Research Review: "Drawing in" Offers Greater Sacroiliac Joint Stability than Abdominal Bracing

By Stefanie DiCarrado DPT, PT, NASM CPT & CES

Edited by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation: Richardson, C., Snijders, C., Hides, J., Damen, L., Pas, M., Storm, J. (2002) The Relation Between the Transversus Abdominis Muscles, Sacroiliac Joint Mechanics, and Low Back Pain. Spine. 27 (4), 399-405 - ARTICLE

Abdominal Drawing in Manuever. Notice how the back stays stable and the abdominal cavity draws inward.

Abdominal bracing. Notice how the back stays stable and the abdominal cavity draws inward. -https://www.allinahealth.org/mdex/ND0008G.HTM

Why is this relevant?:  "Drawing in," also known as, transverse abdominis (TVA) activation is often the first cue given by a human movement professional when guiding an individual through an exercise or movement pattern. "Bracing" is an alternative approach to lumbar stabilization involving an isometric contraction of both deep and superficial trunk musculature.  Controversy regarding which method better accomplishes the goal of lumbosacral stabilization exists among human movement professionals.  This article provides evidence indicating that "drawing in" creates a greater degree of sacroiliac joint (SIJ) stability and may assist in reducing low back pain (LBP).  Using this information, human movement professionals can improve cuing and exercise selection for those with SIJ dysfunction (SIJD) and LBP.

Study Summary

Study Design Randomized cross over
Level of Evidence IIa: controlled study without randomization
Subject Demographics

  • Age:  26 years (mean)
  • Gender: 8 males, 5 females
  • Characteristics: healthy, young individuals without a history of low back pain

    • Height: 1.78m (mean)
    • Weight: 74kg (mean)
Outcome MeasuresPrimary: Percent vibration transmitted from ilium to the sacrum.

Secondary: Real time ultrasound imaging of TVA, external obliques (EO), internal obliques (IO), and rectus abdominis (RA) contraction (increased depth of muscle) & surface EMG activity

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