As the 2026 Winter Olympics continue through Feb. 22, the performances of elite athletes underscore a principle that is highly relevant to orthopaedic practice: optimal outcomes are built on foundational strength, neuromuscular control, and biomechanical efficiency long before competition begins. While Olympians compete at the highest level, the structured core conditioning and balance training that underpin their preparation have direct implications for injury prevention, surgical outcomes, and long-term joint preservation across patient populations.
“Building and maintaining muscle mass through strength training, supported by appropriate nutrition, is critical not only for athletic performance but also for musculoskeletal longevity, metabolic health, and preservation of functional independence,” said Donald Kasitinon, M.D., Assistant Professor of Physical Medicine and Rehabilitation (PM&R) and Orthopaedic Surgery at UT Southwestern Medical Center and Medical Director for PM&R Sports Medicine.
Core Stability and the Kinetic Chain
The core musculature—including the abdominal wall, paraspinals, diaphragm, pelvic floor, and hip stabilizers—serves as the proximal stabilizing unit of the kinetic chain. Deficits in trunk control and pelvic stability can contribute to aberrant lower-extremity mechanics, increased joint loading, and compensatory movement patterns.
Lack of core stability has several clinical implications:
- ACL injury risk: Poor trunk control and dynamic valgus have been associated with increased ACL injury risk. Neuromuscular and core stability programs have demonstrated reductions in primary ACL injury rates and may influence re-tear risk post-reconstruction.
- Post-operative rehabilitation: Early integration of trunk stabilization can support more efficient force transfer and improve lower-extremity alignment during return-to-sport progression.
- Chronic low back pain: Segmental instability and poor core endurance remain significant contributors to persistent lumbar symptoms.
- Hip and knee pathology: Proximal weakness may exacerbate patellofemoral joint stress, contribute to gluteal tendinopathy, and influence post-arthroplasty gait mechanics.
“A strong core provides the biomechanical foundation for efficient movement,” Dr. Kasitinon said. “Stabilizing the spine and pelvis reduces abnormal joint stress, supports appropriate force transmission, and can mitigate both acute and overuse injury.”
Beyond Elite Athletes
Importantly, many musculoskeletal injuries seen in clinical practice are not the result of high-impact trauma but cumulative microtrauma, deconditioning, and poor movement mechanics. The same principles that support elite performance—core strength, balance, proprioception, and proper form—are critical for recreational athletes and aging patients alike.
Reinforcing structured strength training and neuromuscular conditioning as part of both prevention and post-operative pathways may help:
- Reduce primary injury incidence
- Improve surgical outcomes
- Support return-to-sport readiness
- Enhance implant longevity through optimized biomechanics
- Preserve long-term functional independence
The Olympic stage may showcase peak performance, but the underlying lesson is foundational: durable musculoskeletal health begins with proximal stability and thoughtful conditioning.