Exercising Dangerously

I have been trying to avoid poking the hive but alas I feel its an imperative now. We have had too many patients coming into see us with low back injuries that have precipitated after exercising. These aren’t small sprain/strains either, they’re structural problems that these people will have to deal with for the rest of their lives. I’ll admit, and even adamantly say, that we need to exercise to stay healthy and prevent injuries. But it seems that there is terrible information and training at some very popular and/or trendy places around the country. It is my job not only to help those that become injured but to help prevent them from injury in the first place. In my attempt to properly educate our patients in what they are and are not supposed to do, I’ve met stiff objection, and blind faith in those that have trained them. It must be nice to have subjects professing allegiance to something they do not fully understand.

I will be explaining some physiological reasons as to why no one--yes--NO ONE, should be doing some of these work outs. I can and will reference research as well, but that would be overkill as seeing our physiology is understood fully already. The workouts that I would like to ban are as follows: over head squats, Romanian dead lifts, good morning stretch or workout, and Roman chair extensions. All of these workouts have a common theme: trunk flexion. There is something called the flexion/relaxation phenomenon. When we break 70 degrees of flexion our trunk stabilizer muscles such as: quadratus lumborum, psoas, and multifidi, turn off. Our large locomotor muscles: gluteus and biceps femoris, turn on. Essentially, we are relying on our structure not muscle to support us.

This is where we damage discs and ligaments as this is where most of the force is absorbed. Once the damage is done our neurological recruitment changes. Our spinatus muscles, which are small muscles that run from spinous to spinous, act like transducers to tell our brain how much tone is to be applied to larger muscles to protect the lumbar spine. It has been proven that after trunk injuries and/or chronic pain is perceived in area of the lumbar spine this neurological mechanism fails to be accurate. Absolute proper form must be performed in order to achieve what these workout are designed to do. But when we exhaust our muscles we tend to recruit improper kinetic chains which result in injury. It is easy to observe proper form but not to know for certain which muscles are being recruited without a needle EMG. That is to say, why don't we eliminate the potential for failure before we start. There are, however, useful exercises for the core and lower limbs which can prevent injury that do not involve truck flexion. Most do not require an enormous amount of weight and they can be incorporated with other exercises. I believe we keep these large lifts around as a way to measure up or compete with one another. Some of this has been reinforced culturally and some has been instilled with a cultish power that is beyond my comprehension.

I understand our goals can differ from another but we all should have safety and accurate teaching as guidelines. Once passing this information on, I receive staunch unsubstantiated rebuttals. I’m still waiting for a decent argument regarding heavy trunk flexion workouts. My purpose for this is to stimulate and inform. I challenge anyone reading to do the research and to question the safety of the exercises that you perform. I would urge everyone to check credentials of any trainer that is in charge of your work out, and to make sure they have a qualified background to guide you. A weekend seminar and piece paper is not sufficient to properly understand and protect your health and well-being. - See more here