HOLLOWING



So far we have been talked about what the core is and its differences terms. Today we are going to show you a technique or movement to activate it: hollowing maneuver.

Doing exercises for the abdominal muscles are frequently used in the rehabilitation of low back pain. The question of which abdominal muscles and exercises should be targeted in the treatment of low back pain is among experts. Lumbar spine stability is an important issue, especially given its potential link to mechanisms of injury and associated clinical efforts directed toward enhancing stability in patients. The way in which patients activate their abdominal muscles is central to the stability theme (Chang, Lin, & Lai, 2007).

Bergmark (Bergmark, 1989) classified muscles acting on the lumbosacral spine as being either ‘‘local’’ or ‘‘global.’’ It is hypothesized that the local muscles, such as the transverse abdominus (TrA) and internal oblique abdominals (IO), are essential for stabilization of the lumbosacral spine. The global muscles, including the rectus abdominus and external oblique abdominals, are responsible for producing gross movements of the trunk and pelvis. (Drysdale, Earl, & Hertel, 2004).

The strategy to recruit the TrA, through the abdominal hollowing technique, has been proposed as an effective way to increase stability. This exercise is thought to retrain the TrA by having patients isometrically contract the abdominal wall without movement of the spine or pelvis. This exercises is designed to emphasize deep local muscle activity while minimizing that of the more superficial global muscles. Contracting the TrA may increase fascial tension and intra-abdominal pressure, thus creating a more rigid cylinder around the spine (Kim et al., 2016).


Picture extracted from: https://www.google.es/search?biw=1920&bih=949&tbm=isch&sa=1&ei=LEuuWvmRH4aVUbOwpqgJ&q=ABDOMINAL+hollowing&oq=ABD MINAL+hollowing&gs_l=psy-ab.3..0j0i30k1j0i24k1l2.225617.227711.0.227774.19.16.0.3.3.0.212.2205.4j11j1.16.0....0...1c.1.64.psy-ab..1.18.2097...0i67k1j0i5i30k1j0i8i30k1.0.heOppBKy8mw#imgrc=uBl4kPplVCpvxM:

Richardson et al (Richardson et al., 2002) investigated the effect of bracing and hollowing on sacroiliac joint laxity in a nonfunctional task. They found that both improved stiffness but concluded that hollowing was better. However, the muscle resting levels differed between groups. Until now, most of the supporting evidence, for the TrA being an important contributor to stability, has been indirect and qualitative (Grenier & McGill, 2007).

As Heredia J.R. said  (Heredia Elvar, 2013), hollowing maneuver it’s a good option to treat LBP problems to increase sacroiliac joint stabilization as well as in the fist stages of the recovery for patients with LBP.

 You can see a summarize in this link: https://drive.google.com/open?id=1KoCoQhh-DDAJgdzYXdxbjLPeeA-8rxE4 or if you want to watch a presentation: https://drive.google.com/open?id=1GCUXIhYEaBn01-NA1RUx-3-CSbZWLlCs7sTua_Z7ECM

In the next post we will focus on explain what the ‘bracing’ is and its use.

In the next link you can see a video which explain it: https://www.youtube.com/watch?v=Lttvf_F5Bco
BIBLIOGRAPHY

Chang, W.-D., Lin, -Yu, & Lai, P.-T. (2007). Core strength training for patients with chronic low back pain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395677/pdf/jpts-27-619.pdf

Grenier, S. G., & McGill, S. M. (2007). Quantification of Lumbar Stability by Using 2 Different Abdominal Activation Strategies. Archives of Physical Medicine and Rehabilitation, 88(1), 54–62. https://doi.org/10.1016/j.apmr.2006.10.014

Heredia Elvar, J. (2013). Abdominal Hollowing (Maniobra de "hundimiento abdominal") - Instituto Internacional de Ciencias del Ejercicio Físico y Salud. Retrieved March 18, 2018, from https://g-se.com/abdominal-hollowing-maniobra-de-hundimiento-abdominal-bp-q57cfb26e4380f

Kim, M., Kim, Y., Oh, S., Suh, D., Eun, S. D., & Yoon, B. (2016). Abdominal hollowing and bracing strategies increase joint stability in the trunk region during sudden support surface translation but not in the lower extremities. Journal of Back and Musculoskeletal Rehabilitation, 29(2), 317–325. https://doi.org/10.3233/BMR-150633

Richardson, C. A., Snijders, C. J., Hides, J. A., Damen, L., Pas, M. S., & Storm, J. (2002). The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 27(4), 399–405. https://doi.org/10.1097/00007632-200202150-00015

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