Lifting with a rounded back as a physical therapy exercise..

akaidan
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Lifting with a rounded back as a physical therapy exercise..

Hi there!

In the last few months I have had a flair up of an old S1 L5 disk compression injury and I have been reading your book and having slow but steady positive results from the exercises. I also decided to start a back strengthening program called SpineX at the Essentia Health Clinic in Duluth Mn. I am happy with this program for the most part but there are one or two sticking points that leave me unsettled and I wanted to ask your advise. The first day I was having a particularily bad back day and we came to an exercise that consists of lifting a metal crate with varrying weights off the ground and onto a shelf repeatedly. I started doing the hiphinging that I have come to know as a healthy way to lift objects but I was told specifically to lift with a rounded back in order to "get the small muscles of the back to fire". Intuitively I knew this to be a bad idea but I tried it that first day and of course later that day I couldn't walk or move or drive ect...which is almost the worse my back has every been. (They said soreness is normal - but I'm not sure total debilitation is) It took me almost a week to recover and I returned still interested in giving the overall program a go but determined to not repeate the lifting mistake. Since then I have done a little more research on the pro's and con's of lifting with a rounded back during training (they don't advocate doing this for lifting heavy objects). Their reasoning is a somewhat obstinate repetition of; "When you do that (hip hinge) and 'lock out' your back you turn off allot of the small tootsie roll muscles along your spine and only engage the long muscles. We are trying to get those small muscles to fire again" When I think about how easy it is to damage your disks and stretch ligaments with even forward stretching (just your own torso weight) It feels more then misguided, it feels irresponsible. Also intuitively I feel like I'm actually turning off more muscles by lifting this way, relying more on the pressure on the front edge of my vertebrae/disks. Am I totally off base here? Is this a legitimate method of "getting the small muscles of the back to fire" if its just during training? Would you be able to provide me with any other resources/ studies that might support your position?

The second red flag was when I asked if they addressed posture at all in the program and in their response they cited a study that proposed posture wasn't as important as once thought because many people with poor posture have no back pain and many people with excellent posture have back pain. This reasoning seems to contain some fairly obvious fallacies (as well as solicit any number of necessary questions) and perhaps its not even worth mentioning but I'd be curious what your thoughts were on the matter and if in your experience this is common thinking amongst physical therapists?

Thanks so much for your time!

I'm bringing in your book to show them next time i go in.

Esther Gokhale's picture
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09/10/2008 - 8:36pm

Ouch! It's one thing to have foolish ideas; it's another to maintain them in the face of damage caused by the foolish ideas. Weightlifiting with a rounded spine is risky business - see Stuart McGill's books for a good additional treatment of the subject. Or check out just about any guide to weightlifting.

The "tootsie roll" muscles (more common names for them: rotatores, multifidus, auxiliary, stabilizer muscles) are best worked as part of the inner corset - making you taller the face of challenges like weight bearing, impact, vibration etc. They're also part and parcel of twists. The use of them and the need for them to be strong would ordinarily match each other.  

Posture not correlated with back pain? Hmmm. Check out the Lower Back Pain section of healthoutcome.org to see what thousands of people's experience of this is. Lastly, no most physical therapists are not so thick-headed on this subject. 

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