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
The Effect of Graded Activity on Patients with Subacute Low Back Pain:
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The Effect of Graded Activity on Patients with Subacute Low Back Pain: A Randomized Prospective Clinical Study with an Operant-Conditioning Behavioral Approach
PHYS THER. 1992; 72:279-290.
Lindstrom, Nachemson , peterson, Ohlund wallin
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Alf Nachemson: read it here
A great interview with Alf Nachemson ! Download and read the PDF
6 muscles of the back are functionally different from limb muscles
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
Do you slump?
I fix the backs of sedentary people and of several elite athletes, also middle range Crossfit athletes.
One thing Ive notice about those with bad backs is their ability to push themselves beyond the call of duty. In fact they have the reputation of being hard workers, motivated and always on the go!
The reality is , once the doors are closed, they can head for the settee and slump. For hours!!!! They can happily stay in bed if allowed, and they can be very , very lazy.
Hard ( some would say obsessive) work can sometimes be matched by back destroying activity elsewhere.
The twist. Is it deadly.
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.
THE BIG THREE
Im always promising my back pain clients that I’ll publish guidance notes, especially about the exercises you should do at home.
Here are the Big THREE.: Curl-up, side bridge and the bird dog. Aim for endurance.
AndrewStemlerBackaholicNotes.Big3
Its really worth while buying the McGillBooks
Low Back Disorders
back tuck.
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
The recreational gymnast
I was waiting with one of my ( very patient) gymnastic coaches to train in the corner of a club that I don’t often go to. We were watching a class . It was “alright” . Nothing spectacular, but nice. The interesting thing, was the dialogue from my coach. “that poor bitch ” ( referring to the coach) “Everyone starts off like this. Dumped with the recreational gymnasts” .
Gymnastics is a unique sport, Id almost say its the nearest thing to spiritual dedication that there is. ( Btw any physical activity that claims to be spiritual, isn’t. Mastery of static poses, yoga meditation etc is easy peezy by comparison. It takes work, sure , but sitting on your bum navel gazing is a lot easier than tumbling). It is also based on principles of selection. To be successful you need certain natural flexibility and , the ability to throw yourself backwards onto your hands. While Long Term Athlete Development concepts suggest the later starting of dedicated sports, gymnastics is the exception. Get in their early and specialise if you want to be any good. But here is the reality. If you go to gymnastics for 3 hours a week , you are classified as recreational. I think you have to get yo 6 hours a week before people treat you seriously.
This isnt’ a criticism of gymnasts, more a plea to adult learners to moderate their learning targets . In gymnastics even the most basic skills are hard and difficult to master.
Dont rush at the skill
I think, sometimes, both us and our trainers rush at the attempting the big skills without the underpinning conditioning and understanding; Often conditioning is seen as some unrelated activity. In the great bar video, you can clearly see, for example, how the dish is progressed to assist the understanding of the circle