little extra elevation and support so that that "flat back" will be accomplished in the starting position. This exercise has the potential to aggravate the condition if there is overextension of the lumbar spine, so the amount of flexion on this exercise for this particular client will be especially limited until more abdominal control is achieved. It's logical to me that this exercise will strengthen opposing muscles while lengthening the tight muscles.
I'm not a corrective exercise specialist, but all of this is my best analysis of the situation thus far. Bottom line, the best program for this client, in my opinion, is one that emphasizes muscular endurance and flexibility in the muscles that stabilize the spine.
Is that a fair assessment? Am I on the mark or do I need some serious readjustment? I'm open to criticism.
As far as which pelvic tilt I've seen most often, I can say the anterior pelvic tilt seems to be more common among people (judging by friends and family and clients), but I haven't had a large enough client base yet to get a representative sample.
Honestly, I don't see a point in favoring crunches in the traditional sense as an exercise for this client. I don't have a problem with crunches. I don't have a problem with how many or how often people want to do them (within reason, obviously). The important thing to me is that you're balancing out any movement or combination of movements with a proportionally appropriate amount of opposing movements.
Depending on the muscular endurance and to a lesser extent, mucular strength, of the abdominals, hip flexors, erector spinae, and multifidi muscle groups, I may or may not wish to favor a certain group of exercises over others. I might even go so far as to consider what role, if any, the Psoas Major and Psoas Minor muscles might have to play here. In this instance, it's important to determine whether the client's anterior pelvic tilt is a result of structural damage to the spinal column or if the problem results from tight muscles or a muscular imbalance. A referral might be necessary.
In order to answer the question, let's say the problem is tight muscles that are acting on the lumbar spine, the posterior iliac crest, and the sacrum. We'll go with the Multifidi and the Erector Spinae. My common sense as a trainer tells me to design a program for this client that focuses on developing the endurance of the abdominal muscles with emphasis on the LOWER rectus abdominus. I'm a firm believer in balance. I recognize that too much encouragement of muscle growth in the opposing mucsles (mainly the rectus abdominus) has the potential to result in another muscular imbalance. Proper stretching needs to be emphasized for the tight muscles in the back acting at the lumbar spine, the posterior iliac crest and the sacrum. For sample stretches, I would begin with ones that the client could refer to when they leave the gym. See LIVESTRONG:
http://www.livestrong.com/article/349868-stretches-for-spine-lengthening...
In the end, sure, crunches could be included in the routine to correct the anterior pelvic tilt. Crunches, in my opinion, tend be effective and are associated with a low risk of injury. However, I think that one of the best exercises I could include in this client's routine would be the following:
http://www.youtube.com/watch?v=F3h79ud1Y9g&feature=related
An additional note on the ^^^reverse crunch inclusion: For this client, I would elevate the pelvis in the starting position. This could be done by having the client simply rest the top of the tailbone on his/her hands to give a little extra elevation and support so that that "flat back" will be accomplished in the starting position. This exercise has the potential to aggravate the condition if there is overextension of the lumbar spine, so the amount of flexion on this exercise for this particular client will be especially limited until more abdominal control is achieved. It's logical to me that this exercise will strengthen opposing muscles while lengthening the tight muscles.
I'm not a corrective exercise specialist, but all of this is my best analysis of the situation thus far. Bottom line, the best program for this client, in my opinion, is one that emphasizes muscular endurance and flexibility in the muscles that stabilize the spine.
Is that a fair assessment? Am I on the mark or do I need some serious readjustment? I'm open to criticism.
As far as which pelvic tilt I've seen most often, I can say the anterior pelvic tilt seems to be more common among people (judging by friends and family and clients), but I haven't had a large enough client base yet to get a representative sample.
0
This debate has picked up some attention lately and I studied it with an open mind and crunches are still bad.
First I'll address your scenario, then I'll share some information for both sides and let you make up your own minds.
"What exercises or movements would you use with a client who presented with an increased lumbar curve? Let us all assume that this is a healthy client, all assessments have been done and he/she doesn't have thoracic kyphosis or osteoporosis. Is a crunch also known as spinal flexion a no no? Too, in your experience as a personal trainer, do you encounter more people with excessive anterior pelvic tilt or posterior tilt? As you have been doing, please use science to support your position."
I would have this client start in a supine position and initiate the drawing in maneuver while pressing the lower back to the floor. This is to retrain the body to have proper alignment through the Lumbo-Pelvic-complex while relearning to activate core musculature.
Progression:
supine
prone
quadruped
then maintain core position while learning to integrate limb movement
This is best paired with glute bridges and Iso-Prone Abs(plank).
Glute bridge is to retrain the glutes to fire instead of the hamstrings. Some people will have cramps in their hamstrings doing this because of the disadvantaged length of the hamstrings. This can be eliminated by placing the feet in an external rotated position and positioned wider than hip width, upon raising the butt push the knees out. This will help the Glutes to fire and disengage the hamstrings.
Progression:
back on bench feet on floor (decreased lever arm)
back on floor feet on floor
back on floor feet on ball
back on floor single leg on floor
back on floor single leg on ball
Iso-Prone abs will help to stabilize the LPHC in the proper alignment as per-positioned with the drawing in exercise.
Progression:
Plank raises - this is just lifting the body off the floor to a plank holding for 3-5 seconds and returning to the floor, do these for reps.
Plank static holds
Plank static holds with alternating hip extension
plank static holds with alternating arm leg raise
The main point of this program is to progress from learning proper LPHC position to firing the correct muscle to stabilize the core then to stabilizing while moving the extremities. This is a basic progression.
As a side note to this, as pointed out to me by somebody in a recent discussion it is ok to crunch to retrain somebody who has been ambulatory and is learning to get up on their own again. The crunch is a risk reward question more than anything, because we all know it works but so do other exercises with less risk.
I am now going to post a recent article that has renewed some interest in the subject of crunches.
pro crunches:
http://journals.lww.com/nsca-scj/Fulltext/2011/08000/To_Crunch_or_Not_to...
con crunches:recent McGill interview addressing previous study
http://www.myrehabexercise.com/blog/archives/669
I suggest if we want to continue to discuss this topic that we all take the time to educate ourselves to both positions.
First I'll address your scenario, then I'll share some information for both sides and let you make up your own minds.
"What exercises or movements would you use with a client who presented with an increased lumbar curve? Let us all assume that this is a healthy client, all assessments have been done and he/she doesn't have thoracic kyphosis or osteoporosis. Is a crunch also known as spinal flexion a no no? Too, in your experience as a personal trainer, do you encounter more people with excessive anterior pelvic tilt or posterior tilt? As you have been doing, please use science to support your position."
I would have this client start in a supine position and initiate the drawing in maneuver while pressing the lower back to the floor. This is to retrain the body to have proper alignment through the Lumbo-Pelvic-complex while relearning to activate core musculature.
Progression:
supine
prone
quadruped
then maintain core position while learning to integrate limb movement
This is best paired with glute bridges and Iso-Prone Abs(plank).
Glute bridge is to retrain the glutes to fire instead of the hamstrings. Some people will have cramps in their hamstrings doing this because of the disadvantaged length of the hamstrings. This can be eliminated by placing the feet in an external rotated position and positioned wider than hip width, upon raising the butt push the knees out. This will help the Glutes to fire and disengage the hamstrings.
Progression:
back on bench feet on floor (decreased lever arm)
back on floor feet on floor
back on floor feet on ball
back on floor single leg on floor
back on floor single leg on ball
Iso-Prone abs will help to stabilize the LPHC in the proper alignment as per-positioned with the drawing in exercise.
Progression:
Plank raises - this is just lifting the body off the floor to a plank holding for 3-5 seconds and returning to the floor, do these for reps.
Plank static holds
Plank static holds with alternating hip extension
plank static holds with alternating arm leg raise
The main point of this program is to progress from learning proper LPHC position to firing the correct muscle to stabilize the core then to stabilizing while moving the extremities. This is a basic progression.
As a side note to this, as pointed out to me by somebody in a recent discussion it is ok to crunch to retrain somebody who has been ambulatory and is learning to get up on their own again. The crunch is a risk reward question more than anything, because we all know it works but so do other exercises with less risk.
I am now going to post a recent article that has renewed some interest in the subject of crunches.
pro crunches:
http://journals.lww.com/nsca-scj/Fulltext/2011/08000/To_Crunch_or_Not_to...
con crunches:recent McGill interview addressing previous study
http://www.myrehabexercise.com/blog/archives/669
I suggest if we want to continue to discuss this topic that we all take the time to educate ourselves to both positions.
0
This question becomes highly dependent upon the individual you are assessing. Using Stuart McGill as means for not doing sit-ups or crunches is poor methodology and faulty interpretation of his research. His implications for abdominal exercises were based on a study conducted in 1997 and they used a biomechanical model of the spine and EMG to determine compression of the lumbar spine through a range of exercises. They concluded that sit-ups produced large spinal compression over 3,000 Newtons. However, this amount of compression is encountered in many daily activities and through many employment scenarios. The study was designed to compare the risk (compression) to the benefit (EMG) to quantify the “safest” abdominal challenge. So the compression on L4/L5 is something that should be considered as well as the activation of the muscle.
The crunch (or Curl-Up) was also examined in that study and was found to compressive loads of 2009 N and 1991 N with Curl-Up feet anchored and Curl-Up feet free, respectively. The activation of the Curl-Up was 87 and 67% maximum voluntary contraction.
Now your scenario you mention.
Increased Lumbar Curve
If a client or patient has an increased lumbar curve they are experiencing a lot of length and tension discrepancies within muscle structures surrounding the trunk. To determine what structures are of tightness -assessments should be conducted. However, the goal should first to be to attain a neutral spinal curve to alleviate any posterior shearing and poor tension relationships. Training proper alignment through establishing a neutral posture should be the first goal. Having them understand through visual demonstration and verbal cueing should be of initial priority. Once a foundation of a better spinal alignment is evident is when progression to exercises to reinforce this new motor learning pattern. This is where McGill’s research can be beneficial. Understanding the risk and benefits of the exercise is key to its prescription. Obviously, certain exercises will have a larger activation than others. Comparisons of EMG activity and compressive forces upon L4/L4 should both be considered. Also, many other factors come into play here such as training status, goals, etc.
Note: Whether performing a sit-up or crunch the alignment of the spine is of high importance. The lumbar spine should not be flattened to the floor that will stress the passive tissues. Rather, a nice neutral spine alignment (initial training goal) is what should be maintained throughout.
Personal Opinion:
Why are Sit-Ups/Crunches performed? Intention of developing abdominals or in hope of alleviating back pain? (Literature does not strongly support this). The rectus abdominis does not hypertrophy to the extent which can develop large cut abdominals or “6-Pack”. Most already have their 6 pack yet it is hidden beneath layers of subcutaneous fat. As far as alleviating back pain or solving imbalances within multisegmental tissues around the core (back vs. abdominals). There is not conclusive evidence to support this theory in its relationship to back pain. I try to incorporate core work with other dynamic exercises to avoid compressive loads from sit-ups/curl-ups.
The crunch (or Curl-Up) was also examined in that study and was found to compressive loads of 2009 N and 1991 N with Curl-Up feet anchored and Curl-Up feet free, respectively. The activation of the Curl-Up was 87 and 67% maximum voluntary contraction.
Now your scenario you mention.
Increased Lumbar Curve
If a client or patient has an increased lumbar curve they are experiencing a lot of length and tension discrepancies within muscle structures surrounding the trunk. To determine what structures are of tightness -assessments should be conducted. However, the goal should first to be to attain a neutral spinal curve to alleviate any posterior shearing and poor tension relationships. Training proper alignment through establishing a neutral posture should be the first goal. Having them understand through visual demonstration and verbal cueing should be of initial priority. Once a foundation of a better spinal alignment is evident is when progression to exercises to reinforce this new motor learning pattern. This is where McGill’s research can be beneficial. Understanding the risk and benefits of the exercise is key to its prescription. Obviously, certain exercises will have a larger activation than others. Comparisons of EMG activity and compressive forces upon L4/L4 should both be considered. Also, many other factors come into play here such as training status, goals, etc.
Note: Whether performing a sit-up or crunch the alignment of the spine is of high importance. The lumbar spine should not be flattened to the floor that will stress the passive tissues. Rather, a nice neutral spine alignment (initial training goal) is what should be maintained throughout.
Personal Opinion:
Why are Sit-Ups/Crunches performed? Intention of developing abdominals or in hope of alleviating back pain? (Literature does not strongly support this). The rectus abdominis does not hypertrophy to the extent which can develop large cut abdominals or “6-Pack”. Most already have their 6 pack yet it is hidden beneath layers of subcutaneous fat. As far as alleviating back pain or solving imbalances within multisegmental tissues around the core (back vs. abdominals). There is not conclusive evidence to support this theory in its relationship to back pain. I try to incorporate core work with other dynamic exercises to avoid compressive loads from sit-ups/curl-ups.
0
I like planks and lateral motions
I would also use a mirror to show the client his/her posture
I like working on "all fours" and extending right arm and left leg, alternating, I also like trunk flexion on all fours, opposite hand or elbow to knee.
I like controlled bicycles, sometimes on a roller. I also would do a partial roll up, with the concentration being on form and tempo
I think "crunches" are not the best exercise for anyone, really.
I would also use a mirror to show the client his/her posture
I like working on "all fours" and extending right arm and left leg, alternating, I also like trunk flexion on all fours, opposite hand or elbow to knee.
I like controlled bicycles, sometimes on a roller. I also would do a partial roll up, with the concentration being on form and tempo
I think "crunches" are not the best exercise for anyone, really.
