Side plank progressions are an important component of core stability but if clients are progressed to quickly or incorrectly it could lead to injury. Body weight exercises have grown in popularity over the years and the side plank position (SPP) is one of the more widely used exercises for core stabilization. While the side plank looks simple it really is complex and has many factors for the healthcare professional to consider.
The standard SPP produces increased force on the foot, ankle, knee, hip and shoulder. In addition, in the SPP a weak shoulder or hip can create lateral flexion of the spine which may cause compression of the lumbar facet joints leading to pain and spasm. Therefore, it is paramount to understand and establish a systematic test, re-test and progression for the SPP.
Begin with a complete medical history before implementing the side plank into your clients exercise program. Age is a key factor to consider when integrating the side plank because many younger or older clients may not be ready or unable to perform this exercise. Another consideration is the weight of your client which may affect their ability to hold themselves up safely. Additionally, if the client has any history of ankle, knee,hip, back or shoulder injuries they may not be able to perform the exercise due to the increased force on these areas.
The low-impact modified SPP can be used for testing clients with the aforementioned red flags. Time how long they can maintain a neutral spine position without any shoulder, back or hip pain and progress from there. For more advanced clients find their baseline by testing them on a bench in an incline SPP with staggered feet. If the client cannot hold the incline position for 30 seconds then start with a higher bench or decrease the hold time and progress from there. If they can hold this position for 30 seconds they likely can advance to a stacked foot position. Once the client can perform the stacked position for approximately 60 seconds they are ready to progress lower to a bosu ball and eventually the floor.
Once you’ve established your client is capable of performing the side plank on the floor you can systematically progress them to other nuances like thoracic rotation, straight-arm plank, and unstable surfaces. Eventually adding weights to the side plank position may be performed if your client is very advanced, however proceed cautiously with adding increased loads in this position.
Understanding your clients capabilities, medical history and how to progress are important considerations for you and your clients. Be aware of how your clients tolerate the side plank as well as other exercises. There is more than one way or ways to progress your client but ALWAYS assess, test, re-test and then progress.