The relationship of lumbar flexion to disability in patients with low back pain, by M Scott Sullivan , Lisa Donegan Shoaf and Daniel L Riddle (Physical Therapy March 2000 vol. 80 no. 3 240-250)
is an interesting study
method
Patients completed the Roland-Morris Back Pain Questionnaire (RMQ), and the therapists assessed lumbar spine flexion AROM (active range of motion) using a dual-inclinometer technique at the initial visit and again at discharge.
Conclusion
Measures of lumbar flexion AROM should not be used as surrogate measures of disability. Lumbar spine flexion AROM and disability are weakly correlated, suggesting that flexion AROM measures should not be used as treatment goals.
Free full study here. it “sort of” breaks the link between spine mobility and future back trouble.
The study also draws some very interesting observations about therapist biases
As always, this gives us another crop of references to follow up
Im not sure that I agree with some of her therapies, but I was sort of brought up with this book
Get the PDF here
A great interview with Alf Nachemson ! Download and read the PDF
Limb muscles create movement, torso muscles create stability.
The simple act of walking requires spine stability. There are no agonists and antagonists in the torso they are all required to stabilise force generated elsewhere in the body.
If your therapist treats your core muscles in the same way as limb muscles, they are simply going to extend the pain in your back
Elite performers generate force in their hips, and it is transmitted through a stiffened core.
Spinal Control: The Rehabilitation of Back Pain: State of the art and science
edited by Paul W. Hodges, Jacek Cholewicki, Jaap H van Diee
Several researchers have suggested that twisting of the trunk is associated with low back pain. the 1st issue we need to deal with is to distinguish the idea of twisting from generating twisting torque.
Torque in the torso can be achieved whether or not the spine itself is twisted.
In general moderate twisting isn’t dangerous. over the years the debates have included twisting quickly and breaking the speed by hitting the end range of motion, back in 1970, Farfan suggested disc twisting could damage the collagen fibres in the annulus, especially if a neutral arch had been lost. Other reports say that twisting is less dangerous as the facet forms a mechanical stop , thus its the facets that can get injured.
What is Twisting torque? Imagine a twist that applies or transmits force!.As no muscle is designed (as a primary function), to create twisting torque all muscles are contracted, this increases compressive load. 50nm of extension, creates 800 newtons of spinal compression.
Generating high torque, when the spine is twisted is problematic. In short are you twisting… well, Ok! or are you twisting through your spine to load up an axe swing … probably not so good!
Ill show you in a future “Note” how to generate force through your hips and not through your back. But for now, repeated spine flexion will, according to Aultman et al ( 2005), will lead to discogenic trouble.
I like this video:
clearly you can see full extension of the arms, head stays neutral, and the shoulders only go back when the knees drive them back
I don’t know where to put my foot in the lunge for the round off.
This drill helps me think about where it should go. Notice the wobbling knee,and the physical uncertainty. No wonder I cannot drive power into this position. But still, its a drill I can work on
Damn. This has been added to my target list.
For my new routine, I need this. Its called an Upstart.
Andrew Stemler 