Training the Transversus Abdominus in Isolation: Fallacy or Folly?

May 2, 2016 | by Gray Institute

Training the Transversus Abdominus in Isolation: Fallacy or Folly?

Over the past 15 years, movement specialists have embraced a training program for the Transversus Abdominus (TA) muscle that attempts to get the muscle to “contract in isolation”: without the other muscles of the abdomen and spine being activated.  Based on groundbreaking research by Cresswell and colleagues 1,2 and Hodges and his collaborators 3,4, , the isolation program evolved as a result of the interpretation of these and other studies.

The Results: It Can Be Done

The results were interpreted as indicating that the TA fired symmetrically before the other muscles became active, and was not affected by the direction of limb movement, suggesting that there was a unique independent activation system that was often absent or altered in patients with low back pain.

By utilizing a “hollowing maneuver” of consciously contracting the TA while lying supine, the muscle activity could be increased while the other muscles remained relatively quiet.

While some questioned the wisdom of doing this, studies utilizing ultrasound and electromyography verified that, with training and feedback, this could be accomplished.  This silenced the critics and demonstrated that enhancing TA muscle contraction in isolation was not a fallacy; it could be done.

But Why Do This?

Based how human movement is created and coordinated, and the Principles of Applied Functional Science®, a better question is: Why would anyone want to do this?

It is not a fallacy, but at the Gray Institute we believe it is a massive folly.  A folly can be defined as foolish or crazy behavior. A folly is also defined as a silly or nonsensical thing to do.  Calling TA isolation training a folly will anger and infuriate many practitioners, but remember: not a fallacy, but rather a folly.

Training the Transversus Abdominus in Isolation: Fallacy or Folly?

At the Gray Institute, we evaluate everything we espouse, as well as what others promote, based on what we believe are the Truths of Human Movement. Those Principles say that muscles are activated in synergistic groups by the proprioceptors that are stimulated by three-dimensional movement that occurs subconsciously, driven by different body parts interacting with the physical forces of the environment.

As a movement specialist, each practitioner must decide if the above statement is consistent with what is observed (truth of human movement) as they work everyday with patients and clients.

Does it Pass the Litmus Tests?

 

Let’s forget the research for a second and put the “hollowing maneuver” training program through the Principles of Human Movement litmus tests.

  • Isolated, not in synergistic groups.
  • One dimensional, not three
  • Consciously activated, instead of subconscious activation by joint movement.
  • No bone motion, instead of driven by, or having any interaction with the different body segments
  • Supine position on a table, not authentic with respect to gravity and the physical environment.

Based on Research… or Common Sense?

Proponents of the TA isolation program will argue that it is based on research, but common sense and the movements that we observe every day would say “folly”.

The irony is that much of the research that served as a basis for the program was performed standing while using the arms and legs as the drivers of movement in three planes without any conscious activation!  Unfortunately, the movements utilized in the studies did not get transferred to the training program.

 Low Back Pain: What’s the Cause?

The activation of the TA and other muscles may be altered in patients with low back pain 5.  The challenge for movement practitioners is to look for the “probable suspects” that are causing the low back pain.

There will be regions of the body that are not contributing the appropriate degree of motion and/or the proper sequencing of the motions.  Therefore, the goal is to find and resolve those asymptomatic dysfunctions.

Once these dysfunctions are eliminated, the new resources must be integrated into functional synergies required for effective and efficient movement.

Choose Truth

Finally for those that feel compelled to believe research more that the truth that they observe every day, recent studies have questioned the conclusions from the earlier work.

The stated ideas that the TA contracts symmetrically, is not affected by the direction of limb movement, and works in isolation have all been challenged or refuted6,7,8.

Not a fallacy, but a FOLLY !

Want to know more about the Truth of Human Movement? Check out Gray Institute online.

Members of Gray Institute can view over 40 educational videos by Dr. David Tiberio in the Content Library.

Members-Only: Videos about Abdominals

Core Conversion: Training the Core to Functionally Do More
by Doug Gray

Functional Muscle Function: Abdominals
by Dr. Gary Gray

Functional Muscle Function: Abdominals, Walking
by Dr. Gary Gray

Resources

  1. Cresswell AG, et al. Acta Physiol Scand. 1992; 144(4): 409-418
  2. Cresswell AG, et al. Exp Brain Res. 1994; 98(2): 336-341
  3. Hodges PW, Richardson CA. Ex Brain Res. 1997; 114: 362-370
  4. Hodges PW, Richardson CA. Neurosci Lett. 1999; 265(2): 91-94
  5. Hodges PW, Richardson CA. J Spinal Disord. 1998; 11(1): 46-56
  6. Davarian S, et al. J Back and Musculo Rehab 2014; 27(4) 545-551
  7. Allison GT, et al. J Orthop Sports Phys Ther. 2008; 38(5): 228-237
  8. Morris SL, et al. Human Movement Sci. 2013; 32: 1176-1185