Why strengthening could be the answer to your back pain

The two most common questions we’re asked here are ‘why does my back hurt?’ and ‘how can I stop my back hurting?’  Now, of course we don’t claim to know the answer to everyone as there are many causes of back pain but a common factor linking chronic low back pain is insufficient strength in the lumbar (low back) musculature.   Researchers at the University of Florida proved that most of us were walking around with our lumbar muscles in a chronic weakened state, even those of us not suffering from back pain.  When back pain sufferers were studied, they were found to have even weaker lumbar muscles.  These weakened muscles are identified as the root cause of low back pain. 

So, how do we strengthen these weakened muscles?  Simple-through Progressive Resistance Exercise (PRE), or exercising a muscle group against a resistive force which increases over time.  Studies prove that PRE can strengthen low back muscles and reduce low back or pelvic pain.  One study reported that patients who had taken part in a PRE program had a 30% recurrence rate of back pain, compared to 80% of those who did not exercise. 

The tricky bit is ensuring the isolation of the lumbar extension muscles to ensure effective testing and strengthening.  The lumbar extensors work with the hamstrings (at the back of the thighs) and gluteal muscles(that make up the buttocks) to rotate the pelvis backwards.  To prevent these more powerful muscles assisting the lumbar muscles, pelvic movement must be prevented through pelvic restraint. 

Muscles used during lumbar extension exercises without a pelvic restraint


Muscles used during lumbar extension exercises using the MedX machine


Right, we’ve got this far, so how do we restrain the pelvis?  In 1986 a lumbar extension machine was developed by MedX specifically to test and exercise the core and lumbar extensors.  Since its development, there has been a lot of research using this equipment published in medical journals (to see some of this research click here).   As you can see in the image below, the machine stabilises the pelvis through knee, thigh and pelvis restraints.  

The pelvic restraint system on the MedX Lumbar Extension machine



The MedX machine is used for PRE.  The therapist is able to measure progression through tracking repetitions and monitoring resistance.  

MedX have recently secured a contract with the US Military to provide rehabilitation and prevention services to US personnel in Iraq and Afghanistan.  Only 13 per cent of service members who left their units because of back pain were returned to duty and treating active duty and veteran personnel for back pain is estimated to cost $1 billion each year.  News of this contract is great as it gives further weight to the fact that strengthening is often the key to reducing back pain. 

As far as I’m aware, there are only 4 MedX lumbar extension machines in the UK, though they are widely used across the States.  Although the lumbar extensors can be strengthened most effectively through pelvic stabilisation, you can help yourself in other ways by strengthening the deep abdominal muscles which will go some way to helping with mild back pain.  Enrolling yourself in a Pilates class will teach you how to identify and strengthen your core, as will exercises done on a gym ball.

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One Response to Why strengthening could be the answer to your back pain

  1. Pingback: Back Pain and Beyond

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