Joanne Elphinston is the author of " Stability, Sport, and Performance Movement ". This is a fantastic book that I reviewed earlier this year. Joanne was gracious enough to do an interview for this site to answer some other questions. The interview follows below. I would like to thank Joanne for giving such a detailed and thorough interview.
1) It has become popular in athletics to work the core, and to focus on exercises like the plank and the bird dog. Instead, your approach stresses low-level contractions of stabilizer muscles, like the transversus abdominis. Can you explain how you developed your approach?
That is a great question to begin with Matt, as it gets right to the “core” of the issue.
The majority of my work is with elite athletes who have hit barriers that they cannot overcome. These barriers may be persistent or recurrent injuries or a performance/ technical plateau, and almost without exception, these athletes have already been trained extensively in “core stability” in an attempt to address these problems. They have often trained muscles rather than movement relationships, and frequently cannot achieve or control their full range of motion as a result. It is common for these athletes to complain that their hip flexors, hamstrings and lower backs need constant bodywork.
When analyzing these athletes, certain common themes emerge. They often fluctuate between too much muscle tension and too little, (like an off/ on switch), instead of having a “just right” amount of muscle activity for the activity they are engaged in (a dimmer switch, or volume adjuster which increases and decreases muscle activity smoothly). The assumption in sport is that more is always better, but “more” can sometimes block movement and create inefficiency. Excess tension is the enemy of clean, smooth joint movement.
These high performance athletes frequently lack elastic, spontaneous, confident movement, and they have unwittingly been trained to exert force and achieve control when their bodies are compressed using higher force “core” activities which lock the trunk, while sacrificing the ability to lengthen and really unleash their movement without loss of control. From the sprinter exploding out of the blocks to the golfer unwinding from their backswing, it is critical that the body can align itself with balance and release its power in clean lines without restriction. This is a key element in my work and has really underpinned my approach.
This is not to say that there is not a role for high force compressive core work – I would not want to be taking a major tackle in football without having trained my “suit of armor”, but I don’t then expect to be successful using that same core strategy if I wanted to quickly sidestep my opposition and sprint for the touchdown. The body has to adjust like lightning to a change in circumstance, so it needs different modes of control training.
2) Are you surprised that you encounter top-level athletes who have problems with basic stabilizer function?
Sadly no, and there are many contributing factors. Changing times have as much of an effect as training trends. Where we once used to play lots of different sports as kids, now those who show early talent are often scooped up into talent programmes where prescriptive drills take the place of the playground rough and tumble that challenges balance, coordination and functional stability in unpredictable ways. I see talented academy soccer players at age 17 with the kind of overuse problems, especially in groin, back and hamstring, that I used to see in players in their late twenties and early thirties– not exactly progress, is it?
I look at the successful juniors who suddenly move up into a senior squad where the loading or training volume is much higher, but no adjustment period is given – it is sink or swim, and those who figure out a way to cope get by. Some of these kids are still growing, and progress should not be expected to be linear in this situation. After a growth spurt, I usually see a significant temporary drop in body awareness, control and coordination, but the athlete’s strength and conditioning programme may not be responsive enough to account for this. It is the strategy that the athlete adopts in order to cope that I have to mop up five to ten years later.
I’m a believer in building on firm foundations, but there is a relentless push to get an athlete ‘to the next level” which sometimes rushes them right past the opportunity to develop these fundamental movement building blocks. If I strip back my clients’ movement to make sure their basic movement foundations are sound (requiring that they are functional stable and functionally mobile) don’t compromise until they get it and then progress systematically, they move smoothly past their barriers. It’s great when you hear a perplexed coach say that their athlete has never moved so well, and yet it has just required simple steps. Basic things done well, in other words.
3) I enjoyed the section in your book on “effortless control”. Usually, coaches are all about visually seeing efforts from their athletes. Do you think this mindset will eventually change to a model of effortless control?
Isn’t it interesting that a really top athlete is usually the one who makes it look easy – not the one who makes it look really hard. They perform with demonstrable efficiency. Yet so many athletes train both physically and psychologically in effort. Hmmm.
I do think that in some sectors there are changes in outlook, as movement quality is being welcomed back into the realm of athlete preparation. There are some excellent coaches out there who really know how to bring out the best in their athletes, and this is not new news for them. However, there are still many people who really believe that trying harder and “putting in the effort” will get them further.
It’s a funny conversation to have with an Olympic weight lifter, asking them to “make it look easy”, or with a golfer who wants to increase his distance off the tee. However, it really does let them drop the tension that they don’t need and feel where their lines of force need to be, without consciously being aware that they are doing it. I want athletes to look like masters of their movement – and feel what it is like to take the handbrake off.
4) One thing I’ve noticed is that children seem to have very strong stabilizer muscles. Have you observed any type of correlation among your clients, where the older clients are less likely to have control of their low-level stabilizer muscles?
Well, it is a bit of a mixed bag, actually!
I love seeing children at ages two or three, with all the spontaneous, automatic stabilizer function happening beautifully. Watch a kid lifting a ball above his head at this age, and you will generally see a lovely abdominal response as the belly moves towards the spine. Do the same thing with a population of adults, and the abdominal wall often falls forward, inactive. Why? Well life happens – as just one example, if your shoulders become stiffer and no longer go all the way up, your body will find a way to make it happen, and this is usually back bending. The spine bends backwards to help the arms, but the belly switches off. This becomes the way you do things until your back finally protests.
I can’t blame it all on age though – I have a fair population of child patients from about seven years old on, coming in with persistent knee or Achilles problems. These kids, although involved in sport, tend to present with major control problems, so I need to address the multiple factors involved in functional stability including balance, coordination and body awareness and integration.
An active older person, although not necessarily a “trained” one, will often perform on basic stability testing very well. Over here we have the “right to roam”, as the ancient walking paths in Britain now take you across fields and paddocks as well as wilderness. Older folk who get out and walk have to climb over things, keep their balance on uneven ground, go up and down slopes and generally handle whatever comes up along the way. These folk often test way better for control than a twenty year old athlete, as they are experiencing a greater variety of sensory stimuli and control challenges.
5) Why do you think the stabilizer muscles “switch off” for so many people? Is it posture? Modern footwear?
I guess I’ve touched on this a little already, but there are so many factors.
Firstly, research on certain key postural stabilizers has shown that if there has been pain or swelling in an area, they will switch off, and not necessarily come back on line after the pain has gone. Spraining your ankle can actually take your glutes offline (Bullock Saxton and Janda, 1993), but the effects of this may not be seen until some years later when you develop groin pain associated with pelvic instability. The same thing applies with the knee and the back, so you think all is well when the acute pain disappears, but its effects remain, only to emerge sometime later as a recurrence of the same injury, or in some other body part that has been put under strain.
Footwear can certainly make a difference! The soles of our feet drive muscular stabilizing action throughout the leg, yet we traumatize our feet in absurdly narrow, high, sloppy or ill fitting but fashionable shoes. Sensory input in general is critical, but I find people to be generally switched off to parts of their body, especially their feet.
Posture also is a major driver of stabilizer function, but our jobs can compromise our posture, as can our emotions. The posture of “overwhelm” is collapsed in on itself, and the posture of “I’m fine, I can cope, but don’t get in my way” is the exact opposite, tense in the back with shoulders pinned back. Neither of these postures encourage natural function from the stabilizers, as they have both mechanical and neuromuscular effects.
6) I thought it was surprising that “facial fixing” could create stability in the body. Can you explain how such a minor muscle contraction can affect stability?
The body is so clever – it will always try to find a way to compensate for its shortcomings! Fixing in any part of the body will subtly increase overall body control by generating a little extra tension, or “tone”. It can be seen in the feet, the arms and hands, the inner thighs or the back, but it is very obvious in the face.
7) I did have questions about the “listening foot” exercise on pg. 72 of your book. Is your calf muscle supposed to be loose when you are doing it? Are you rotating the lower leg with your hands?
This motion requires a little action from several areas. The hands do not actually move the leg – they are just there to help you to work out what is happening. If the calf is super active instead of just a bit active, place your hands under your hamstrings, because they are involved in this too. You should feel more of your lateral hamstring when you move the pressure to the outside of the foot, and more in the medial hamstring if you take the pressure more to the inner side of the foot.
This is such a critical movement – I’ve had interesting times this week using it to help a dressage rider find a better foot placement in the stirrup, an older former athlete with hip pain to be able to balance on one leg, and a footballer to regain lateral pelvic control. Such a small movement, but such big gains,
8) In the past, I developed lower back pain from running, which is not that uncommon among runners. How do you think this relates to the stabilizer muscles?
Most of the runners I see with back pain get it from two main sources. The first of these is that they run with their spine in a backward curve (extension). They think that this is upright, but it is fact backwards. This has a few unhelpful effects. Firstly it blocks the normal rotation of the spine which is necessary to reduce impact forces on spinal structures, and it reduces shock absorption and mechanical efficiency. With this strategy, the back muscles are working hard, which in itself can give rise to pain, and if they are holding the spine in this fixed position, the deeper abdominals switch off. The pelvis is also at an angle which discourages the gluteals from activating, so you lose a major support group.
There is also often a lack of shock absorption in hip and knee, which again can have the effect of amplifying forces in the spine. You can work your pelvic stabilizers all you like, but without training them to respond with the right amount at the right time, there is little carryover.
9) What are your thoughts on barefoot running?
Whether you take to barefoot running or not can depend greatly upon your individual running style and foot structure, so it is unsurprising that some people find it wonderful and others get hurt. This is generally conducted as a very foot-centric argument, and much of the rather patchy research is only looking at what happens in the foot and ankle.
On the plus side, I am keen on increasing people’s sensory feedback through their feet, as this can often stimulate better lower limb activation patterns. Those whose natural foot shape is forefoot equinus will tend to favour a style that puts them on their forefoot. However, if they cannot organize the rest of their body properly over that foot, then other problems can arise, and this is the part of the argument that never seems to see daylight.
Barefoot running will force the runner to rediscover the shock absorbing capacity in their hips, knees and ankles, and this aspect has been reflected in the research in terms of elastic energy storage and “stiffness”, but again, some will be very successful at this, and others will need to be taught how to get that message from brain to body successfully.
In short -- it isn’t so simple as to decide which is better overall, but what suits the individual, their running goals and physical capability.
10) Do people need to perform the stabilizer exercises on a daily basis, or do these patterns eventually become ingrained in the nervous system?
This depends upon a person’s environment, function, history and level of self awareness.
I ask athletes to do low threshold movement control work (as opposed to stabilizer exercises) in the same way as they clean their teeth – a part of their general maintenance routine. It mops up any accumulated tension and checks that everything is online.
For other folk, it comes down to themselves. If they commit to moving beautifully, which helps to keep everything activating appropriately; counteract their daily life ( if eight hours has been spent in front of a computer, something will need to be done to remind the body that it is, after all an active entity); and visit their movement control work if under stress, all is generally well without daily exercise after the initial learning period. Pain and stress can knock off your stabilizers alarmingly effectively, however.
The habits can become ingrained, but through self awareness rather than pure repetition. For best results, aim to move beautifully on a daily basis.
For more information on the science and art of moving beautifully, keep an eye out for my forthcoming website at www.Jemsmovement.com