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Things We Already Know: low back (part II)

Posted by tdifranc on July 5, 2010

Now that the 4th of July is over and we are all done lifting heavy coolers (filled with healthy food/beverages) and big boxes of fireworks it’s time to get back to work and back to the gym.  How many hot dogs did you really eat this weekend???? (When you go to the doctor for your physical and they ask you how many alcoholic beverages you have per week they always add 2-4 to your answer to get the real answer…..same with hot dog consumption).

In the last post we discussed the negative effects of extreme flexion or extension during a lift.  Now lets talk about something else related to the low back that we all already know: repeated flexion of the lumbar spine is BAD!

In another great segment from Porterfield and DeRosa’s Mechanical Low Back Pain they suggested the following: Repeated and/or prolonged static forward bending may cause damage to the posterior aspect of the disc and it’s surrounding tissues.

This should set off some red flags for those of you who either sit or lift for a living.  What about when you go to the gym?  You are being active and staying healthy but are you doing it in a back friendly way?  Everyone in the gym does some sort of “ab” workout – how many of those include repeated forward bending?  From my experience in gyms…..most of them do!  People want to feel that BURN in their “abs” so they do 82 thousand sit-ups every day…..ok maybe that’s an exaggeration.  What is happening to your discs at the expense of getting that burn in your “abs”?

If you sit (prolonged static forward bend) or you lift (repeated forward bending) at work then you go to the gym and do a bunch of ab-burning sit-ups you may be setting yourself up for some bad back pain and even worse – disc herniation.

Lets see who's disc we can blow out first!!!!

Craig Liebenson is one of the leaders in spine rehab, dynamic stabilization, and strengthening.  He has a great new book titled: Rehabilitation of the Spine – A Practitioner’s Manual.  It displays an overflow of his own expertise/knowledge as well as material from other experts in the field.  In chapter 5 written by Dr. Stuart McGill mechanisms of back injuries are discussed.  To put it in perspective McGill, Liebenson, Porterfield and DeRosa would probably be on the Mt. Rushmore of spine research and rehab (if there was one).

In this chapter McGill made it very clear that “classic disc herniation” apparently develops related to repeated flexion, side bending, and/or twisting motions.  Furthermore, he pointed out that repeated forward bending/flexion with only a moderate load associated can do the trick!  In other words it sounds an awful lot to me like the exact movements that McGill points out as dangerous and damaging to the spine/discs are the exactly what many people do for “abs” at the gym everyday!!!

We already know that sitting with bad posture, repeated flexion, twisting, or bending are all BAD for the structures in the low back but somehow this doesn’t stop many people from religiously following a daily schedule similar to the following:

7:00 am – wake up and sit with bad posture to eat breakfast

7:15 am – get in the car and sit with bad posture all the way to work

7:45 am – get to work and park as close to the front door as possible take 30 steps to our desk and sit with bad posture for the next 8-10 hrs (a few breaks for bathroom, food, and do some office banned text messaging – with bad posture)

5:00 pm – get back into the car and sit with bad posture all the way to the gym

6:30 pm – workout including 85 million sit-ups

7:15 pm – get back in the car to sit some more with bad posture

7:30 pm – get home to sit and eat dinner with bad posture & watch some TV with even worse posture

10:00 pm – go to bed (many people sleep in horrible positions of prolonged forward flexion or twist)

So what should you be doing instead?  Well for starters try being more aware of your posture if you MUST sit.  If there is any way to limit your sitting to brief periods then do it!  When you are sitting don’t find yourself in a slumped over sloppy posture – clean it up!  The following pic might be a bit extreme but at least she’s trying:

I wouldn't take it this far......pretty impressive though!

Try avoiding traditional sit-ups that our gym teacher taught us how to to do 85 years ago!!!  Switch in a few planks, side planks, or even a one sided farmer’s walk – this will add some stability to your lumbar spine, strength to your “Core” and take some pressure off of your discs.

References:

Liebenson, C: Rehabilitation of the Spine: APractitioner’s Manual.  Baltimore: Lippincott Williams & Wilkins, 2007.

Porterfield, JA and DeRosa, C:  Mechanical Low Back Pain.  Philadelphia:  Saunders, 1998.

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2 Responses to “Things We Already Know: low back (part II)”

  1. […] Rather than ramble on and bore you about how crunches are bad and planks are good, I will just refer you to a few posts from the archives (if you are interested) – Things We Already Know: low back Part 1 & Part 2 […]

  2. […] The term “Anti-Extension” simply refers to the idea that the primary muscles being targeted (anterior core/ab muscles) are engaged in order to prevent spinal extension. Read this post from the TDAE archives to understand why repetitive/forced spinal flexion is ALL-BAD!… […]

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