Core Strength and Core Strength and

Stability: Why Should I Stability: Why Should I

Care? PRPCare? PRP New Treatment New Treatment

Option?Option?

Evie Burnet, DPT, PhDEvie Burnet, DPT, PhD

Michael Potter, MDMichael Potter, MD

Tina Tina KeaseyKeasey, ATC, CSCS, ATC, CSCS

Running InjuriesRunning Injuries

Topics:Topics:

–– Importance of Core Strength and Importance of Core Strength and

stabilitystability

–– Relationship to common running injuriesRelationship to common running injuries

–– Injury preventionInjury prevention

–– Therapy and strength training specificsTherapy and strength training specifics

PRP new treatment?PRP new treatment?

Running InjuriesRunning Injuries

Weak core and poor stability can Weak core and poor stability can

lead tolead to

–– Runners knee or patellofemoral Runners knee or patellofemoral

syndromesyndrome

–– Iliotibial band syndromeIliotibial band syndrome

–– Stress fractures in tibia or femurStress fractures in tibia or femur

–– And many more injuriesAnd many more injuries

Running InjuriesRunning Injuries

27 to 70% of runners injured per 27 to 70% of runners injured per

year year (Niemuth 2005; Davis 2005; Wen 1998; Jacobs 1986; Lysholm 1987)(Niemuth 2005; Davis 2005; Wen 1998; Jacobs 1986; Lysholm 1987)

–– Females > males Females > males (Rauh 2000)(Rauh 2000)

Majority are overuse injuries Majority are overuse injuries (Macera 1989)(Macera 1989)

Traced to training errors, anatomic Traced to training errors, anatomic

or biomechanical factorsor biomechanical factors

–– Increased focus on biomechanics of the Increased focus on biomechanics of the

hip and pelviship and pelvis

Ground ContactGround Contact

Stance phaseStance phase

Vertical ground reaction force (vGRF) Vertical ground reaction force (vGRF)

2 to 5 times body weight 2 to 5 times body weight (Cavanagh 1990)(Cavanagh 1990)

–– Altered mechanics = higher vGRFAltered mechanics = higher vGRF

–– Linked to lower extremity (LE) injury Linked to lower extremity (LE) injury

and increased metabolic costs and increased metabolic costs (Ferber 2003; Taylor (Ferber 2003; Taylor

1980l Farley 1992)1980l Farley 1992)

Importance of core strength/stabilityImportance of core strength/stability

Core Strength/StabilityCore Strength/Stability

Coordinated activation of muscles to Coordinated activation of muscles to

produce muscle strength and endurance produce muscle strength and endurance

resulting in proper alignment and stabilityresulting in proper alignment and stability

Abdomen, pelvis, and low backAbdomen, pelvis, and low back

Primary musclesPrimary muscles

–– Transverse abdominusTransverse abdominus

–– ObliquesObliques

–– Quadratus lumborumQuadratus lumborum

–– Hip musculatureHip musculature

MusclesMuscles

MusclesMuscles

Why Are Runners Targets?Why Are Runners Targets?

What is the purpose of running?What is the purpose of running?

–– To run as quickly as possible from one To run as quickly as possible from one

point to the nextpoint to the next……straight linestraight line

–– So, little to no rotation or sideways So, little to no rotation or sideways

movementsmovements

Without cross training (core Without cross training (core

strengthening) core stabilizers are strengthening) core stabilizers are

weakweak

Clinical ExampleClinical Example

SnapshotSnapshot

Why Should I Care?Why Should I Care?

INJURY!!!INJURY!!!

Poor performancePoor performance

–– Metabolic inefficiencyMetabolic inefficiency

What Should I Do?What Should I Do?

Injury preventionInjury prevention

–– Cross training (core strength/stability)Cross training (core strength/stability)

–– Running analysisRunning analysis

PRPPRP

A new A new ““experimentalexperimental”” procedureprocedure

Very common in EuropeVery common in Europe

Early studies and results are promisingEarly studies and results are promising

Used to treat overuse injuries that have Used to treat overuse injuries that have

failed traditional treatmentfailed traditional treatment

PRPPRP

What is it?What is it?

–– Draw the patients bloodDraw the patients blood

–– Centrifuge bloodCentrifuge blood

–– Separate the platelet/growth factor rich Separate the platelet/growth factor rich

layerlayer

–– Inject into injured or abnormal tissueInject into injured or abnormal tissue

–– Accelarates the repair/healing responseAccelarates the repair/healing response

PRPPRP

PRPPRP

transforming growth factor beta transforming growth factor beta (TGF(TGF--b) b)

plateletplatelet--derived growth factor derived growth factor (PDGF) (PDGF)

insulininsulin--like growth factor (IGF) like growth factor (IGF)

vascular endothelial growth factors vascular endothelial growth factors (VEGF) (VEGF)

epidermal growth factor (EGF) epidermal growth factor (EGF)

fibroblast growth factorfibroblast growth factor--2 (FGF2 (FGF--2) 2)

THE ENDTHE END

QUESTIONS?QUESTIONS?

I’m sorry, Mr. Gronewald, but running red lights does not count as an

exercise program.