In talking with a potential client, he had some questions about core stability in his cycling. He also mentioned that he had recently purchased a book that he was going through to help improve his stability. I asked him what book he was referring to and he said, “Tom Danielson’s book.” The book sounded intriguing; and even though I had not met with the client yet, I found it at a local bookstore that evening. I figured I would skim several of the chapters and look through the exercises. Then I got caught up in reading the background story of Tom’s career. Several hours later I decided, why not just finish the whole thing and then post a great review for everyone! If you have questions, please feel free to use the comments below.
Remember that I am coming from the position of a Physical Therapist. It is my job to help people move better and more efficiently as well as reduce their pain while doing so. I am also a cyclist, I can relate with Tom’s story of back pain problems from two perspectives. I am not a pro cyclist, but I have spent a good deal of time in the saddle, enough to recognize pain in my back, neck, wrists and such. I have also treated cyclists, runners and other active/competitive clients with the same issues. I have studied many forms of exercise, core strength, stability and rehab throughout my schooling and career. So, with that covered . . . Tom Danielson’s Core Advantage:
In general, I feel like the book was well written and does a good job of covering its objectives. We could compare it to an early morning training ride. It has its ups and downs, a couple of hard bumps, but in general will leave you feeling refreshed and better for having done (read) it. I will point out some of the bumps, cracks and uphill battles of the book shortly; as there are some things that could potentially harm those not prepared (just like with a training ride you are not ready for). However, this book has many great tips and is well written. As you would expect from an exercise/self help book, the chapters are short and flow well one to the next. There is a good deal of educational background that will help readers become more familiar with anatomy, mechanics and what “core” strength/stability means. Tom goes into a brief history of his career and how it relates to back pain and how he got over it. This serves to validate the effectiveness of the routines in the book. The stretches and exercises are well described, have good quality pictures. I also like that there are three different levels of routines. There is an appendix in the back that can be used as an exercise log. There are 45 exercises in all and 5 warm-up activities. In all there are 195 pages. Most of the reading is in the first 93 pages with drawings to help illustrate topics. It would be a very easy 1-2 day read for most people. The rest is just learning and trying the routines.
With the quick overview out of the way, I want to get deeper into the book and point out some major bumps and cracks that I believe you should be aware of. The first chapter is straightforward in explaining what core strength is and why it is important to cyclists. They also go into having balance in your muscle systems and why that is important. As a therapist, I was very happy to see these educational points in the book.
The second chapter goes into detail of common injuries for cyclists. In the portion about hip flexor pain the book only lists five muscles that act to flex the hip. However they leave off an important part of the thigh that also help with flexion, the Adductors. Not only do several of them help with flexion, but they also help to counter balance the Abductors and help prevent pain in the hip and knee. The next section about knee pain is good other than some minor anatomical mistakes such as indicating the bump on our hip which the IT Band passes over has no name. That is not correct, and it is known as the Greater Trochanter. The book also states “the best approach to alleviating chronic knee pain,” is to work on gluteus medius. This can often help with chronic issues, however not all cases. So be careful to take their statement for what it says, “often” not always. In the neck and upper back section he forgets to mention the rhomboids or the middle portion of the trazieus muscle in being stretched and over worked. It is also stated that the upper trazieus is held at its max length in cycling, which not true for many riders, especially as your rides get longer and you tend to shrug your shoulders. It is also stated that “the muscles of the neck and upper back are excessively overstretched and lengthened during cycling”. Again, this may be true for some, but for most, especially in regards to the neck, the muscles are shortened and overworked. As we move on into the back section there is a little misinformation in what happens with a herniated disc. The book states the herniation puts pressure on the sciatic nerve. Technically it places pressure on an individual nerve root, not the whole sciatic. There are also specific numbers given as to the amount of motion that should occur at the sacroiliac joints. Throughout schooling and to this day I have not been able to find a scientific confirmation of this and it continues to be a source of controversy in the medical world. There is also a section that talks about maintaining the health of our discs and they leave off smoking, nutrition, and general health as major contributing factors.
Chapter 3 deals with posture. I am very glad that posture was put into this book. As with the other sections above, Tom makes some general statements that should be read with caution. He indicates that pain at the bottom your spine and to one side means you likely have a “misalignment” of your SI joint. This could be possible, however there are multiple other reasons such as leg length difference, muscle imbalance, spinal curvature issues. There is also talk about the SI joint being improperly “aligned” causing it to pinch the nerves. It could just be that the SI joint is inflamed or even infected and give you pain down your leg.
Chapter 4 deals with flexibility. It describes different types of stretching: Static, PNF, Ballistic, and Dynamic. The description of PNF (Proprioceptive Neuromuscular Facilitation) describes it as just a static type of stretch provided by another person. This is not true and there are many types of movements within PNF that included some static, some ballistic and some dynamic movements. The majority of the dynamic movements are great movements. However, if you have history of shoulder pain or problems proceed cautiously through the ones involving holding on a wall, they could be dangerous for you.
Chapter 5 is where the exercises and routines begin and I think they are laid out very well. The different levels are explained and the goals you are to achieve with each level. I like this approach as it gives you some progression over time. Not just one set of activities. The remaining chapters are used to proceed into the various exercises and levels. Some of the exercises, especially in level II and III could actually hurt someone. If you currently have pain, don’t just go right into all the exercises.
Again, there is an appendix with blank logs for your to keep track as you go through the levels. There is also a list of references used in writing the book. The majority of the references are 12-14 years old, so for things like anatomy and physiology, that is not a problem. However, for current evidence about injury and treatment, ideas change frequently as we learn new things. I would have liked to see more references from 2010 and beyond to show a current level of understanding.
My last gripe, which is more personal than anything, is that he does not mention physical therapy. He mentions doctors and chiropractors, but PT’s. Oh well, maybe he just has not had the chance to find one he likes.
Most of the detailed issues with the book above will not detract from its ability to help you improve in core strength. You just can’t take everything that is said as fact and may need help from a professional to make sure you are not going to make things worse. The exercises are quite well targeted to cyclists and the positions that we maintain. I don’t recall there being much of a disclaimer to the book, so I would like to add one . . . if you currently have back, neck, knee or other pain from cycling it would be in your best interest to seek the help of a qualified physical therapist. You need to be checked for imbalances, proper fit, and many other things before recommending jumping into the book. Any good therapist would be happy to look at you, explain your situation and give you a road map to getting better and using the book to do so with additional exercises as needed (such as hip adductors liked mentioned above). In closing this review I really think it is great book and I have tried many of the exercise and look forward to learning the others. Tom did an overall great job and has much more knowledge about anatomy, pain and movement than most do. I am glad that I purchased the book.