Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)
In the last few years I learned a new term, “strawman argument”. What does THAT mean? I like this definition “A strawman is a fallacious argument that distorts an opposing stance in order to make it easier to attack. Essentially, the person using the strawman pretends to attack their opponent’s stance, while in reality they are actually attacking a distorted version of that stance, which their opponent doesn’t necessarily support.” Of the most common examples I have come across is discussing is rounding the low back okay or not.
The strawman argument people will often say how out of touch most of the therapy and fitness world is by not allowing people to round their low back. That the idea that we can hurt our low back by rounding is just a fallacy that is made up and actually can hurt people with low back pain. You may have heard this one, but what makes it a strawman argument?
For one, no one has ever said you can not round your low back. Well, that isn’t completely true, if you are post-surgery in the first 3 months have a low back procedure you have probably heard this for good reason. However, overall, this is not something that is said by anyone of note in the therapy or fitness arena. In fact, I use the toe touch as an assessment for my patients.
I am not just looking to see what their hamstring flexibility is like, but I am looking to see IF they can move through their low backs properly and do they have any guarding? There are people that won’t move through their low back in the toe touch and use excessive flexibility through their hamstrings to accomplish the goal while others will just fall way short of touching their toes because they aren’t moving through their low back. This isn’t a hamstring issue, but we still need to know why they are falling short.
Of course, the misunderstanding of such a situation is that we need to round our low back MORE if we aren’t able to move through the low back. That isn’t necessarily true. Many people have their nervous system guarding this movement for a variety of reasons. In fact, I find that many people with excessive movement in the segments of their low back (which is common and I’ll describe in a moment) are guarding in the movement because of the instability poses a risk to their bodies.
How do you know if it is guarding? Many times I will have someone in the toe touch try to relax as much as possible and take a few deep diaphragmatic breathes in the position and see if they gain more range of motion. I would say 99% of the time they do, which indicates their low back CAN move, but their nervous system is scared about there being an issue in ALLOWING the low back to move this way.
The Myth Of Spinal Segmental Mobility
Many times when I hear people promote training of deliberately rounding the low back in exercises, they will say something along the lines of, “building better segmental mobility”. Firstly, is this something we even want? Research actually shows us that those with low back pain have often TOO MUCH segmental movement.
“Many therapy approaches have the objectives of strengthening muscle and increasing spine range of motion. This is problematic (Parks et al, 2003) since those who have more motion in their backs have a greater risk of having future back troubles” (Designing Back Exercise: from Rehabilitation to Enhancing Performance)
You can see in the above study that those with low back actually had MORE movement of their low back segments than those with no pain. That means most people with low back pain need more STABILITY, than mobility. Therefore, if you are trying to improve spinal segmental mobility that just seems to be missing the solution for people with low back pain. Also, we have to discuss the idea that we know people have challenges performing foundational movements like squatting and hip hinging, but we think they have the body awareness to be able to move L3 and not L4? That sounds like a big leap to make!
What SHOULD we be focusing on with spinal stability then? We have some great options in our DVRT system.
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Isn’t NOT Moving Is What The Experts Say?
This is another myth about low back health that gets thrown around a lot. Literally NO ONE has ever said do not move your spine. What people HAVE pointed out is that we need to be aware of who is moving their spine, when they move their spine (for example the morning can predispose people to issues because the discs are not as hydrated), and do you move your spine under load or not.
One of the biggest considerations is knowing what one’s tolerance and capacity is for spinal flexion. That basically means how much can one tolerate of the movement before issues start to arise. While there are many that will claim this can be improved by doing MORE flexion, the truth is we also have structural considerations to take into account that are difficult for the average person to measure.
As renown spine expert (also often misquoted), Dr. Stuart McGill points out…
“I have been misquoted along the lines, “McGill states that XXXXX bending cycles cause disc herniation”. There is not a single number – it is a variable. Many variables influence the rate of the herniation process. For example, the shape of the persons disc influences whether the herniation will be focal (Yates and McGill, 2010) and responsive to McKenzie types of rehabilitative exercises, or not (Scannell and McGill, 2009). These responsive discs are predominantly limacon‐shaped. In contrast, ovoid discs survive twisting cycles better. The thickness of the spine also influences the rate of gradual herniation – thicker spines have higher bending stress and herniate faster with flexion cycles. For example, a NFL linebacker must have larger diameter discs to survive the compressive loading, but these same discs will not do well performing a 1000 situps. In contrast, it has been pointed out to me that there is a fellow in Brazil on Youtube who does 1000 situps everyday, implying by logical extension that I must be in error. But you will notice that he has a very slender spine so the bending stresses are small.
But his thin spine would not survive the loading of a single NFL game. These elements of biological variability preclude the recommending of an exercise approach simply because it was tolerable by another individual. Further, time of day influences the rate of herniation. After rising from bed, the disc nucleus’ are fully hydrated and have much higher stresses during flexion. It is more risky to train repeated bending earlier in the morning. Occupational studies have shown avoiding flexion motion in the morning reduced disabling workplace backpain (eg Snook et al, 1998). Different spines mean different injury mechanisms, different resiliencies to motion, and different training approaches. Choose your parents (disc geometry and thus stress patterns came from your parents), then choose your best way to train!”
The real question is what are you trying to improve with the low back? If you understand how the low back functions then identifying the most effective strategies will become more apparent. Typically, with the low back, it isn’t just ONE thing. We need to improve core stability, hip mobility, as well as lifestyle factors that can impact one’s perception of their pain as well. However, the point is that we can’t make blanket statements that people need to avoid rounding their low back all together as well as we can’t say the focus should be rounding the low back. You need to understand the why’s to avoid the confusion that social media is so good at creating.
That is why I have series like those below that help people understand what we need to focus upon and how we build layers to better solutions of training.
We have BOGO back where you can get any Ultimate Sandbag, educational program, or workout program and get a second of equal or lesser price for HALF off! Just use code “bogo” HERE
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