of rehabilitation is not only to restore core function
by itself, but also is the first stage of extremity
rehabilitation.
Progressions for lower extremity rehabilitation
include forward and side lunges, integrated trunk
rotation/hip rotations, and knee flexion/extensions
with trunk rotations.[34,36] The frequency and intensity
of each of the exercises will depend on the individual
response to the exercises.
Shoulder and upper extremity rehabilitation may
begin with a posture of bilateral leg stance, hip
extension and trunk extension.[36] Activation patterns
may start with ipsilateral muscles and proceed
to contralateral activations. Diagonal patterns in- Fig. 9. Diagonal trunk rotation around a stable base: starting position.
volving trunk rotation around a stable base imitate
habilitation for extremity injury should start with the throwing motion (figure 9, figure 10, figure 11).
core emphasis. The lower extremity activation drives the scapular
and shoulder activation. All upper extremity exer-
In order to create a stable base, the rehabilitation cises should end in the same position of trunk/hip
protocols start with the primary stabilising muscula- extension. One method to assure this posture is to
ture such as the transverse abdominus, multifidus, ask the patients to end with ‘the elbows in the back
and the quadratus lumborum. Due to their direct pockets’. Progression for upper extremity rehabilitaattachment
to the spine and pelvis, they are responsi- tion include integrated scapular retraction/arm abble
for the most central portion of the core stability. duction/external rotation and ‘low rows’, integrated
Exercises include the horizontal side support (figure trunk extension/scapular retraction/arm extension
7) and isometric trunk rotation (figure 8). This stage (figure 12) and hip/trunk rotation with scapular retraction
(figure 13).
Core stabilisation should avoid emphasising the
use of single planar exercises that isolate specific
muscles or specific joints. They may be used at
times during the rehabilitation protocol, but emphasis
should be on early progression to functional