Sports Med 2006; 36 (3): 189-198
CURRENT OPINION 0112-1642/06/0003-0189/$39.95/0
 2006 Adis Data Information BV. All rights reserved.
The Role of Core Stability in
Athletic Function
W. Ben Kibler,
1
Joel Press
2
and Aaron Sciascia
1
1 Lexington Clinic Sports Medicine Center, Lexington, Kentucky, USA
2 Rehabilitation Institute of Chicago, Chicago, Illinois, USA
The importance of function of the central core of the body for stabilisation andAbstract
force generation in all sports activities is being increasingly recognised. ‘Core
stability’ is seen as being pivotal for efficient biomechanical function to maximise
force generation and minimise joint loads in all types of activities ranging from
running to throwing. However, there is less clarity about what exactly constitutes
‘the core’, either anatomically or physiologically, and physical evaluation of core
function is also variable.
‘Core stability’ is defined as the ability to control the position and motion of
the trunk over the pelvis to allow optimum production, transfer and control of
force and motion to the terminal segment in integrated athletic activities. Core
muscle activity is best understood as the pre-programmed integration of local,
single-joint muscles and multi-joint muscles to provide stability and produce
motion. This results in proximal stability for distal mobility, a proximal to distal
patterning of generation of force, and the creation of interactive moments that
move and protect distal joints. Evaluation of the core should be dynamic, and
include evaluation of the specific functions (trunk control over the planted leg)
and directions of motions (three-planar activity). Rehabilitation should include the
restoring of the core itself, but also include the core as the base for extremity
function.
1. What is the Core? to its local functions of stability and force genera-
tion, core activity is involved with almost all ex-
The musculoskeletal core of the body includes
tremity activities such as running, kicking and
the spine, hips and pelvis, proximal lower limb and
throwing. Therefore, the position, motion and con-
abdominal structures. The core musculature in-
tributions of the core must be evaluated and treated
cludes the muscles of the trunk and pelvis that are
as part of the evaluation and treatment of extremity
responsible for the maintenance of stability of the
spine and pelvis and help in the generation and
injuries.
transfer of energy from large to small body parts
This article provides a general functional defini-
during many sports activities.
[1,2]
The muscles and
tion of core stability, describes the anatomy and
joints of the hip, pelvis and spine are centrally
physiology of core muscles, discusses core stability
located to be able to perform many of the stabilising
in function and dysfunction, provides principles of
functions that the body will require in order for the
clinical evaluation of core stability, and describes
distal segments (e.g. the limbs) to do their specific
rehabilitation and conditioning programmes to max-
function, providing the proximal stability for the
imise the effect of core stability on athletic function.distal mobility and function of the limbs. In addition

190 Kibler et al.
2. Definition of Core Stability single-joint segmental stabilisation that allow the
longer, multi-joint muscles to work more efficiently
Core stability is an important component max-
to control spine motions.
[5]
This combination of
imising efficient athletic function. Function is most
muscle activations helps create the ‘neutral zone’
often produced by the kinetic chain, the coordinated,
control of the spinal segments. In this ‘neutral zone’
sequenced activation of body segments that places
the ligaments see minimal tension.
[5-8]
the distal segment in the optimum position at the
The abdominal muscles consist of the transverse
optimum velocity with the optimum timing to pro-
abdominus, the internal and external obliques, and
duce the desired athletic task.
[2]
The core is impor-
rectus abdominus. Contracting the transverse ab-
tant to provide local strength and balance and to
dominus increases intra-abdominal pressure and
decrease back injury. In addition, since the core is
tensions the thoracolumbar fascia. The transverse
central to almost all kinetic chains of sports activi-
abdominals have been shown to be critical in
ties, control of core strength, balance and motion
stabilisation of the lumbar spine.
[9,10]
Abdominal
will maximise all kinetic chains of upper and lower
muscle contractions help create a rigid cylinder,
extremity function.
enhancing stiffness of the lumbar spine.
[11]
It is
There is no single universally accepted definition
important to note that the rectus abdominus and
of core stability. A general definition of core stabili-
oblique abdominals are activated in direction-spe-
ty that will be used in this article is the ability to
cific patterns with respect to limb movements, thus
control the position and motion of the trunk over the
providing postural support before limb move-
pelvis and leg to allow optimum production, transfer
ments.
[3,12-14]
Contractions that increase intra-ab-
and control of force and motion to the terminal
dominal pressure occur before initiation of large
segment in integrated kinetic chain activities.
segment movement of the upper limbs.
[15,16]
In this
manner, the spine (and core of the body) is stabilised
3. Anatomy, Physiology
before limb movements occur to allow the limbs to
and Biomechanics
have a stable base for motion and muscle activa-
tion.
[17]
Clinically, it has been shown that only a very
3.1 Anatomy
small increase in activation of the multifidi and
abdominal muscles is required to stiffen the spinal
The core acts as an anatomical base for motion of
segments (5% of maximal voluntary contraction for
the distal segments. This can be considered ‘proxi-
activities of daily living and 10% of maximal volun-
mal stability for distal mobility’ for throwing, kick-
tary contraction for rigorous activity).
[18]
ing or running activities.
[2,3]
Most of the prime mov-
Core stability requires control of trunk motion in
er muscles for the distal segments (latissimus dorsi,
all three planes. In order to provide stability in all
pectoralis major, hamstrings, quadriceps and iliop-
planes of motions, muscles may be activated in
soas) attach to the core of the pelvis and spine. Most
patterns that are different from their primary func-
of the major stabilising muscles for the extremities
tions. For example, the quadratus lumborum (QL)
(upper and lower trapezius, hip rotators and glutei)
muscle functions mainly as a stabiliser of frontal
also attach to the core.
plane flexion and extension activities. However, the
Numerous muscles make up the complex known
QL is attached from the transverse processes of the
as core muscles. Some are small, short muscles with
spine and the 12th rib to the iliac crests. This orien-
small lever arms to span single joints. These are
tation allows QL muscle activation that occurs in
activated in ‘length dependent’ muscle activation
association with flexion, extension and lateral bend-
patterns.
[4]
Others span numerous spinal segments
ing activities to buttress shearing of the spine in the
and function as prime mover muscles to integrate
plane of movement, making it more than just a
several joints and produce force. They are activated
frontal plane stabilising muscle.
[19]
in ‘force dependent’ activation patterns.
[4]
Coordina-
tion of both activation patterns is required in the The roof of the core muscle structures is the
multi-segmented structure like the spine. The mul- diaphragm. Simultaneous contraction of the dia-
tifidi are an example of short muscles that provide phragm, the pelvic floor muscles, and the abdominal
 2006 Adis Data Information BV. All rights reserved. Sports Med 2006; 36 (3)