In speaking with an osteopath over the weekend, he really got me thinking about core function. We were discussing the current state of the literature and he pointed out that while the research to date are all fine and dandy, there doesn't seem to be anyone who's utilized truly healthy individuals that are free from visceral/organ dysfunction. That's not to say that the subjects who have participated in McGill's, Hodges' and others' studies are not "healthy", but it seems as though such particular issues have yet to be addressed.
The rationale behind his insight was the fact that our current society consumes far too much *you know what* to ensure that our abdominal organs are functioning optimally. And as a result, many in today's society suffer from certain inflammatory conditions that may have negative effects on proper core muscle function.
Take for example the Transversus Abdominis. This is one of the deep muscles of our core and through research, has been shown to have a delay in firing in those with chronic low back pain. Now if our intestines and organs are "inflamed", the possibility of influencing muscle function surely exists. Think about the length-tension relationship and the ability to generate force. So perhaps the T.A. may be dysfunctional in those with chronic low back pain due to the above.
On a different level, think about the role stress plays on organ function? Aside from the negative cognitive consequences it may have on those with chronic pain, what about those with chronic low back pain?
So where do we go from here? We were in mutual agreement that we should probably start with inclusion and exclusion criteria. Don't get me wrong, I know that this is not an easy task but perhaps we may be able to get an even better idea of what truly goes on in the core with more optimal subject population.
But in the meantime, if we're working with people suffering from faulty core function, perhaps it may be prudent to spend even more time considering the role of stress and common allergens.