Abstract
This paper evaluates several abdominal exercises, and highlights factors which are important for their safe prescription and effective use. The function of the abdominal muscles and hip flexors is considered, and the importance of the infra-umbilical portion of the rectus abdominis is emphasized. The effects of flexion on the lumbar spine are outlined. The trunk curl, sit-up, and straight leg raise are analysed, together with modifications of these exercises. The effect of foot fixation and hip flexion during the performance of the sit-up is discussed. The sit-up performed with foot fixation, and the bilateral straight leg raise can compound hip muscle imbalance, and both hyperextend and hyperflex the lumbar spine and are therefore not recommended. The importance of muscular control of pelvic tilt is considered with reference to muscle imbalance around the pelvis. It is recommended that a musculoskeletal assessment should be performed before prescribing abdominal exercises. Exercise therapy to re-educate control of pelvic tilt is described. Intra-abdominal pressure, and the effects of abdominal exercise on this mechanism, and lumbar stabilization are examined. The importance of training specificity is stressed.
Full text
PDF








Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adams M. A., Hutton W. C., Stott J. R. The resistance to flexion of the lumbar intervertebral joint. Spine (Phila Pa 1976) 1980 May-Jun;5(3):245–253. doi: 10.1097/00007632-198005000-00007. [DOI] [PubMed] [Google Scholar]
- BARTELINK D. L. The role of abdominal pressure in relieving the pressure on the lumbar intervertebral discs. J Bone Joint Surg Br. 1957 Nov;39-B(4):718–725. doi: 10.1302/0301-620X.39B4.718. [DOI] [PubMed] [Google Scholar]
- Bogduk N., Macintosh J. E. The applied anatomy of the thoracolumbar fascia. Spine (Phila Pa 1976) 1984 Mar;9(2):164–170. doi: 10.1097/00007632-198403000-00006. [DOI] [PubMed] [Google Scholar]
- Dunlop R. B., Adams M. A., Hutton W. C. Disc space narrowing and the lumbar facet joints. J Bone Joint Surg Br. 1984 Nov;66(5):706–710. doi: 10.1302/0301-620X.66B5.6501365. [DOI] [PubMed] [Google Scholar]
- Freeman M. A., Dean M. R., Hanham I. W. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br. 1965 Nov;47(4):678–685. [PubMed] [Google Scholar]
- Harman E. A., Rosenstein R. M., Frykman P. N., Nigro G. A. Effects of a belt on intra-abdominal pressure during weight lifting. Med Sci Sports Exerc. 1989 Apr;21(2):186–190. [PubMed] [Google Scholar]
- Hemborg B., Moritz U., Hamberg J., Löwing H., Akesson I. Intraabdominal pressure and trunk muscle activity during lifting--effect of abdominal muscle training in healthy subjects. Scand J Rehabil Med. 1983;15(4):183–196. [PubMed] [Google Scholar]
- Kennedy B. An Australian programme for management of back problems. Physiotherapy. 1980 Apr;66(4):108–111. [PubMed] [Google Scholar]
- Konradsen L., Ravn J. B. Ankle instability caused by prolonged peroneal reaction time. Acta Orthop Scand. 1990 Oct;61(5):388–390. doi: 10.3109/17453679008993546. [DOI] [PubMed] [Google Scholar]
- Lipetz S., Gutin B. An electromyographic study of four abdominal exercises. Med Sci Sports. 1970 Spring;2(1):35–38. [PubMed] [Google Scholar]
- Lundin A. P. Measuring quality care in hemodialysis. Nephrol News Issues. 1991 Feb;5(2):22–30. [PubMed] [Google Scholar]
- Miller M. I., Medeiros J. M. Recruitment of internal oblique and transversus abdominis muscles during the eccentric phase of the curl-up exercise. Phys Ther. 1987 Aug;67(8):1213–1217. doi: 10.1093/ptj/67.8.1213. [DOI] [PubMed] [Google Scholar]
- Ricci B., Marchetti M., Figura F. Biomechanics of sit-up exercises. Med Sci Sports Exerc. 1981;13(1):54–59. [PubMed] [Google Scholar]
- Saal J. A., Saal J. S. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine (Phila Pa 1976) 1989 Apr;14(4):431–437. doi: 10.1097/00007632-198904000-00018. [DOI] [PubMed] [Google Scholar]
- Taylor J., Twomey L. Sagittal and horizontal plane movement of the human lumbar vertebral column in cadavers and in the living. Rheumatol Rehabil. 1980 Nov;19(4):223–232. doi: 10.1093/rheumatology/19.4.223. [DOI] [PubMed] [Google Scholar]
- WALTERS C. E., PARTRIDGE M. J. Electromyographic study of the differential action of the abdominal muscles during exercise. Am J Phys Med. 1957 Oct;36(5):259–268. [PubMed] [Google Scholar]
- Yang K. H., King A. I. Mechanism of facet load transmission as a hypothesis for low-back pain. Spine (Phila Pa 1976) 1984 Sep;9(6):557–565. doi: 10.1097/00007632-198409000-00005. [DOI] [PubMed] [Google Scholar]