Most trainees in gyms today have seen the huge wave of popularity of the stability ball, or Swiss ball, in training.  The stability balls were used for a variety of low back exercises which came to be known as stabilization exercises and then “core exercises”.  The term “core exercise” is as abused as the term “holistic” . . . no one really knows exactly what this means even though it conjures up many ideas and images. 

Many readers of IRONMAN may have been given these stabilization exercises by physical therapists or chiropractors after a low back injury.  The exercises may have started in the seated position on the large stability ball and led to crunches across the ball, and then exercises while laying face down across the ball raising arms and legs in various movements.  The ball can also be pulled with your legs while your back is on the floor and you can also roll with the stability ball.  These types of movements, with various degrees of difficulty, have helped some people after injuries. 

However, these exercises eventually turned into movements that they were never designed to be.  Any exercise or program design has to answer questions to make training effective and worthwhile:  What am I trying to achieve?  Why am I doing this exercise? We usually want to be stronger, bigger, and/or faster from training (most sports-oriented weight training or weight lifting programs are designed to make the athlete faster and more explosive).  Performing common weight training exercises while standing on stability balls or wobble boards is allegedly supposed to increase “core strength” because of the difficulty balancing during the exercise.  Many questions should be asked before we join the Pied Piper down the stability ball “core exercise” path.   How much “stability” is really being developed?  How much is the original intent of the exercise being compromised?  What are the risks on some of these movements?

The risks of the use of the stability ball are the biggest concern.  I have seen professional athletes who have been advised to perform squats without weight, or with light weight, while standing on the ball.  The risk is enormous for this movement.  Again, the risk:benefit ratio is not worth it.  While attempting to develop “core strength”, a trainee or athlete can easily fall off the ball and incur head and/or neck trauma, ankle sprains and fractures, shoulder dislocations, wrist injuries and more.  Trainees are not trained circus seals.  Do not stand on balls while performing squats.  Other patients and athletes have told me of performing squats while standing on a wobble board.  Some would begin their squats with 155 lbs. and work up from there.   Squats with weight while standing on a level surface requires enormous “core strength” from the glutes, erector spinae, obliques and abs and anyone who has ever performed a properly executed squat with enough weight knows this.  Squatting on a surface that tilts or moves may make muscles increase and decrease their activity, or firing, which can dynamically de-stabilize the spine and increase the risk of disc herniation and sprain.  I had an athlete present to my office that was performing bench presses with 245 lbs. while lying on a stability ball.  This is an absolutely absurd movement.  The risk of this athlete slipping on the ball, the weight bar tilting to one side or the other while attempting to stabilizing it and being unable to stop the rotation on the ball, and lastly and least likely the risk of the ball deflating (either by defect in the ball or by damage to the wall of the ball from any number of possibilities in the weight room).  The risks of any of these situations include shoulder dislocation, elbow dislocation and fracture and well as significant wrist injury.  

Another consideration for re-evaluating the use of the ball in training is the efficiency of the movement.  If you like to perform dumbbell military presses to strengthen your shoulders and arms, then you should do so.  This is an excellent exercise.  If you kneel, or sit, on a stability ball, you will not be able to use as much weight, so a de-training effect will take place and the shoulder muscles will not be as strong.  What did you gain?  How much “core strength” did you really develop?  I will have more on this in the next installment.