As a middle-school math teacher, I have seen many students who do understand abstract concepts, and even enjoy learning about things like Pi and the Pythagorean Theorem, but who appear to be unable to do so due to a weak grasp of math fundamentals.
However for the most part, when a worksheet is needed to help drill down a procedure, standard, or lesson, its effectiveness can and will vary.
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These students have weak immediacy. This means that compared to other students, they are slow to come up with the right answers to basic math problems like 6 x 8, or 35 divided by 7. While other kids have the answer stored in their memory, these kids do not. This causes big problems when they try to work through the more complex problems they encounter in junior high math.