Discs Mechanics & Dr. Adam’s Interview

Disc mechanics are frequently discussed in rehab exercise particularly principles of loading or unloading the spine.  Previous posts have discussed Professor Stuart McGill’s work and the advice that most people with back pain or at risk for back pain should likely avoid repeated, loaded end-range flexion, such as avoiding sit ups.

Recently posted on myrehabexercise.com is an interview with Mike Adams, PhD discussing his research on discs.  I’ll let you read Dr. Phil Snell’s interpretation of his interview and listen to it for yourself.  Adams Interview

Normal (left) & Degenerated (right) discs

The summary I will leave is simply this:

  • Continued research and thoughtful challenge to current thinking is always necessary.
  • We need to be careful in taking things that may be beneficial in late stages in appropriate cases and generalizing it to the public or average back pain patient.
  • Joints have a neutral zone, not just a neutral position.
  • Judicious assessment and monitoring is necessary before and while attempting higher load and higher risk positions and exercises.  [Read: Individual assessment by a skilled rehab specialist]

Hate sit ups??? Perfect, stop doing them….

We’ve been doing sit-ups for decades to strengthen the abs and protect the back. While there is truth to the fact that core strength (and endurance) is protective for the low back, the best way to train this is still debated (or at least not widely adopted).  It is not uncommon to see people in many gyms or even elite athletes doing sit ups and leg lifts.  But commonality does not mean it is correct.  Professor Stuart McGill of the University of Waterloo has taken the effort to quantify the load placed on the lumbar spine and disc during many of these common exercises.  It has become very clear that sit-ups, crunches, leg lifts, and many other common ‘abdominal/core’ exercises have unsafe back loads and are likely more harmful and injurious than they are protective.  We need to move beyond the idea of training the abdominals to simply look good at the beach or pool and start doing better core training.

This is discussed in a NY Times article on Core Myths.  Please read the short article.

The obvious question then becomes what exercises should I be doing, if sit ups and crunches aren’t ideal.  McGill has popularized his Big 3 and has research to support their effectiveness in activating the core as well as showing lower spinal loads during the activity.  The Big 3 include:

  1. Side Bridge
  2. Bird Dog
  3. Curl Up

As with all exercise proper form is essential.  Without proper form the exercise is not as effective and more likely harmful.  If you have questions consult a competent health care or exercise professional.  [Looking for one?  Try searching the ISCRS website]  To view these exercises, and another challenging core stability exercise called ‘Stir the Pot’ view this 3 minute video. McGill- Core Values.