Monday, June 3, 2013

Don't Let Low Back Pain Sideline Your Workouts!


Low back pain (LBP) is one of the most common musculoskeletal injuries active Americans face today.  It is the number one work related disability in those under the age of 40.  It is also the third most prevalent orthopedic problem affecting those who exercise.  This can lead to extended time out of the gym which can have a big impact in your ability to reach your fitness goals. 

What do we know about low back pain?
Current research indicates that 80 percent of the population suffers from one form or another of LBP.  Of those, 65-85 percent have had a recurrence of LBP within two years of the initial episode.  The implication is that either our understanding of the complexity of the system is not well understood or that we are not educating patients well enough in prevention types of programs.  Currently, LBP accounts for 14.3 percent of new patient visits to their primary care physician and is considered the second to fifth most common reason for someone to seek medical attention. 

Training for Prevention
When training to prevent LBP, there are several things to keep in mind.

  1. Stability is complex.  Stability of the spine and prevention of LBP depends on the interaction of more than 30 muscles.  It affects the entire system, from your feet to your core.  Weakness in one link can result in misalignment of the system and add to wear and tear of the spine.
  2. Balance plays a critical role in stability of the spine.  Current research shows that those who lack stability or balance during dynamic balance activities are more likely to suffer from LBP than those who are more stable.  This is especially more prevalent in those who are participating in athletic activities.  In our research study, we looked at more than 400 athletes and found a high correlation with lack of balance with an increased incidence of low back pain.
  3. Pain results in weakness.  Research show that pain results in a 25 percent decrease in strength of muscles important to stability of the spine (multifidus).  This same study show that if you do not strengthen this muscle, it does not return to it’s previous level of strength.  So, you have to strengthen your back to keep it strong, not just when you are having pain.
Remember, proper core stabilization is an essential part of preventing LBP. 

Don’t let low back pain sideline your workout! Working with your certified instructor or personal trainer, you should be able to develop a program that keeps you in the game. 

About the author: Trent Nessler, P.T., D.P.T., M.P.T., is a physical therapist and CEO/Founder of Accelerated Conditioning and Learning. He is the researcher and developer of the Dynamic Movement Assessment™, author of the textbook Dynamic Movement Assessment: Enhance Performance and Prevent Injury, and associate editor for International Journal of Athletic Therapy & Training.

References:

  1. Deyo, RA.  Practice variations, treatment fads, rising disability: Do we need a new clinical research paradign?  Spine 1993; 18: 2153-2162.
  2. DeRosa, CP; Porterfield, JA.  Mechanical Low Back Pain: Functional Anatomy and Treatment Perspectives.  Saunders. 1993.
  3. Frymoyer, JW.  An overview of the incidence and cost of low back pain.  Orthopedic Clinics of NA 1991; 22:262-271.
  4. Frymoyer, JW.  Epidemiological studies of low back pain.  Spine 1980; 14: 419.
  5. Hides, Julie A. PhD; Richardson, Carolyn A. PhD; Jull, Gwendolen A. MPhty. Multifidus Muscle Recovery Is Not Automatic After Resolution of Acute, First-Episode Low Back Pain. Spine. 21(23):2763-2769,1996
  6. Leetun, D. T., Ireland, M. L., Willson, J. D., Ballantyne, B. T., and Davis, I. M.: Core stability measures as risk factors for lower extremity injury in athletes. Med. Sci. Sports Exerc. 36:926-934, 2004. 
  7. Zazulack, B; Hewett, T; Reeves, P; Goldberg, B; Cholewicki, J.  The Effects of Core Proprioception on Knee Injury : A Prospective Biomechanical-Epidemiologic Study.  Am J Sports Med; 35:368-373.
  8. Zazulak, B, et al.  Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk:  A Prospective Biomechanical-Epidemiological Study. American Journal of Sports Med, Vol 35, No.7, 2007

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