Monday, March 10, 2008

Common exercises and machines to avoid

Individuals often come to the clinic and describe what they see and are instructed to use as exercise training techniques. Occasionally the design of some machines can be quite stressful, particularly to the spine.

There are a number that I would classify as higher risk. Which means basically that the exercises might be more irritating than beneficial. Exercise training of any sort, can no doubt aggravate - muscle stress, overuse, tendon inflammation. Beyond this, some types of training should be avoided or techniques modified. For most of us, the focus should be on endurance not generating high forces by moving large amounts of weight. This is particularly true regarding the lumbar spine. Ensuring there is a balance between abdominal work and extensor muscle work is critical.

Many active participants in a variety of sports do quite a few sports activities and never have any problems but, the movements are potentially stressful nevertheless. One should not make the assumption that because you always did a certain exercise and never had a problem, that the exercise was or is stiil safe. It could be you were just lucky.

Here are a few exercises to be careful doing and you may consider avoiding them all together:

Lat pull - if you are going to use the bar and machine pull the bar to your chest. Avoid bringing the bar behind your neck.

If the bar is pulled behind the neck, which is still common, the cervical spine can be excessively forced into flexion.

Good alternative

Others to keep in mind:

Military press - for some reason this is a very common part of circuits given to a wide range of participants in a number of gyms. The difficulty is that the average person places a substantial amount of compression through the lumbar spine. If your goal is to help reduce your back pain by becoming more active and fit - avoid this one. If you like to use free weights, use them individually and raise arm into forward flexion but keep the back well aligned.

Toe touches - the sun salutation uses a variation of this called the forward bend, but if you think you may have disc irritation or this is a completely new movement/exercise - pass over this part of the sequence. If you are attached to this movement, at least bend your knees and hips to reduce some of the stress. As a general rule be extra cautious in the morning, since this is the time the discs are fully rexpanded, after lying all night and the pressure of standing has been removed. This would seem contradictory to the yoga concept of doing the sun salutation early in the morning. Keep in mind the traditional yoga practitioners were Indians who, up until recently were not plagued with disc problems like us in the west. If you wish to do the sun salutation with the sun - get up an hour early and let the disc pressures normalize at least partially. Substitute with a few tai chi moves - forward step or side lunge.

Abdominals - While on your back practicing mini crunches or lying on the ball don't place the hands behind the neck; if you are weak in the abdominals you will inadvertently place a lot of force on the cervical spine soft tissues including the disc joint complex. Consider keeping the neck supported, in line with the chest. Aim to bring upper chest, head and neck all off the floor at the same time. Only enough to put a small bit of space between shoulder blade and floor. Another alternative, keep the neck supported and tighten the abdominals by moving the hips/knees, like a bicycle.

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