I have questions about bracing vs hollowing—seems just subtle difference in how you recruit the abdominals, and most PT’s I talk to cite TA research concluding that hollowing is the way to go. The other question involves back braces and lifting belts—How effective are these? One patient complained that when she drew in to engage the abdominals the belt is no longer as snug so she has less support.
First off, as far as the PTs that you have spoken to about this issue, I would recommend stop talking to them as they are poorly educated and unskilled. You have resources available to you to learn that they are speaking nonsense. Even Dr. Richardson from Queensland that was part of the original TA research would say TA’s role in incredibly overrated and misinterpreted.
- TA is never off unless you are treating a corpse. TA has never been shown to be off or on at any appreciable deficit in any study of any individual, back pain or no back pain.
- ONLY in the presence of back pain, TA has been shown to be delayed in its activation. ONLY in the presence of back pain should strategies to reduce that delay be employed.
- In the rare findings of hypertrophied TA, there is a direct correlation to back pain.
- Draw-in of about 1/4″ is what is appropriate to pre-tension TA. The sucking in the belly button is useless.
Regarding lifting belts, appropriate technique is to engage the diaphragm by pushing OUT against the belt, not sucking in the stomach. Your patient/client indeed weakened her core and rendered her faciltation device, the belt, also useless.
If you are not a competitive strength athlete where you are allowed to compete with a belt, training with a belt is optional in my opinion. If you do use a belt in squats and deadlifts, it is absolutely imperative to maintain fantastic anterior core progressions in parallel.
Bracing is simply how we move. It is the resident reaction of the spinal muscles in the presence of loading and rotations of the arms and legs. Improving the ability of the core to react based on the challenges the arms and legs are trying to engage is clearly the preferred and evidence-based approach.
Seeing with gross flexion with an attempt to brace is common. It is a result of unfortunate individuals that have done a ton of crunches and flexion-based core training. When engaging the abdominals, their brain says to flex. It is a motor learned concept that can be difficult to get away from. The tall and skinny cue works, but so does ignoring the individual bracing strategy and just let the core react to the movement. Taking that movement-based approach will reveal mobility and stability limitations and guide you into your training program.