Transverse Abdominis (TVA) Activation: Quadruped Exercise and Progressions

This course describes transverse abdominis exercises (commonly referred to as transverse abdominis activation, TVA activation, TA activation, TV muscle activation, intrinsic core muscle exercises, and included in the terms core exercise and lumbar (lower back) stabilization exercises). Performing quadrupeds, with the addition of the drawing-in maneuver (belly button to spine), dorsiflexion of the ankle, and maintenance of a neutral spine has significant advantages. For example, quadrupeds with these additional cues may improve recruitment (isolation) of the transverse abdominis muscle, while decreasing recruitment of commonly over-active muscles such as the rectus abdominis. Although the forearm plank may be an excellent abdominal exercise, it does not improve the activity of the transverse abdominis relative to the activity of the superficial core muscles.

The transverse abdominis, internal obliques, pelvic floor, diaphragm, and multifidus act as stabilizers of the thoracic spine, rib cage, lumbar spine, sacroiliac joint, and pelvis. These muscles increase stability by increasing intra-abdominal pressure, and tension in the thoracolumbar fascia. Note, this increases lumbar stability (lower back) without compression of the lumbar spine. Compression of the lumbar spine does occur with increased muscle fiber recruitment of the more superficial core muscles (ab muscle).

It is common to include these exercises in programs designed to address lower back pain correlated with signs of lumbopelvic hip complex dysfunction, including an anterior pelvic tilt, asymmetrical weight shift, and/or inadequate forward lean. However, these exercises may also be recommended to reduce arms fall, knees bow in (functional valgus), knee bow out (functional varus), feet turn out, and feet flatten (pes planus). Addressing these signs has been correlated with improving and reducing the risk of back pain, diastatis recti, neck pain, hip pain, knee pain, sacroiliac joint dysfunction, ankle dysfunction, and improving sports performance. Movement professionals (personal trainers, fitness instructors, physical therapists, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) should consider adding these exercises to their repertoire with the intent of improving patient/client outcomes from their integrated exercise programs and therapeutic (rehabilitation) interventions.

Isolated Muscle Activation Exercises:

• Quadrupeds
• Quadruped Progressions (Gali Pedis)

Reactive Muscle Activation Exercises:

• Quadruped Crawl
• Quadruped Sled Drag
• Crunch and Catch

Subsystem Integration Exercises

Last, it is important to integrate the increase in transverse abdominis activity into functional exercise. The Brookbush Institute accomplishes this with anterior oblique subsystem and posterior oblique subsystem integration. Some example movements for these purposes include:

• Kneeling Chop (AOS)
• Static Standing Chop (AOS)
• Reverse Lunge To Row (POS)

Pre-approved credits for:

Human Movement Specialist (HMS) Certification

Certified Personal Trainer (CPT) Certification

Pre-approved for Continuing Education Credits for:

• Athletic Trainers
• Chiropractors
• Group Exercise Instructors
• Massage Therapists
• Occupational Therapists - Intermediate
• Personal Trainers
• Physical Therapists
• Physical Therapy Assistants
• Physiotherapists
• Yoga Instructors

This Course Includes:

• AI Tutor
• Study Guide
• Text and Illustrations
• Audio Voice-over
• Research Review
• Technique Videos
• Practice Exam
• Pre-approved Final Exam

Caption: Dynamic quadruped exercise

Pre-approved Credits for:

• Certified Personal Trainer (CPT) Certification

Pre-approved for Continuing Education Credits for:

• Athletic Trainers
• Chiropractors
• Group Exercise Instructors
• Occupational Therapists - Introductory
• Personal Trainers
• Physical Therapists
• Physical Therapy Assistants
• Yoga Instructors

This Course Includes:

• AI Tutor
• Study Guide
• Text and Illustrations
• Audio Voice-over
• Research Review
• Technique Videos
• Practice Exam
• Pre-approved Final Exam

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    • Electromyographic (EMG) Activity
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    • Targeting the Transverse Abdominis
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    • Planks, Crunches and Quadrupeds
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    • Extension Exercises (and 47)
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    • Shoulder
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    • Additional Resistance (and 57)
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    • Comparing Exercise Outcomes:
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    • Low Back Pain and Recruitment during Quadrupeds
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    • Targeting the TVA and Normalizing Recruitment
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    • Low Back Pain Outcomes
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    • Addition of Stabilization Exercise
87. Jeong, U. C., Sim, J. H., Kim, C. Y., Hwang-Bo, G., & Nam, C. W. (2015). The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. Journal of physical therapy science, 27(12), 3813-3816.
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    • Quadrupeds for Other Pathologies
90. Im, B., Kim, Y., Chung, Y., & Hwang, S. (2015). Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. Journal of physical therapy science, 28(3), 951-955.
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92. Ehsani, F., Sahebi, N., Shanbehzadeh, S., Arab, A. M., & ShahAli, S. (2020). Stabilization exercise affects function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. International Urogynecology Journal, 31(1), 197-204.