Abdominal curl-up with elastic band prevents excessive activation of superficial cervical flexors

Abstract

BACKGROUND: The abdominal curl-up is an important exercise for training the core abdominal musculature and is an essential part of rehabilitation in patients with back pain. The curl-up exercise may, however, activate the superficial cervical flexors, such as the sternocleidomastoid (SCM), which can induce neck pain. The purpose of this study was to assess the effectiveness of using an elastic band to decrease SCM activity while maintaining abdominal muscle activity during the curl-up. METHODS: Twenty-two healthy male subjects performed three curl-up protocols in random order. The three protocols included, a traditional curl-up exercise, a curl-up with neck flexion restriction, and a curl-up with an elastic band. Surface electromyography signals were recorded from the sternocleidomastoid (SCM), rectus abdominis (RA), and external oblique (EO) muscles on the dominant side during the exercises. One-way ANOVA was used to compare the differences in normalized EMG muscle activity of the SCM, RA, and EO muscles among the three curl-up techniques. RESULTS: The curl-up technique with an elastic band showed a significantly lower root mean square (RMS) value of SCM activity compared with the traditional curl-up (P<0.001) and the curl-up with neck flexion restriction (P<0.001). There were no significant differences in the RMS values of RA or EO activity between the three techniques (RA: P=0.294; EO: P=0.097). CONCLUSIONS: The results of this study suggest that the curl-up technique with an elastic band can reduce SCM activation while maintaining activation of the abdominal muscles in healthy subjects compared with the traditional curl-up or the curl-up with neck flexion restriction. In patients with neck discomfort during curl-up exercise, abdominal curl-up with suspending a band on the occiput can be an option to keep core muscle training without overfiring superficial cervical flexors.