INJURY PREVENTION

case, return to a basic level, demonstrate and then give hands-on advice until the exercise is being carried out correctly.

Feedback Once players have developed a basic grasp of the exercises, they can be performed individually. By using mirrors or pressure biofeedback players can be certain that they are performing the exercise correctly. It is important for them to be reviewed fre- quently in order for them to be progressed.

Progression There are a wide variety of progressions which could include the use of equipment such as the Swiss ball, inflatable discs, free weights and Therabands. Any exercise which uses the arms and legs while main- taining the trunk position are beneficial to the player as it makes abdominal control a subconscious activity.

a. Swiss ball (Fig.2) Roll over the top of the ball, hands should be shoulder width apart, with the shoulders over the hands. The head and spine should be in neutral. It is important not to allow the spine to drop into extension. The feet are placed so the toes are pointing directly through the middle of the ball.

legs. Brace again at the end then slowly bring the knees together.

Figure 4: Theraband d. Free weights (Fig.5)

Performing free weights strength- ening sessions on the ball will also provide an excel- lent work out for the abdominal muscles which again are made to work subcon- sciously.

Figure 5: Free weights

e. Russian V sits (Fig.6) If no equipment is available simply utilis- ing body weight is sufficient, such as Russian V sits (Fig.6). Sit with the arms lightly supporting the weight. Keeping both legs together while maintaining the spine in neutral, lift both legs straight, as far as you are able without compromising spinal position.

Figure 2: Use of Swiss ball in progression

b. Inflatable disc (Fig.3) Using the bridging assessment position in figure 1, place the disc under one foot and perform alternate leg lifts, holding for increasing periods of time. To increase dif- ficulty try straightening the lifted leg then returning it to the start position.

Figure 6: Russian V Sit Figure 3: Use of inflatable disc in progression

c. Theraband (Fig.4) With the knees together, brace the abdom- inal muscles and, very slowly open the

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f. Competition (Fig.7) This game can involve any number of par- ticipants. Each balances on a ball. A ball is thrown between each player in random order and at varying trajectories. The win- ner is the one who maintains their balance without falling off the ball.

‘The Pelvic Girdle’, referenced below is an excellent book and expands on the subject of progression.

Figure 7: Competition

Conclusion The core stability programme outlined above has been used at Middlesbrough FC and was devised in conjunction with our exercise physiologists. We worked on a periodised programme of eight weeks before progressing stages. We have found excellent compliance from the players, many of whom found the old abdominal regime boring. Even more so when a com- petitive element is added (Fig.7).

It is too early to say if the new regime will reduce the number of injuries which occur during the season. It is hoped the research from the FA Audit Of Injuries will support the adoption of this style of abdominal training in clubs across the UK and that it will show a significant reduction in the number of abdominal related injuries.

Further reading ● Diane Lee – The Pelvic Girdle – Churchill Livingston

● Joanne Elphinston – The Core Workout – Total Performance

● Christopher Norris – Back Stability – Human Kinetics

David Binningsley, MCSP is the chartered physiotherapist for Middlesbrough FC. He has a specific interest in proprioception, core stability and isokinetic training.

EXERCISECARDS All the exercises featured in this article, including those in Box 1 and Figs. 1-7 can be purchased as lami- nated cards. We have standardised exercises featured in SportEX arti- cles so they can be purchased indi- vidually and used as part of your own circuit or as complete exercise circuits as featured in specific SportEX articles. For an information leaflet on what is available please telephone 020 9287 3312 or visit www.sportex-medicine.com