Last installment I addressed some of the issues and risks surrounding the popular fad today of weight training while standing on the stability balls, or Swiss, balls as well as and half or hemi-balls.  The original use of the Swiss ball was to develop activation of back and abdominal muscles in patients who had chronic and acute low back injuries and those who had surgery.  There is no question that some patients improved with this approach.  It is also true that some did not improve, and some actually aggravated their symptoms.  This is not a condemnation of the stability ball.  Any procedure or treatment has three possible outcomes: improvement, worsening of symptoms, or no change in symptoms. 

The problem is the widespread use of the Swiss ball into “stability” and “core” exercises that were never meant to be “core” exercises.  The true concept of “core” strengthening is mostly valid.  For decades the focus on “core” strengthening, particularly following low back pain episodes, was to strengthen the abdominal muscles.  Again, the ab work helped some patients and made others have more back pain.  There are many causes of low back pain but this is a topic for another installment of this column.  Finally, the back muscles, or erector spinae or simply paraspinal muscles, were recognized as muscles the need to be strengthened to help stabilize the spine or “core”. 

The current train of thought with the next level use of stability balls is to have the trainees perform curls, laterals, front raises, military presses, triceps extensions, bench presses, flyes, and more while standing on the ball.  This is supposed to “strengthen the core”.  Balance is certainly involved while performing these exercises.  How much “core” strength do you think is achieved by balance work alone?  Balance work certainly does have a place in training, particularly in training for sports.  I have included balance training in programs for elite athletes.  However, balance training is just that . . . balance training.  There is not pretense of improving “core” strength. 

The difficulty the balance provides also compromises the trainee’s ability to perform all the exercises mentioned above.  Why should each exercise revolve around “core” strength?  Should each exercise be compromised?  If we go back to the fundamental questions: What do I want from training? and What will I achieve by doing this exercise? we see that these ball exercises may not achieve the trainee’s goals.  The amount of weight the trainee can handle is reduced by standing on a ball.  So how effective will the curl, military press, triceps extension be if the limiting factor is the trainee’s balance?  The targeted muscles will not be taxed to the same degree as if the trainee performed them on a stable surface. 

Core strength is obtained by placing a progressive resistance demand on the abdominal muscles and back muscles.  The can come from squats, deadlifts, Romanian deadlifts, hypers, glute ham raises, variations of the Olympic lifts, abdominal training, and various medicine ball throws.  These types of movements can be performed as light as the situation requires.  Beginners are taught these movements with a PVC pipe that weighs 0.5 lbs.  This can be used for post-injury patients as well.  They can be incorporated with the traditional stability ball exercises and then progress the patient/trainee past the ball work.  Any trainee who has performed any of the above mention exercises has felt the increased stability of the “core” muscles.  The abdominal muscles and back muscles fire to protect the spine while the exercise is performed.  Anyone who has never performed these lifts will not understand this concept.  There is a reason that elite weightlifters perform their lifts while wearing lifting shoes with wooden soles while standing on wooden lifting platform.  A stable surface is needed to have maximum effort in the muscles that are firing during the lifts.  The core stability of the weightlifters is superior.

My advice for the readers of this column is to use the balance board for balance alone if you wish and do so without performing other exercises with it.  Perform your exercises on a stable surface (athletic shoes on the floor) so you can safely push your lifts harder and more safely and therefore make better gains.