Back Pain Treatment

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Welcome to the Back Pain Solutions Podcast – Back Pain Treatment

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Introducing Back Pain Treatment

Without training the muscles around the spine we do not have the resilience we need to prevent injury. We can’t rely on the passive tissues of the body to keep the spine stable. Without an appreciation for the muscles that contribute to spine stability it will be very challenging for individuals who suffer from back pain to make improvements in the long term.

In this episode we discuss the role of the muscles of the body in contributing to spine stability and why it is so important that we understand the different muscle groups involved. Training these supporting muscles is an underutilised approach in the management of back pain, in most cases, so if you want to take back control of your back health you need to learn to control your muscles.

What structures make up the spine and contribute to back pain

We introduce the different ligaments that contribute some stability to the spine but discuss why we can’t rely on them to provide enough support without the muscles around them. With poor control of the muscles comes strain on the ligaments which start to ‘creep’ and become weak. As the ligaments become stretched, and strained, under continued pressure, due to a lack of conditioning of the supporting muscles, that is when other structures become damaged and cause pain. The ligaments help to provide stability when we keep our spines in neutral but they cannot replace the muscles.

There are a number of muscle groups that we discuss when looking at spine stability, some of which may be surprising to the listener. We introduce the different muscle groups in this episode and give an overview of the role they play in providing stability. We also discuss how we should consider training these muscles so they help provide support during the daily activities we perform rather than being trained in isolation for specific movements, which could actually increase the risk of injury, and is why we see so many people with back pain who frequently attend a gym.

When we look at the ‘core’ we’re not just focussing on the abdominal muscles, which, whilst playing an important role, are not contributing to stability in isolation. The core extends from the shoulders to the pelvis both at the front and the back of the body. We need to think of it as a barrel of muscles that we learn control together, as a unit, in order to provide stiffness around the spine. This is what helps provide stability to the spine whilst helping us generate force at the hips and shoulders.

The anterior abdominal wall doesn’t just include the muscles that create the six-pack you see in some athletes. There is a whole layer of muscles that contribute to the anterior abdominal wall specifically, which includes 4 different muscles. All of these muscles contract in different directions so when working together creates a taught band, similar to a drum, around the front of the body. They extend from our ribs, all the way down to the pelvis and extend backwards to attach to muscles in the back of the spine via strong non-contractile tissue. Above this group of muscles are the pectoral muscles of the chest which themselves contribute to stiffness around the spine, and help with shoulder stability as well.

Moving around the back, we have the extensors, which allow us to extend backwards through the spine. There are multiple muscles in the back, some of which extend over multiple segments of the spine and create more movement whilst other smaller muscles play a greater role in stability. Its important when we think about the way these muscles work that we keep our backs in a neutral position because this influences the direction the muscles work. If we break out of a neutral spine position then the muscles will create more compression on the spine, which we must avoid.

One muscle that is often overlooked when we think of spine stability is the latissimus dorsi, the muscle that creates the v-shaped effect within the back. It contributes so much stability because it runs from the shoulder blade, and upper arm, all the way to the low back vertebrae and pelvic bone. It creates stiffness, and strength, along the whole ‘barrel’ of muscles around the spine. Activating the ‘lats’ when doing heavy work provides stability from the shoulder blade all the way to the lower back.

Laterally we have the quadratus lumborum and psoas. The QL runs from the ribs, down the side of the spine, to the pelvis and is a stabiliser laterally (to the side). It helps us stay upright when on one leg. If you imagine for example standing on your right leg, the QL on the opposite side, the left side, would stop your pelvis dropping down and allows you to walk. It is a very important muscle in providing stability to the spine and research shows its active constantly during many activities.

When training these muscles we must consider their role in preventing movement, and not creating it. For example, if we think in purely anatomical terms, we would train the abdominal muscles by doing an exercise such as the classic sit-up. However, this puts a lot of pressure on the discs in the spine and over time can lead to injury. Instead, we want to train these muscles in neutral, doing exercises such as the plank. Here we are working the muscle but the spine does not move. It is this ‘stiffness’ that we want to develop throughout our ‘core’ to help resist movement around the spine. Creating stiffness, and being able to control it, provides the stability we need to move confidently, and prevent injury.

Show Highlights Low Back Pain Exercises

Lower back pain exercises HAVE to respect the spine and focus on the core muscles that contribute to back stability. There are numerous muscles that contribute to back stability and help with injury avoidance and back pain recovery. These muscles can be trained safely, with the correct advice, so you can develop a lower back pain workout plan and commit to back pain exercises at home to work yourself out of pain.

Interview Transcription for …..

Ben James 0:00
When we’re young, we move in freedom and confidence with a great resilience to injury. Somewhere along the line, we’ve developed poor habits and become more vulnerable to back pain. Smart, strong features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better health. So join us as we demystify some of the commonly held beliefs about back pain. build your confidence, stronger back, the smart Welcome back to the smart strong podcast with me Ben James and my co host and good friend Jacob stain. Good morning, Jacob.

Jacob Steyn 0:35
Good morning, man.

Ben James 0:36
So today we’re talking further on anatomy. We’ve talked a lot about disc so far in the previous episode, today we’re talking ligaments and muscles, we’re going to give an overview of the important muscles that surround the spine and contribute to stability of the spine and talk about some of the important functions, but we’re not going to go into too much depth because there’s a lot of muscles and a lot of important points about training the specific muscles. So this is kind of an introductory podcast and then in subsequent podcasts we’re going to focus in on some of those important muscles such as the abdominal wall at the front extensors at the back and focus in on those specifically and on a separate podcast so we can do justice. So, ligaments First of all, if you if you think of ligaments are some of the ligaments in the body provide a lot of resilience to movement such as cruciate ligaments in the knee, it’s often a ligament that people are aware of, in terms of stability at the knee, in the spine, we also have ligaments, bone to bone, non contractile tissue to give stability to those joints throughout the spine. But actually, how much did they contribute to stability in contrast to some of the ligaments in our limbs such as the ligaments in the knee. So, to start us off Jacob, let’s talk about some of the key ligaments, some of the features and the role that those ligaments play in the in the spine. And I think that would be a good place for us to introduce the core and the muscles after we’ve done that,

Jacob Steyn 2:19
So we have, I’m quickly going to name the ligaments, so we have five of them. You probably have to go online and have a look at a picture of these to really comprehend where exactly they are. Yet, just as a brief introduction, we have the anterior longitudal longitudinal longitudinal ligament, we have the posterior longitudinal longitudinal ligament, we have the ligament and Flavin. This is actually a interesting ligament because it actually has more contractile tissue than a stretchy tissue than the other ligaments. So I can actually stretch a little bit and then we have the supraspinatus ligament This is at the back of the bony bits that sticks out which you can feel if you run your fingers down the back. And then we have the interest spinors ligament, which runs from one vertebrae to another. And I have to say these ligaments cover a lot of the vertebrae, so it gives a lot of stability to, to the, to the vertebrae, when we remove the function of the muscles. So that’s the point here and that’s what Ben was saying about the knee and about the cruciate ligaments providing a lot of stability in the knee. The ligaments in the back, interestingly enough, don’t actually are not actually relied on as much when we cooperate the muscles so the muscles give real stability to the back into the spine, where the ligaments are really asked to help out when we lose that neutral spine and we lose the the musculature doing the work. Then we go into the function of the delivery. And that’s something that we’re going to discuss a little bit more.

Ben James 4:03
Yeah, and I think, you know, like you say, if we remove the muscles, and you put only a small weight on the spine with the ligaments in place, it doesn’t take much for the spine to buckle. And and what I mean by that is kind of collapse effectively. So once the ligaments do provide some stability, if you take away the muscles, your resilience would be very, very low, your tolerance will be very, very low. But what is important to say is, when we’re in those sustained poor postures, like those poor seated postures or flexion, as we’ve kind of reiterated in a lot of these podcasts, you’ll start to put strain on these ligaments, and those tissues can then start to creep and that’s they start to kind of stretch and they do have a lot of appropriate active function as well that kind of joint to position sense. That’s another feature these ligaments in terms of The joint position of those vertebra in trying to tell the body and feedback to the body that actually the postures that we may be in aren’t suitable.

Jacob Steyn 5:13
And then I want to mention too, that when you sit down, you actually, if you sit down for a long time, you lose the communication between the brain and the muscles. So in that sense, we’re actually removing the function of the muscles. And then we start relying more on the ligaments. And that’s when we get what Ben mentioned, the creep effect, that’s where we get the ligaments too. And also the disc in between the vertebrae to deform. So we get the stretch effect. And that’s exactly what we don’t want. To a certain extent we we don’t we can handle and cope with that. But we’re talking about prolonged periods of sitting having this effect on the on the ligaments, this unwanted effect.

Ben James 5:54
Absolutely. And some of these ligaments, for example, the anterior longitudinal in the posterior Machine all day run. And so until your knowledge, you know, for example, runs right the way down the spine at the anterior aspect of the vertebra, so right the way down whereas some of the other ligaments, ligaments and flavor and they, they are in between two vertebra, so they attach laminator lamina, for example, and then the super spine is ligament, right the way down the back of Jacob says are there, those spine is processes those, those bony prominences that you can see when you look at somebody from behind you, you can see their spine and someone athletic for sure. And that’s where that ligament goes. And that one particularly helps to resist that flexion again, but in the absence of muscles, there’s very little your ligaments are going to be able to do to resist movement and help keep that spine neutral and healthy. The other the other reason that we don’t dwell too much on the ligaments, we know that they can be affected by poor, sustained postures, and we know that they can provide some feedback in terms of pain, certainly pain sensitivity and discomfort, but they’re not structures that we can actively train. So yes, by being in a better posture, you’re putting less strain on those ligaments potentially over the longer term. But we can’t actually train those structures. Breathing is important to make the awareness for the listener that that the ligaments do play a role and we can affect them and an impact them. Certainly through trauma, but again, through sustained poor postures, but in the absence of those muscles, the stability of the spine is very, very low.

Jacob Steyn 7:42
Exactly. So the I think the take home message here when we talk about the ligaments is that we want to rely as little as possible on the ligaments. So we want to avoid poor, poor sustained posture. Also something like picking up something Heavy from the ground with without the neutral spine where you’re hanging your back. This is giving all the work to the ligaments, we want to avoid this, we want to give as much work to the muscles as possible. That means finding out where is the, the nice lumbar curve that you’re back enjoys and where you’re the strongest at maintaining that through the use of the muscles, and then lifting something off the ground. Similarly, when you’re sitting, maybe sitting in an active position is going to be better than actually just slouching and hanging through and giving all the work to these, these soft tissues.

Ben James 8:37
Absolutely, yeah, absolutely. And with that in mind, you know, the, the muscles and a good analogy is, you know, for anyone that’s ever been camping, if you imagine trying to put up a tent, without the guidelines or out pegging in that 10 then it’s gonna fall over. And so think of the muscles as the guidewire to the spine. Okay, and what are the important muscles. So we’re going to talk about the kind of groups of muscles that contribute to core stability. And some of the links between these different muscles and some of the muscles, possibly, for those that have a bit of an awareness of anatomy might be a bit of a surprise in terms of their contribution to stability at the spine, and certainly, as we progress through to athletic performance, significant impact in terms of stability. And then what we’ll do is focus in on some of those muscle groups in subsequent podcasts to really give some key messages around those muscles, and around the exercises that we want to be looking to do to really challenge those muscles, specifically insurance which is the key but in a safe way, because that’s the important thing, training the muscles in a safe way to keep this by a new tool to ensure that we don’t impact on our spine health and increase our risk of injury, but train the insurance of those muscles. So our guide wires are really, really effective. And we’ve got that stiffness. So, good place to start is in an area where people are going to be more familiar, which is Jacob, the anterior called anterior abdominal abdominal wall. Exactly, exactly. And most people will think of that as the classic six pack.

Jacob Steyn 10:32
Yeah, so shall we look at the at the muscle groups that do it consider. So if I mentioned the muscle groups, we have the abdominal wall, as Ben just mentioned, and that’s made up of the rectus abdominus. That’s the six pack in the front, and that’s joined on the side by three muscles, the transversus, which runs in a horizontal fashion. Then we have next to it we have the internal oblique. And then next to that we have the external oblique. So we have three muscles layered up as a sheath running over each other. And they they, interestingly enough, they actually contract in different directions. So if they all contract, we get this taut band similar to the skin on top of a drum. And that’s joined to the front, the rectus abdominus. And this forms the abdominal wall. They run from the chest bone down to the pelvic bone and they run on the side all the way back to the back muscles.

Ben James 11:39
Exactly. And that I think, is something that is important to mention. Because not all of these muscles are just joined from a bone to a bone, as you might think of something like they’re the hamstrings for example. So these muscles are connected to other muscles via fascia which is another connective tissue that we won’t go into the detail of but, but these muscles are joined together to form almost this, this barrel around the spine. And that’s why we always talk about training the muscles as a unit, almost you as an orchestra, because without them working collectively together in synergy, then again, we’re not, we’re not working them effectively. And I think that’s where a lot of people fail. And particularly those that go to the gym, they’re all always focused on trying to isolate muscles, and trying to isolate and bite through particular exercises, such as the situp for example. It’s a classic.

Jacob Steyn 12:45
Yeah, and when we isolate these movements and we trained only specific muscle groups, the translation to everyday life becomes very, very poor. When we when we when we when our bodies are asked to do something heavy or in And if you’re in a difficult find yourself in a difficult posture and you’re not, you’re not capable of actually using the core and a proper way to protect your spine, because you’ve not been training that way. And I think, and that’s what I also see a lot of people are surprised that they they do go through their back or they have they have an injury somehow working in the garden. And they don’t understand why because they go to the gym three times a week. Absolutely. That’s, that’s what we want to clear up for a lot of people, how do I train effectively, and make sure that it translates to the outside world, the things that I do every day, so I’m a little bit more resilient?

Ben James 13:41
Yeah, exactly. And it’s that classic. You know, we’ve both seen, seen the patients whereby, you know, they’ll have friends that don’t train, and they don’t have any back issues, and they themselves train and they do have back issues and what you often find and what we see is that poor exercise choices in the gym, particularly after maybe sitting at desk all day for exercises in the gym, as we mentioned on previous podcasts can then cause the trauma initially, or they can certainly compound the issue of that sedentary posture throughout the day. So it’s all about exercise choice. As opposed to, you know, I’m just exercising Therefore, I should be okay.

Jacob Steyn 14:28
Yes, I think that you can give that you can you can look at it in three ways. Are my exercises, making me stronger, more resilient? Do they? The second option would be are they having any effect? And the third option is actually, is it making the problem worse? Is it giving me a problem? is it affecting my back in a bad way? And I think a lot of people, I mean, I talk from experience, if you’ve been to the gym and you feel the next day that your back is, you know You don’t, your back feels pretty bad. And maybe you’ve done a little bit too much. And, or maybe you’ve you’ve, you’ve moved a little bit too much to this a little bit too much through the spine. So I think these are things you have to pay attention to get, get to know your own your body better, better and that way understand what you’re capable of.

Ben James 15:26
Yeah, absolutely. And as always, if you are going to the gym and you notice there’s an exercise that may increase that back discomfort. Like we’ve said, we’re always looking to remove the cause of pain first, that’s our first step. So stop that exercise if it’s causing you discomfort because there might be no more appropriate exercise which, you know, we’ll be covering in these podcasts and on the on the website, for more safe should we say exercises for your for your training, so it’s definitely something But you say, be much more aware of and it’s about education because unfortunately, some of the PTS and a very good, but some are not so good if you go into a gym where you’re, you’re not getting that appropriate advice and the education isn’t there to support you. And so you really are at risk. So that’s not to put you off training. It’s just as always picking the appropriate exercises with what we’re, we’re here to support. And I guess Jacob, moving on what if we continue anteriorly we talked about how not all these muscles are attached bone to bone via tendons, they attached via fascia as well to other muscles, and anteriorly what might surprise a lot of people and we look at the core and that kind of barrel at the pecs, there are links there with the pecs, which is when we say brace, we are looking to recruit the pectoral muscles as well. Your muscles, the chest muscles.

Jacob Steyn 16:57
Yeah, that’s you have to Look at this barrel not only from the perspective of, it’s here at the front of my tummy, you have to look at it as a barrel that runs from the shoulders down to the pelvic bone to the hips. And I think that in, in that understanding, we have to see it as a whole, together with the pecs, and with the lats, the big muscles running from the shoulder blades down. And there’s a lot of fascia which are being pulled on here. And the idea is to actually be able to stiffen the whole area between the shoulders and the hips. So that we can we can propel ourselves forward through the hip, or generate force through the shoulder. Yeah, and that’s and I just want to get back to the last point quick and mention that a lot of people might see a good exercise online or be given a good exercise by a personal trainer or, or or a trainer and then you You, it’s supposed to be good for you, but you might still experience some pain or discomfort. Well, the question is, like Ben said, Is it the correct exercise for you? And secondly, are you actually performing it well? I want to mention that sometimes it is a good exercise. But if you tweak it just a little bit, you’re going to see that it has a very different effect or remove the pain that you feel during the exercise.

Ben James 18:23
Great point. Yeah, no great point, you see a lot of poor form in the gym. And the exercise that you say might be right, but it’s just the technique and the way it’s done. And again, you know, if you’re not in a really good gym, then, you know, maybe the trainers are just not aware of it. Or maybe their role is not to interrupt and advise and I think that that’s where they fall down a little bit. I think that should be an important role, that they’re observing different people and making sure that those techniques are correct. If Of course they they understand. What is good technique, but now I think that’s a great point. Great point. Moving around to the back, we’ve we’ve talked abdominal wall and there’s a and a number of muscles involved not just the six pack muscle move around the back, we’ve got the extensors. We’ve got a lot of muscles in the back.

Jacob Steyn 19:15
Yeah, we have, the more the smaller muscles. Those are the multifidus. And we have the longest famous and ilio co stars, they are the longer multi segmental muscles and they usually run in a vertical fashion so they go from head down to sleep. And they started the upper back and they go to the lower back and also into the sacrum, the bony bit just below the spine, and these are called the extensors. So they, they extend they cause you to bend backwards. They’re usually and therefore they usually use especially when you’re when you’re picking something up from the ground. You know if you live to From the floor.

Ben James 20:01
Yeah. And I think the important kind of point here is there are a lot of muscles. And there’s a lot of different names. And again, as always go to the show notes, we’ve, we’ve got some great videos and some, some more detail around some of these muscles to support the podcasts. But try not to worry too much about the individual muscles in and the reason for that is there’s very few if any people that can independently isolate and contract and move those individual muscles, you’re always going to move as a group, you’re going to find it very difficult, for example, to Jacob mentioned, the multifidus and the starless. There’s not going to be many, if any exercises I can even imagine where you could train one of those muscles over the other, you know, you’re always going to move them again collectively, but one We talking a little bit more in detail about these expenses, there are some important points to raise about these muscles. And I think one of the most important things to in terms of the take home of this group of muscles for this episode is the, the line of drive and pull of some of these muscles only work effectively if we’re in the right posture. So if we have neutral spine, one of the roles of some of this muscle group is to pull back on the vertebra ultimates stop them kind of sharing or slipping forward. So if you’re in a neutral spine, the orientation of those fibers helps to pull them back. But as soon as you bend that spine, as we say, and you break that neutral, that line of pole is gone. And it’s more parallel to the spine so it contributes to some compression and doesn’t resist that shear, again, increases your risk of injury. So like Jacob said previously, you might be doing the right exercise such as a deadlift, great exercise for for overall strength. But if you’re lifting with a flexed spine, there’s a hell of a lot of shear force on that back, which could be the cause of your back pain or causing your problem initially. So it’s..

Jacob Steyn 22:12
Just just to sorry to interrupt just to get back to what we said earlier, that’s actually when you give the work to the ligaments. So you’re removing a great deal of strength from the muscles, and you’re actually handing it over to a more soft tissue element, which are the discs and the ligaments. And like we said, in terms of stability that’s really provided by the muscle. So you have to you have to understand how what’s happening, first of all, when I have a certain posture, picking up something from the ground, and how do I correct that, and how do I find the perfect alignment? And this is something we hope for you to develop an understanding of what I’m doing with my body, that awareness off my body in space. And yeah, that’s what I wanted to say.

Ben James 23:07
Yeah, absolutely. And then staying on the back latissimus dorsi, the kind of the muscle everyone sees, or again, a lot of guys in the gym on a train because it’s that muscle that that makes gives you that V shape in the back. And again, it’s a muscle that people probably would be surprised, or I would assume would be more surprised, contributes to that stability in the spine.

Jacob Steyn 23:38
Yes. So why does it contribute so much to the stability of it’s basically because it runs from the shoulder blade and the upper arm, all the way to the low back vertebrae and to the pelvic bone at the back. That’s that’s a very important and interesting alignment or direction of pool, you imagine the shoulder blade being connected to the low back. That’s, that’s very important to know. And it’s very simple. It creates stiffness and strength in this barrel at the back, but along the whole barrel, and I think we will in the subsequent podcast discuss this in more detail, but just understanding that most people aren’t actually using this muscle. Yeah, they like to give the work to the the trapezius the muscle on top of the shoulder, Rania to the neck. And instead of actually knowing and understanding that when I, when I do heavy things, I want to activate the lat because the lead provides the stability from pulling something with my hand, the shoulder blade all the way to the low back and that’s how I protect my no back.

Ben James 24:57
Yeah, and similarly to the to the chest muscles pectorals. anteriorly when people some people think that bracing or lifting Well, they’re often not recruiting both the pecs, chest muscles, or the lats in the back, it kind of they they think of it as it’s just those abdominal muscles and then I’m okay. You’re in a much better position than someone that’s not recruiting those or lifting a poor posture for sure. But by contract and embracing from those shoulders, as you say, that stiffness is, is again just increased significantly and I was speaking to a patient of the day, who I think I mentioned previously to you that as soon as they were drawing those shoulders down and embrace him from the pecs and lats, they just felt immediately more confident in their stability and strength in the core. So it will definitely have an impact and is a muscle that Like you say we’ll focus on in more detail, but it’s hugely important. And then as we delve deeper, closer to the spine, I guess, we there’s also some additional muscles that we want to discuss their, the QL the quadratus lumborum, for example.

Jacob Steyn 26:15
Yes, so I’m going to add to the quadratus lumborum, another deep muscle and then we can discuss them individually. That’s the PSOAS. The PSOAS is the big Hip hip flexor. Basically, when you stand and you pull your knee up into the air, that’s the same as doing it. The qL quadratus lumborum that also runs from the side of the spine, and runs basically from the side of the spine to the to the pelvis to the hip bone on the side and your low back. And it’s a it’s a stabilizer with regards to lateral flexion. So bending to the side, or if you stand on one foot, it maintains the stability in the hip. bone, assuring that the hip on the one side where you lifted your foot off the ground doesn’t drop drop to the ground. So it basically takes care of the stability of the spine on top of the, the the pelvic bone. Yep. And, and I just want to say this, this is a very interesting muscle when they tested it fires all the time. Doesn’t matter if you are on two feet or one foot, it’s just incredibly active in providing stability in the low back.

Ben James 27:28
Yes, yeah. And I think, you know, a good the QL is a good muscle to kind of bring up the next point, which is, if you’re looking purely anatomically, you’ll look at the quadratus lumborum. The QL, which is either side of the spine extends from the the lower rib down the side of the vertebra into the top of the pelvis there. A lot of people would look at that and say, Well, okay, if I apply anatomical theory as it were, then that must move the spine laterally. Yes, it does. But I think what were.. the important take home from this podcast is all of these muscles when we’re talking about the spine, and we’re talking about lifting or sitting or movement in general, that is healthy for the spine, these muscles are preventing movement. They’re designed to resist movement at the spine, and help keep that spine in a neutral posture, which is what is important for spine health. So, don’t think of these muscles and atomically of it moves in this way. And a good example, again, when we talk about the six pack people think well actually extends from there to there. So historically, a good exercise therefore would be the setup, just because that’s the movement that it creates. Whereas actually we want to keep in a neutral spine and stop that movement, we can train that muscle far more effective. without necessarily having any movement to the spine, the plank being a very good example. So we are isometrically. And that is, that means we are challenging that muscle without it lengthening or contracting, we’re putting a lot of effort on that muscle and we can build a lot of endurance without actually moving the spine at all. And that’s the key here. We can train these muscles incredibly effectively, without creating any movement at the spine. And that’s important, because that’s what they’re designed to do, resist that movement and create that stiffness, and therefore, that’s how they should be trained. Now, we might have athletes that are, for example, a cyclist, a cyclist, you’ll see them and always in that kind of bent, bent over flex posture. There has to be some unfortunately, I guess, compromises that we make if we want to develop certain athletic level. performance. So a cyclist can’t say Well, I’m not going to bend on my back because of that aerodynamically, etc, etc, contributes to is going to contribute to their success. However, we can train them in a very different posture such as with the plank, so that then we’re only doing those or, or taking those poor postures during a race, for example, or, you know, when we’re training on the bike, and I think this is where we, we need to focus our efforts. And I think this is where we need to be making improvements in the gym setting that actually, you know, train the muscles as they are designed to perform functionally. But yes, there’s got to be compromises in certain athletic events.

Jacob Steyn 30:46
I want to want to name another example and that is handball. I think for a lot of people. handball is a sport they’re not familiar with. That’s basically where you throw a ball at the The other two teams, I’m not exactly sure how many players there are in, in the team. But I’ve seen, I’ve seen these guys and girls work with a ball. And there’s a lot of spinal bending, especially a lot of lateral bending as I try to be very quick at throwing the ball from a place where the opponent doesn’t expect that. And so, so in the sport, you break the line, you break the neutral spine, in many ways and a lot of the time, but this is also the sport very prone to to cause hernias and this Karen Yes, and the low back and the skull problems. So it’s important to understand that the moment we go into making a compromise we or we take a risk, you know, there’s there’s always the risk of actually damaging tissue. And it doesn’t mean that we’re going to train a lot of a lot of spinal bending for these athletes, we’re actually going to do exactly what Ben said. We’re going to work in training the spine in resisting movements. So we’re going to make it very strong around these segments, so that when we have to bend, we’re more resilient than we can cope with it much better. And that’s the idea was we don’t we don’t want to break the spine in the training, we want to leave that for when we compete. So and I think that’s the, that’s, that’s the important thing to understand is that there’s a certain amount of load that these soft tissue structures going to have and then they start breaking down.

Ben James 32:30
Exactly. And I think you know, that’s, that’s the great and take home message here from this episode is that the muscles contribute to spine stability. Yes, we’ve got ligaments there that will also contribute but the muscles the guidewire there’s a lot of muscles that we need to recruit that are important in terms of spine health and resistance to movement. lightening systems door sigh, big back muscle like the chest muscles, the pecs and What we need to be aware of is that those muscles are designed to resist movement when we’re talking spine health. They’re resisting movement. We’re not trying to create movement at the spine through the recruitment of these muscles. And as a result, we have to change the way we think about exercise in terms of training these muscles so that we are training them in a neutral spine position. And we’re working on the insurance of these muscles, such that A, we are far more resilient to injury when we’re lifting and when we’re sitting at a desk all day, and also when it’s athletic performance. We’re training in a healthy way so that we’re more resilient to injury when we do have to adopt those postures that unfortunately have to be the compromise for certain athletic events and performance. So Take a look at the show notes. We’ve got some videos to support the podcast to give an introduction to these core muscles and the the barrel around the spine as we like to call it. And then in subsequent episodes, we’re going to dive in in a bit more detail and discuss some of the key exercises that we want to be looking at and avoiding for these muscles. And first up is going to be the abdominal muscles in the next episode, and a key focus on that is avoid the sit ups. So if you’re going to the gym later today, don’t do any sit ups. And we’ll catch you next time on the subsequent podcast. Thanks again Jacob

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