MicroBlog

Controlled trials of exercise for low back pain often suggest that the type of exercise doesn't matter.  And if you love "stability" exercises then these results can really challenge what you think and could even make us expert clinicians feel like we have less "special" knowledge...always challenging to be confronted with this.

In the attached video we look at my daughter who has a lot of spine extension and when she extends this leads to a “hinge” in her lower back.  What is often advocated during spine extension is a gentle and gradual “rounding” that is equal at each segment.

Whether the spine should flex repeatedly and under load is an old debate that we are still having having and we should be having it because I don't think its settled.  I thought it was settled 20 years ago but I should have challenged my biases more.  The basic question is whether you are at less risk for pain/injury if you minimize the flexing movement of the lumbar spine during activities and if minimize the flexed position when lifting heavy. The case to minimize flexion is laid out in this article here detailing how the Canadian Military has removed the sit-up and trumpeted the death of the sit-up. Link here.  I have probably taught 1000s of people to hinge at their  hips and try to minimize spinal flexion during many activities...certainly activities that demand high loads on the spine...But is this right?