Exercise Therapy to Strengthen the Spine
What exercise should back pain patients perform? A group of scientists called the "Cochrane Group" reviewed 43 randomized controlled trials of chronic back pain sufferers (symptoms lasting longer than 12 weeks). They made the following recommendations. A successful chronic back pain program should contain the following elements:
1) Individually designed and supervised programs
4) Improvement in pain and function
A key component of the Cochrane report is the strong recommendation for exercise and its implications. A supervised exercise program is recommended because it is safe and does not increase the risk for injury. Think of exercise as a tool to increase endurance, flexibility, and strength. Exercise also improves pain, mental status and behavior.
In a systematic review of the literature, James Rainville, MD and other spine researchers reported that exercise therapy in rehabilitation accomplished three important goals:
1) Elimination of impairment by increasing patient function
2) Reduction of pain intensity
3) Reduction of pain related disability
Doctor Rainville's review showed these three goals could be accomplished without increasing the risk for future episodes of back pain.1
Apart from general exercise, strengthening exercise is important to rehabilitation success. The most successful rehabilitation programs understand movement and function require strength. Therefore, such rehab programs make strength training central in their overall treatment plans. Patients who perform strengthening exercise in a supervised clinical setting gain confidence to increase their daily activities when away from the treatment facility.
Strengthening exercise using resistance machines during rehabilitation is helpful because activity levels can be accurately measured. Therapeutic exercise can be likened to a medication, and patients should be given a 'prescribed' dose to accomplish the most in their personal rehab programs. The therapeutic 'dose' of prescribed exercise is best measured in an objective clinical setting. The dose can thus be safely increased with increasing strength.
Strength Training Pioneers
In the United States, Thomas DeLorme, MD was a strength training pioneer for back pain patients. Doctor DeLorme developed a series of Progressive Resistance Exercises (PRE) to rehabilitate injured military personnel. He provided the first results showing the importance of strength training as a rehabilitation tool.2 Other scientists and clinicians conducted studies and reported their findings about the importance of strength training in back pain patients.
In the 1960s, Arthur Jones introduced the first variable resistance exercise machines. This was the first time exercise machines isolated specific muscle groups and challenged them through their full range of motion. Mr. Jones took his ideas further and, during the 1980s, formed a company to specialize in the testing and measurement of back and neck strength and range of motion. His successes lead to the development of the MedX™ lumbar and cervical extension machines. For the first time, MedX™ equipment measured back and neck strength. A distinctive feature of these machines is their unique ability to isolate back and neck extensor muscles. More than 50 published scientific articles prove the value these machines offer in spinal strengthening, increased functional capacity, greater range of motion, and pain reduction. The MedX™ lumbar and cervical extension machines have helped to quantify the importance of strength training in a clinical setting.
Preventing Episodic Back Pain
What about preventing back pain? Strength training is important to build and preserve functional capacity while reducing the risk for future injury. Although the value of aerobic exercise cannot be discounted, strength is the fitness element critical to maintain function throughout life. Regular strength training should be considered a priority to anyone working toward optimal functional capacity.
Cybex® and Nautilus® are exercise machines available at most health clubs and are designed to help maintain a good level of overall strength. MedX™ Corporation has continued to be innovative in the field and created a group of machines used by Core Spinal Fitness Systems™. These exercise machines isolate the back and neck musculature for overall core strengthening to increase function and protect against injury risk.
Do you fall into the group of 85% of people who will experience episodic back and neck pain? You may not be able to avoid back pain, however - the spine strengthening strategies summarized in this article could be your first step toward a stronger and healthier back.