Conservative treatment

Core strengthening, stabilizing the body’s central block

FHL causes a global functional disorder that destabilizes the trunk. Abdomino-lumbo-pelvic core training restores the stability of this central block, an essential condition for developing effective force in the limbs.

Why core strengthening is part of the treatment

If we were to sketch the human body roughly, we would draw it as a massive central block, the trunk, around which the four limbs and the head articulate. Our locomotor system is obviously more complex, its movements resulting from the interaction of hundreds of muscles, tendons, ligaments, and joints. Yet this basic diagram illustrates a key element of biomechanics: good stability of the central block is essential for developing effective force in the segments attached to it.

Through the global functional disorder it causes, FHL destabilizes this foundation by imposing a forward projection of the trunk. Stabilizing the trunk with core strengthening exercises is therefore an essential element of management.

The two girdles to train

Comprehensive management includes core strengthening exercises for the abdominal girdle and the pelvic girdle. These muscles are trained mainly in isometric or small-amplitude contraction, and in resistance work. The skills sought are fatigue resistance and holding the bony structures in the most stable position. This is how the efficiency of the limb muscles is improved and how imbalances related to handling external loads are avoided.

Girdle 1

Abdominal girdle

The muscles that connect the rib cage to the pelvis and stabilize the lumbar spine.

Girdle 2

Pelvic girdle

The muscles that connect the pelvis to the structures above (abdomen, lumbar spine) and below (lower limbs).

The abdomino-pelvic core exercises

The number of possible exercises is countless: standing, lying down, supported on surfaces at various angles. Here are a few examples of core-strengthening positions used in practice.

Progression and technical rigor

As the level increases, ground contact points can be reduced and support on unstable surfaces increased. These movements must be executed with great technical rigor, which is why turning to professionals is recommended for optimal care.

Caution

Poor execution can generate counterproductive tension and pain, at the risk of making the situation worse. Professional supervision is essential, especially at the start of the program.

The core exercises on video

Three filmed demonstrations illustrate work on the anterior, lateral, and posterior chains on an exercise ball.

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Anterior chain core work on an exercise ball

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Lateral chain core work

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Posterior chain core work on an exercise ball

Going further on video

Three complementary videos on trunk stability, lumbopelvic rehabilitation, and physical activity as we age.

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Active back physiotherapy with older adults

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Lumbopelvic rehabilitation and rebalancing

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Physical activity and aging

Next pillar

Foot core, core strengthening for the foot

Strengthening the intrinsic foot muscles to stabilize the foot’s anchoring to the ground.

In practice

Goal

trunk stability

Girdles

abdominal, pelvic

Work type

isometric, resistance

Key skill

fatigue resistance

Progression

unstable surfaces

Supervision

professional advised