AVOID A BACK INJURY THIS SPRING

I see them everywhere - digging, planting, raking, trimming, mulching - it's that time of year! What do these folks have in common? (Besides being more industrious than me of course!) They are bending and twisting!

The preponderance of evidence is clear - improperly performed repetitive activities such as is common this time of year can accelerate degeneration of the tissues of the spine. This early degenerative cascade leaves the spine vulnerable to injury and in many cases; improperly performed bending or twisting is the direct cause of injury.

While you may not be able to avoid the occasional sore back you absolutely can prevent serious spine insult, misery and missing out on all the great weather by following a few simple guidelines. The old saying is true - “An ounce of prevention is worth a pound of cure” – 

• Never bend lower than your fingertip level. Become a squatter!
• When you do bend do not bend the spine, bend from the hips. That's right - Butt Out and Head Up!
• Do not reach more than arm's length from your body without supporting your thighs or by bracing your spine with your hand.
• Maintain your flexibility at the hips and hamstrings.
• Strengthen your core body.
• Drink lots of water and don't smoke - hydrate, don't choke your discs

If you are unfortunate enough to be one of the 8 out of 10 people who have already had an initial acute back injury, working your deep core is critical in preventing recurrences. Research indicates that up to a 25% atrophy and reflex inhibition occurs within the deep segmental stabilizers of the spine.

This is a similar process to what occurs to the quadriceps muscle with an acute knee sprain. The difference is that we rarely think in terms of re-education for the back muscles - however, if these muscles are not rehabilitated early after the initial inflammatory period there is a 78% recurrence rate in back pain!

This huge recidivism rate is completely unnecessary as well as costly. Traditional strengthening of the global superficial trunk muscles alone cannot substitute for the fine motor control of the deep stabilizers and results in movement rigidity, excessive superficial muscle activity and unchecked segmental motion which continues to degenerate the spine and leave it vulnerable.

Make sure that any spine rehab in the acute or sub-acute period (between 1 and 8 weeks post injury) includes:

• A thorough assessment of the motion and position of the spine segments
• A movement based approach to rehab - self-treatment versus passive modalities
• Re-education of the deep core stabilizers
• Body mechanics training to focus on alignment, base of support and weight shifting