SPORTS
It seems like in physical therapy and fitness everything revolves around the core, core, core. If you have a shoulder problem, you have a core impairment. If you have low back pain, there is some sort of core weakness. It is always an easy exercise prescription to tell an individual to just add planks to your work out program and you will get stronger. However, are people training the core correctly or just performing exercises that have been around for ages? You must see people at the gym performing sit-ups, seated trunk rotation machines and the typical 1 minute plank while talking to their buddy next to them. But are these the best exercises to perform to improve one’s core strength or endurance?
The plank is an excellent exercise, as long as it is performed correctly. It is an isometric exercise that includes holding your body in a pushup position or from your elbows. The muscles it activates range from the glutes, abdominals, erector spinae, hamstrings, quads and shoulders. It is typically used to build core strength and most people perform this exercise as a long duration hold. The worlds longest plank was performed by an ex-marine named George Hood on June 3rd, 2015 of 5 hours, 15 minutes and 15 seconds. He beat the most recent record of 4 hours and 26 minutes by Mao Weidong from China on September 26, 2014. But lets put this in perspective, what in the world does holding a plank for over 5 hours do for someone in real life? Don’t get me wrong, that is pretty impressive. But really? There are so many other things that you can do. You can fly from Boston to Seattle in that amount of time! In my opinion the majority of people that perform a plank really are not performing it correctly. A common complaint is lower back pain which means that abdominal and lower back muscles are not activating efficiently and the individual is hanging out on the spinal ligaments for stability. This does not seem effective does it?
So if we think of functionality, people in every day tasks do quick and repetitive movements all day. These movements do not take take long. They typically last for a few seconds. For example, a factory worker may lift numerous boxes all day long from one pile to another. Each lift the individual has to activate muscles throughout the body for a few seconds and then rest in between the next lift. So if this person worked a full work day lifting box after box, then how would performing a long duration core exercise help assist in this activity?
I believe that there is a much more efficient and effective way to teach the plank. The plank should be performed as an all out exercise. Every muscle in the body should be activated from the forehead all the way down to the foot. So why don’t we combine the idea of daily activities and exercise together. By performing the plank in short duration, high repetition you can improve core and body strength to replicate normal activities of daily living. So here is how I would prescribe the addition of planks in an exercise program. Perform 10 repetitions of 6-10 second holds with 2-3 second rest periods in between repetitions. Repeat 3-4 times to make a total of 3-4 minutes of work. I give the cue of “think that at any point someone is going to punch you in the stomach” or “push you over’. What this does is make you activate every muscle in your body to stabilize yourself in this position. This is a good starting point. Even high level athletes struggle at this sequence because it is tough but it is more specific to work and sport activities. This can clearly be modified and progressed depending on the individual and sport or work tasks. I would also suggest as you master the front plank, the side plank can be added to improve unilateral stability. The most important thing to remember is, if there is pain with this or any other exercise, stop and reassess the movement. If the pain persists, than do not do it!
Brian Smith, PT, DPT, CSCS
