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| May 2007 |
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| Posted Jeff Biehl Lower back pain is one of the most common causes of job-related disability and why some people miss work. It is also the second most common neurological ailment in the United States, second only to headache. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain. For some fortunate people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, during which case the condition is termed as chronic and progressive, meaning it can only grow worse over time. Moreover, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year. According to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are reflexively inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if people do not feel pain and are able to return to normal activity levels. In a recent article in Sports Injury Bulletin (SIB), Owen Anderson discussed research that showed how important it is to have good strength endurance of the spinal muscles. Specifically, the Erector Spinae and Multifidus muscles need to be able to hold the spine stable. A common exercise for strengthening these muscles is the back raise (see picture A). The problem with this exercise is that the spine compression forces are actually over 6000 N, which is very high and completely unsafe for any patient recovering from a low-back injury, (McGill, Low Back Disorders, 2002, Human Kinetics). A safer alternative is the 'Alternate Superman' performed in a kneeling position (see picture B). The compression forces are 2000N, which is tolerable, but the spinal muscles are still recruited. Because the opposite arm and leg are activated in turn, the left and right sides of the spine are worked alternatively. There are actually four sections of the spinal muscles: Thoracic left and right and Lumbar left and right. When the left arm and right leg are raised, the right Lumbar and left Thoracic muscle areas are working and vice versa. Hence to get an effective training benefit you need to either hold each position for significant time, or complete lots of repetitions. Raphael Brandon recommends starting with three sets of 30 seconds holding each position, building up to three sets of 60 seconds. Be sure to hold a neutral posture during the exercise as your leg extends back and arm raises forwards, which encompasses the head, upper, mid, and low back. The challenge is to stay aligned and balanced with only one hand and knee on the floor. Jeff Biehl, Fitness Director Memorial Athletic Club |
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| Picture A | Picture B - 'Alternate Superman' performed in a kneeling position. |
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