This Lesson Covers the use of the Wright Balance® Express and Optimization prior to systematically building and balancing the Core Muscles. Before I begin with illustrations of that process, let's take a brief moment to discuss another important finding reported in the Journal of the American Medical Association (JAMA, March, 2020). This illustration shows survival rates as related to walking.

This study was conducted over 10 years with 4,850 adults 40 years and older. These adults wore an accelerometer 14 hours a day. Speed of walking was not considered in the results, just total daily distance walked. In a 10 year followup, 1,165 deaths occurred from the original 4,850 participants. As you can see from the graphic above, those individuals who walked less than 4000 steps per day had the highest mortality rate, actually a 10 times greater mortality rate than those individuals who walked between 8,000 to 12,000 steps per day.

We have heard repeatedly how a sedentary lifestyle is a predictor for loss of mobility and an early death. Physical Therapist have a saying: "If you don't use it you Lose It."

When I managed Pain Centers many years ago, the most common problem I saw was the following. When a person in pain and immobile began to feel better, they would over-do on the weekend because as they stated: "who knows when I will feel this good again" and they would experience recurring setbacks in their progress. All of our patients wore pedometers and they graphed their daily walking distance. Those who increased their distance slowly each day had the best results. As you complete your Wright Balance Express and Optimization Exercises, you will begin to feel better with less stiffness, soreness and greater mobility. I would encourage you to purchase a pedometer, wear it daily, graph your progress and slowly increase your walking distance. These exercises will increase your ability to get into a walking program, please do so slowly. Keep in mind the walking study presented above and set a goal to slowly walk further each day.

One last thing before we begin. Recall Level 2 of the certification programs. They covered the Wright Balance® Express and Optimization Exercises. Both of those exercise programs eliminate all drag and the pelvis stays square in all planes of motion.

As of this writing, Wright Balance® is the only program that creates symmetry and eliminates drag. This Wright Balance® Core Challenge presented in this video is the prerequisite for all training and therapy programs. By the way, as of this writing, not training or therapy program has accepted the Challenge shown in this video

Core Optimization With Every Exercise Set

Poor Core strength is reflected in Poor Posture, lower Back Pain, hip or knee pain. Posture changes when the muscles of the Core are weakened to the point of collapsing creating a slumped posture. Back Pain will evolve as a result of weakness in the muscles opposing the abdominal muscles. Posture and Back Pain issues can be resolved with the Wright Balance® Core Express and Optimization Exercises followed by the Wright Balance Core 360 Exercise programs.

When you either over work the front or back of your Core or your Core is weak due to unused muscles or atrophy, pain follows. When you have stronger abdominal muscles based upon an exercise or overuse and you have back pain, it is called a Lower Cross Syndrome. It is simply an imbalance of muscles. The same is true in the Upper Core as well. That is called an Upper Cross Syndrome. If, for example your exercise is focused on planks and push-ups or bench presses, you are strengthening the front of the Core and weakening the back of your Core. This muscle imbalance will result in soreness, pain and a loss of mobility.

When we lose motion for any reason the result is almost always soreness, pain and stiffness. We know through the Wright Balance® functional test when measured before the Wright Balance® exercises that nobody has freedom of movement in all planes of motion. The Wright Balance® Core Express and Optimization Exercises eliminate all restriction of motion in all directions. This loss of restriction allows you to begin to strengthen, and when done properly in the 9 Core Region Stance Widths, you are able to balance your muscle strength as well

Wright Balance® refers to any restriction of motion as "Drag". "Drag" can be the most subtle of restrictions. I will show you a simple strategy to measure "Drag" later in this Course.

Our Core Muscles are the supporting structure of our Skeletal System and responsible for all movement. When we get out of bed, stand from a seated position, get up from the floor, pick up a child or any object, crawl, walk, run, swim, swing a club or bat or find balance when we stumble, we use our Core Muscles. If any of those Core Muscles are weak, it is reflected in our performance. We need Core Muscle "strength" to perform any of these activities.

So, where do we get this "strength"? If we exercise our Core Muscles, we become stronger in the regions we exercise. Our demonstrated "strength" comes from the force we exert downward into the floor or ground. Strength is expressed as we recruit the necessary Core Muscles to perform the activity in what is referred to as the Kinetic Chain. When we exert this force, we don't always have equal strength in in every "Link" in the Kinetic Chain to do whatever the activity may be.

We see senior citizens slowly rise from a chair with observable instability. Their ability to use the force they exert as they push into the floor or arms of the chair is diminished in recruitment of the muscles of the Core when there is Core weakness in more than one Region.

These same "weak links" in the Kinetic chain exist in Elite Athletes. These "weak links" are disclosed as injuries. Thus, equal application of force throughout the entire Core (Vertical, Horizontal, Front and Back) in each of the 9 Core Region Stance Widths is imperative. Wright Balance® has mapped the Core and identified the precise Regions of Recruitment. Exercise programs using the same frequency or intensity in each of these Regions will increase flexibility and strength thus minimizing the potential for injury. These Core exercises apply equally to the Elite athlete and to the senior citizen rising from their chair.

The Jello Factor

The concept of a Kinetic chain explains our ability to recruit Power from the ground and transfer that power in Performance. We recruit maximum force or Power when each of the "Links" in the Kinetic chain are connected and strong. I recently heard Wright Balance Professional, Dr. Robert Giombetti describe to a player that they appeared to be strong but lacked Rotational Force due to weakness in his Core. Dr. Giombetti said that the transfer of power through this player's core was like transmitting a "charge" through "Jello". One weak leak leads to the a loss of Power. The result of weak "Links" in the Kinetic Chain vs strong "Links" can be compared to the following: Weak "Links" in the Kinetic Chain will gradually lead to soreness, pain and finally injury.

Core Strength and Symmetry is a "state" of the body where there is Absolute Symmetry and Balanced Strength in each of the Wright Balance® 9 Core Regions. These 9 Core Regions encompass the front of the Core, the Sides of the Core and the back of the Core. When this state of Symmetry and Strength is present there is a strong Kinetic Chain, this presents the opportunity to apply maximum force to the ground and recruit maximum Power with the least stress on the Skeletal System. Thus, the potential for injury is minimized with optimal performance. This is true whether you are a Elite Athlete, a Weekend Athlete, a Senior Citizen rising from your chair and anything in between.

Wright Balance® has "mapped" the Core in 9 Horizontal Regions and 18 Vertical Regions front and back. Each of these Core Regions is "recruited" by different Stance Widths in a standing or prone / supine posture. Wright Balance® is able to predict precise recruitment of different Regions of the Core from the Jaw (Bite) to the Pelvic Floor. This precise recruitment enables targeted weight bearing gravity driven exercises that balance each region of the Core through use of body weight.

Not only is Core Symmetry imperative but also Core Strength for the application of maximum Force resulting in maximum Power. Core Strength is developed through a consistent Core Exercise Program that targets the entire Core from the roof of the mouth to the pelvic floor. This comprehensive Core Exercise Program includes the strengthening of the arms, shoulder girdle, legs, glutes, pelvis and internal and external obliques front and back, and many more muscles groups. The back and the front of the Core are engaged with resistance exercise using the person's body weight. Core Strength increases gradually overtime with increased exercise repetition using all 9 Stance Widths of the Wright Balance® Core 360 exercise program.

It is my belief that Core Symmetry (Absolute Balance) should be created before embarking on any training that requires motion from swinging a golf club, to running to lifting a box in your garage. I further believe that our senior population should have the opportunity to embark on a Core Exercise Program that enables them to rise comfortably from a chair without fear of falling. Core Asymmetry sets the stage for injury, regardless of activity or age. Core Strength Training should be a part of any Core Exercise Program using all 9 Wright Balance® Stance Widths.

**Core Optimization with the Core 360 Exercises
**
Let's take a look at how the Wright Balance® Core Optimization Exercises are used in the Wright Balance Core 360 exercises to ensure equal application of force.

The following illustration was done by Wright Balance Master Professional, Mathieu Paradis from Quebec City, Canada.

When doing any exercise, you want to have an equal application of force throughout the entire Core. After any exercise set, the Core is disrupted until that exercise is done in all 9 Wright Balance® Stance Widths. This disruption produces asymmetry of the body. The next exercise set will have an unequal application of force during the exercise unless the entire 4 second Wright Balance® Optimization Exercise is done in that Stance Width. Please remember, balance is the primary focus on any exercise. Optimizing the Core for Core Symmetry is a must to create an equal application of force as you exercise.

So before each Wright Balance® Core 360 exercise on each of the 9 Stance Widths, do the 4 second Wright Balance® Core Optimization Exercises to ensure equal application of force. The Wright Balance® Core Optimization should be done once your feet are set and ready to do the exercise from the Wright Balance® Core 360 program on each of the 9 Stance Widths.

Core Memory of Time and Repetition

Observations on Core "MEMORY": Repetitions and Time. Our Wright Balance research shows that the Core Stores a "MEMORY" of repetition (within 5 repetitions) and time (within 10 seconds) of any exercise either timed or in sets in each of the 9 Core Region Stance Widths. What does this mean? Do the same amount of time or number of repetitions on each of the exercises in the 9 Stance Widths. Even if you have to divide the repetitions or time in 2 or more segments to equal the "work" in all of the 9 Stance Widths. If you divide the time or repetitions as you do them, be sure to also do the 4 second Wright Balance® Optimization on each of the divided sets.

Cyclic Loading

Exercises that have intermittent application of stress on Core Muscles are called cyclic loading. Cyclic Loading and Static Loading are the same exercise with different technique. For example, a plank that is held in one position in each of the Wright Balance® 9 Core Region Stance Widths is an Isometric Loading or static exercise. Push-ups done in the same 9 Core Region Stance Widths are called Cyclic Loading exercise. Each of these exercise techniques (Cyclic Loading and Static Isometric) are important in Core Training. The Static Isometric Exercises show the greatest Strength Training. Whether you should cyclic and static loading interchangeably over successive exercise days is still to be determined.

Research shows that both Cyclic Loading and Static Isometric show the same changes in measured flexibility.

Research shows that Cyclist have Bones unlike somebody walking or running.

What you have learned thus far:

1. The Wright Balance® Core Express Exercises create a state of Core Symmetry that has the greatest resistance to disruption. The Wright Balance® Core Express Exercises should be done prior to any other activity or exercise for prevention of injury.

2. If you do not do the Wright Balance® Express Exercises, the 4 minute Wright Balance® Core Optimization should be done before each set on all of the 9 Stance Widths

3. Our Core stores a memory of the amount of time in timed exercises. Do the same amount of time for each exercise in each of the 9 stance widths even if you have to divide your workout into 2 or 3 segments. Time is stored in the Core (central nervous system) the in one continuous duration "hold" or in segments.

4. Our Core Stores a memory of the number of repetition of any one exercise in each of the 9 Stance Wdiths. Similar to the timed exercise, you may divide the repetion into 2 or 3 exercise periods as long as the total repetition in each of the 9 Stance Widths is the same.

5. Exercise should be "measured" for differences in Cyclic Loading and Isometric Hold.

6. All exercise should be equal across all 9 Core Region Stance Widths in both the Horizontal and Vertical Planes.

Wolff's Law See summary of Wolff's law below and review more online that discusses remodeling of bone.

Recall: Core Optimization With Every Exercise Set

When doing any exercise, you want to have an equal application of force throughout the entire Core. After one exercise, the Core is disrupted

**Why Core Symmetry and Core Strength are Important# **

Core Symmetry: 100 percent of the population has one shoulder lower and one hip higher. You want your spine to be perpendicular to your pelvis in all activities. By leveling your hips and shoulders, you have set this perpendicular relationship. When you move, you have dramatically reduced the wear and tear on your body due to this perpendicular relationship of spine and pelvis. When you don't do these exercises, the angled relationship of your spine and pelvis is setting you up for soft tissue pain and soreness and the long term potential of skeletal stress that leads to other problems as we age. Core Symmetry provides for maximum efficiency for application of force to the ground. However simply creating Core Symmetry does create maximum Core Strength. To have maximum Core Strength, there are exercises for each of the Regions of the Core.

Core Strength: You must have Core Symmetry to have maximum Core Strength. Our power comes from applying force to the ground then recruiting that application of force through the body as a chain. This chain is referred to as the kinetic chain. This chain has links composed of bones, ligaments muscles and tendons, among other things. The kinetic chain is a strong as its weakest link. When there are weaknesses in one or more links in the kinetic chain, there is a concurrent loss of overall strength. If you want to maintain strength and mobility as you age, keeping a strong Core in all regions while maintaining Core Symmetry is the answer.

(NOTE: Review the following and add 25% of elderly with hip fractures die within 6 weeks.

D**o not use verbatim and check reference:) **

According to the National Council on Aging:

"One in four Americans over 65 falls each year.
Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.

Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.

Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.
In 2015, the total cost of fall injuries was $50 billion. Medicare and Medicaid shouldered 75% of these costs. The financial toll for older adult falls is expected to increase as the population ages and may reach $67.7 billion by 2020."

Twenty-five percent (25%) of adults over 70 with hip fractures die within 6 weeks.

Osteoporosis is a common aging malady, especially in women. As bone density decreases with age, the bone becomes more porous and fragile. These changes lead to a greater risk of fracture when the bones are stressed, especially with falls. Unfortunately there are no clinical signs of bone loss other than what would be observed with a bone density scan compared to later scans.

Osteopenia occurs when bones begin to weaken but not break. Osteopenia is the threshold of Osteoporosis. A loss of height, fracture and back pain are some of the clinical signs that are associated with bone loss with Osteoporosis. If you have these signs, see your physician for a bone density scan. Bone Density scans results are usually compared to adults in your age group. If you have an earlier Bone Density Scan as a baseline comparison, that is ideal to follow bone density changes as you age.

According to German anatomist and surgeon Julius Wolff (19th century)bone strength is directly related to the load that is place on it. This is referred to as Wolff's Law. According to Wolff, if loading on bone is gradually increased, the bone will remodel itself to become stronger. (This is consistent with research done by Donald Ingber, MD, Ph.D. on Tensegrity and Bone development as related to "Close Packing.") This remodeling strengthens the bone with repeated, structured loading. The opposite is also true. That is, when the bone has inconsistent to no loading due to a decrease in weight bearing activities, bone loss occurs.

NOT JUST OLDER ADULTS

During the 2018 NCAA Football season, Alabama quarterback Tua Tagovailoa had a right knee sprain and wore a brace on his right knee during the season. October 19, 2019 had a right high ankle sprain and surgery the week of October 20, 2019 following a game against Tennessee. He resumed play November 16, 2019 against Mississippi. During play, Tua had a dislocation of his right hip and a right hip wall fracture after what appeared to be a routine play where he was tackled. How much of these injuries from right knee beginning in 2018 to right ankle requiring surgery in 2019 culminated in a loss of bone density due to decreased weight bearing activities. Anything is speculation at this point. However, shouldn't bone density be assessed post injury and again before resuming performance activities?

Astronauts lose 1 to 2 percent of bone density per month due to the weightless environment and the absence of loading on their bones in space. This is viewed as a problem for long term space travel. More recently, dietary / nutrition changes during space travel has reduced the impact of bone loss.

As you can see, strengthening your body and improving balance is important to strengthen bones and prevent falls in every day activities. A gradual loading program using the Wright Balance® Core 360 Exercise Program should follow a structured program where bone loading by limb and Core Region is gradual. Overloading too soon could result in bone fracture.

Wright Balance Set for Pre Lifting or Exercise

What I am going to demonstrate here should be done prior to each set of Exercises or prior to lifting anything from a child to a box for maximum Ground Reaction Force. Once you have your set you will be able to apply equal force / stress to your Core Muscles if you do this simple pre-lift exercise. Please remember that your feet must remain stationary after the you set your Core Muscles in preparation for lifting. You will note that this posture set not only sets your Core Muscles for the application of equal force throughout your Core, it also sets your Core for maximum rotation. With that said, one of the worst things you may do is lift and rotate or rotate and lift. Many disc herniations have occurred with these combined movements.

There are two ways to do this Wright Balance Core Set.

**END EDIT add 2 ways to do the exercise set

Now I am going to launch into the Wright Balance Core 360 Exercise Program and the impact each exercise has on what Regions of the Core. There are many of you reading this that don't want the narrative. Be certain that you do the Wright Balance Core Set prior to each set of exercises after your feet are set stationary in each of the nine (9) Core Region Stance Widths.

If you are reading this in preparation for a certification exam, please know I consider the content that follows the exercise descriptions equally important. I believe you and your students need to know the mechanisms involved in the exercises. You will find as many, if not more, questions on the certification exam from the content that follows in the explanations of the Kinetic Chain, the Jello Factor and much more.

This diagram is shows several Core Exercises and what part of the Core is impacted by each exercise.

The net result of the exercises in this Matrix, when done in all 9 Core Regions, is Symmetry and improved Core Strength. Improved power as a result of a stronger Kinetic Chain, unrestricted movement in all directions and reduced pain due to soft tissue strain and injury are the experiential results of these exercises.

Horizontal Plane of Front of Core (Anterior Axial or Transverse Plane)

The following illustration the Axial or Transverse Plane. This plane divides the body from Top to bottom at any point.

When the body is divided front to back, it is called the Coronal or Frontal Plane. This illustration shows this division.

The Front of this Plane is recruited when the 9 Horizontal Core Stance Widths are used for exercise in any exercise where the front of body is angled downward. When the chest is face down during exercise, the front of this plane is recruited by one of the nine (9) Stance Widths. The front half of the body is shown in this illustration.

 There are 9 total Core Regions on the  Horizontal Plane.  Imagine this division of the horizontal plane, top to bottom of the body in 9 precise areas as shown in this illustration.

The following are exercises that impact the Horizontal Plane on the Front of the Core. The original research was done first by the width of the knees.

We have tested this exercise on "all fours" in bed and observed the pelvis square. It is imperative to do all of these exercises in all 9 Stance Widths. Be conscious of the width of your feet (or knees in this case.)

You may graduate to doing planks on the knees...

... and to a full floor plank or push-ups, always doing all 9 Core Region Stance Widths and being cognizant of the width of your feet.

As an alternative to floor planks or push-ups you may do wall planks or wall push-ups as shown in these illustrations. When the Position is held without movement, a timer is set for a comfortable number of seconds and gradually increased over several days of exercise.

Placement of your student's feet at 90 degrees to their stance line is imperative as they do each of the 9 Core Region Stance Widths.

Note in each of these photos that their is a measurement tool at the knees or feet. Be certain you are doing all 9 Stance Widths of your Core. The Core is a House of Cards. You will understand what that means as you read on.

Each of the above exercises impacts the Horizontal Plane (Anterior Axial or Transverse Plane) on the front of the Core.

How do we know these exercise impact the front of the Core?

The TEST

Before the exercise

Horizontal Plane on Back of Core (Posterior Axial or Tansverse Plane)

This illustration is the Horizontal Plane on the back of the Core.

The following are exercises that impact the Horizontal Plane on the back of the Core.

1. Wall Sit
2. Bridging (Static Hold)
3. Bridging with repetition
4. Crunches

Body Measurements

Wright Balance® Body measurements are input on the Wright Balance website and processed by a proprietary algorithm then emailed to the Student and the Wright Balance Professional. The result is a series of Stance Widths by Core Region as shown below. These Stance Widths appear in inches and centimeters.

Please see this EBook on how to do the body measurements and set up the Stance Widths from the emailed results for use in the Wright Balance® Core 360 Exercise program.

https://instructions.wrightbalance.com/how-to-measure-your-student/

I am going to review the Horizontal and Vertical Plane Exercises of the Wright Balance® Core 360 Program then follow with the training and measurement of each of these regions.

We have 9 Horizontal Planes on the front of the Core as shown in this illustration...

...9 Horizontal planes on the back of the Core that are distinctly separate from the front of the Core...

Measurements of the Front Horizontal Plane

There are 2 measurements of the Front Horizontal Plane

Why the Anterior (Front) Horizontal Plane and not both the front and Back? The Front and Back Horizontal Planes are measured similarly. However, they are distinctly different Core Regions divided by the Front and Back of the Body.

This illustration shows that division.

This Plane of Motion is called the Frontal or Coronal Plane. It divides the body front to back.

This is the first of the 3 Planes of motion we will discuss. There are 2 simple functional measurements.

The first funtional measurement of the Horizontal Plane of the front of the Core is Pelvic Rotation.

Measuring the Horizontal Plane on the Front of the Core
**
Note: the Horizontal Plane is also known to Kinesiologist, Neurologist and Anatomist as the Axial or Transverse Plane. This Plane of Motion is Rotational and divides the body top to bottom in a cross section at any point shown in this illustration. The bar the hips measures rotation of the pelvis.

The front of the Horizontal Plane has 9 Regions as shown in this illustration.

As noted, there are 3 measurements specific to the Horizontal Plane of the Front of the Core

1. Pelvic Rotation as you have seen in the prior illustrations and measured either by force sensors under the feet or rotation as seen with a bar across the hips.

2. How the Hands Hang at the side before and after the exercise program that specifically recruits the Anterior (Front) Region of the Front of the Core on the Horizontal Plane (Transverse or Axial).

Their are "secondary measurements" that are present when the total Core is balanced and subsequently disrupted by the initiation of a new exercise period, generally within 24 hours of a prior Core Exercise Period.

These "secondary measurements" are:

1. Hip and Shoulder Height: The usual observation is that one shoulder is lower than the other and one hip is higher than the other. Generally speaking the right shoulder is observed to be lower and the right hip is also higher creating a "collapsed appearance on the right side of the body.

2. Lift Test: The Lift Test is done from a standing tall with the feet a comfortable width apart. The person slowly bends from the hips as though they are going to pick something from the floor. As the forward flexion continues there is an observed rotation of the pelvis and the arms and hands move right or left of the legs so that picking up any object shows from this torso rotated position implies a potential for injury due to the obvious asymmetrical relationship of the pelvis and spine.

3. Jaw Symmetry: We know from our work that the Core extends into the jaw and can be assessed by "Bite"

Balancing the Horizontal Plane

When we balance the Horizonal Plane in all 9 Stance Widths from the Measurements, there is no Pelvis Rotation in any Stance Width. The bar on the hips remains absolutely square no matter what the Stance Width or whether it is one of the 9 Widths where the exercises were done.

The Core is defined as everything but the arms and hands. Wright Balance® has identified 162 Regions of the Core on Vertical and Horizontal Planes on the front of the body (Coronal Plane) and 162 Regions of the Core on Vertical and Horizontal Planes on the back (also the Coronal Plane) for a total of 324 individual "Core Cell".

Core Symmetry is the net result of a targeted Wright Balance® Core 360 Exercise Program. The Horizontal Plane is divided into 9 Regions as shown in this illustration, front and back.

Jaw Symmetry

The front side of the "Coronal / Frontal Plane" goes into the Jaw Line and is demonstrated with changes in Core Region Stance Width changes by bite. Changes in heel to toe balance change the orientation of the bite front to back.

Stand tall and move your weight toward your toes, close your mouth and notice that your bite goes to the front of your mouth. Next move your weight to your heels. Notice that your bite moves to the back of your mouth. This same process happens with each change in Upper to Lower Core Stance Widths.

This illustration shows the mapping of the bite by Stance Widths.

In the Upper Core Stance Widths the bite will move forward in your mouth. In the Lower Core Stance Widths, your bite will move toward the back of your mouth. In Middle Core Stance Widths, your bite will be in the middle of your mouth.

If there is a rotation of the Transverse Plane in, for example, a Middle Core Stance Width, your bite will be in the Middle of your mouth and touch only on one side.

You will be able to track your Core correction with the "planking exercise" by changes in your bite. Following each of the 9 Core Region Stance Width "Planking Exercise" you will note that your bite is even on both sides and corresponds precisely with the Core Region Stance Width that you Planked.