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	<title>Comments on: Low Back Pain &#8211; The Negative Side of Current Spine Research</title>
	<atom:link href="http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/feed/" rel="self" type="application/rss+xml" />
	<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/</link>
	<description>Hybrid Strength &#38; Conditioning - Fort Lauderdale, Boca Raton Personal Trainer - Sports Performance - Fitness Trainer</description>
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		<title>By: Ricardo Gonzalez</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-6513</link>
		<dc:creator>Ricardo Gonzalez</dc:creator>
		<pubDate>Thu, 29 Jul 2010 12:37:12 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-6513</guid>
		<description>Awesome blog entry. I would comment more or use my real name but it seems like siding with Nick would cause me to be put into one camp or another camp.</description>
		<content:encoded><![CDATA[<p>Awesome blog entry. I would comment more or use my real name but it seems like siding with Nick would cause me to be put into one camp or another camp.</p>
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		<title>By: Mark S.</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-2091</link>
		<dc:creator>Mark S.</dc:creator>
		<pubDate>Mon, 29 Mar 2010 13:47:39 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-2091</guid>
		<description>McGill can’t show you a single well done clinical trial that his version of core stabilization or any other version of core stabilization exercise is any better than simple back exercises for either treating back pain or preventing back pain. Virtually all studies on this issue show NO difference.

This guy is just PR himself and that will help him get more research grants or sell his books on what the well done clinical trials show to be nothing but a failed paradigm (i.e. core stabilization).</description>
		<content:encoded><![CDATA[<p>McGill can’t show you a single well done clinical trial that his version of core stabilization or any other version of core stabilization exercise is any better than simple back exercises for either treating back pain or preventing back pain. Virtually all studies on this issue show NO difference.</p>
<p>This guy is just PR himself and that will help him get more research grants or sell his books on what the well done clinical trials show to be nothing but a failed paradigm (i.e. core stabilization).</p>
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		<title>By: nick</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1740</link>
		<dc:creator>nick</dc:creator>
		<pubDate>Sat, 13 Mar 2010 20:49:03 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1740</guid>
		<description>James,

Thanks for your comments!

I&#039;m curious - Allen who?

And what is Allen saying about the Swiss weight Stability work?

Coach N</description>
		<content:encoded><![CDATA[<p>James,</p>
<p>Thanks for your comments!</p>
<p>I&#8217;m curious &#8211; Allen who?</p>
<p>And what is Allen saying about the Swiss weight Stability work?</p>
<p>Coach N</p>
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		<title>By: James</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1718</link>
		<dc:creator>James</dc:creator>
		<pubDate>Sat, 13 Mar 2010 04:45:50 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1718</guid>
		<description>Just throwing it out there that I&#039;m a long-time reader of TMuscle and Nick&#039;s, and a long-time (due to knee/shoulder issues) patient of Allen&#039;s, and it&#039;s absolutely hilarious to me to see these worlds collide. Allen talks the same way in real life that he writes on a blog&#039;s comments page, which shouldn&#039;t surprise anyone. It&#039;s just nice to have a chiropractor here in MD who&#039;s actually been around the gym himself.</description>
		<content:encoded><![CDATA[<p>Just throwing it out there that I&#8217;m a long-time reader of TMuscle and Nick&#8217;s, and a long-time (due to knee/shoulder issues) patient of Allen&#8217;s, and it&#8217;s absolutely hilarious to me to see these worlds collide. Allen talks the same way in real life that he writes on a blog&#8217;s comments page, which shouldn&#8217;t surprise anyone. It&#8217;s just nice to have a chiropractor here in MD who&#8217;s actually been around the gym himself.</p>
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		<title>By: nick</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1627</link>
		<dc:creator>nick</dc:creator>
		<pubDate>Sat, 06 Mar 2010 16:16:46 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1627</guid>
		<description>Alle,

First off, many thanks for your insightful and detailed comments.

I could not agree more with what you say about supermans and other similar supine back extension exercise. I personal do not use supermans or any movements resembling them,

This is why I developed the superdog exercise shown here - http://www.youtube.com/watch?v=6p0nizbm1SI 

and wrote these articles about why NOT to perform supermans -
http://www.tmuscle.com/free_online_article/sports_body_training_performance/how_not_to_warm_up&amp;cr=

and
http://www.tmuscle.com/free_online_article/sports_body_training_performance/five_new_exercises

If you watch the video and read the above articles, you&#039;ll find you and I agree on most things.

Best regards!

Coach N</description>
		<content:encoded><![CDATA[<p>Alle,</p>
<p>First off, many thanks for your insightful and detailed comments.</p>
<p>I could not agree more with what you say about supermans and other similar supine back extension exercise. I personal do not use supermans or any movements resembling them,</p>
<p>This is why I developed the superdog exercise shown here &#8211; <a href="http://www.youtube.com/watch?v=6p0nizbm1SI" rel="nofollow">http://www.youtube.com/watch?v=6p0nizbm1SI</a> </p>
<p>and wrote these articles about why NOT to perform supermans -<br />
<a href="http://www.tmuscle.com/free_online_article/sports_body_training_performance/how_not_to_warm_up&#038;cr=" rel="nofollow">http://www.tmuscle.com/free_online_article/sports_body_training_performance/how_not_to_warm_up&#038;cr=</a></p>
<p>and<br />
<a href="http://www.tmuscle.com/free_online_article/sports_body_training_performance/five_new_exercises" rel="nofollow">http://www.tmuscle.com/free_online_article/sports_body_training_performance/five_new_exercises</a></p>
<p>If you watch the video and read the above articles, you&#8217;ll find you and I agree on most things.</p>
<p>Best regards!</p>
<p>Coach N</p>
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		<title>By: Allen</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1610</link>
		<dc:creator>Allen</dc:creator>
		<pubDate>Sat, 06 Mar 2010 05:40:24 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1610</guid>
		<description>The bottom line with supermans and the like is that the amount of force driven into the lumbar spine cannot be tolerated.  When you read x-rays and MRIs, you see subtle changes or serious degenerative changes, based on many reasons, of course.  However, someone with facet hypertrophy and/or disc bulging who is performing extension exercises is really not doing the right activities...there is no way around this.  Just because you don&#039;t hurt doesn&#039;t mean you aren&#039;t creating a problem...on that note...

Most people have no idea what is going on with their spine until they hurt it...then they find out the damage they&#039;ve been causing.

In regards to Newton energy into the lumbar spine, this simply cannot be discounted.  I guess if someone wants to believe that a certain group of people can get away with biomechanically flawed movements, they&#039;re going to believe that no matter what.  That&#039;s fine...it keeps the physical therapists, physiatrists, orthopedists, and chiropractors quite busy.

Simply put, you need to understand bone deformation, disc function, and the piezoelectric effect to comprehend what is going on when you put pressure on bone that isn&#039;t meant to take the pressure. 

You also cannot compare standing up and bending backward as it creates nowhere near the pressure of supermans, roman chair extensions, etc...

You can get away with poor biomechanical movements for a while, but sooner or later, you&#039;ll feel the effects.

The more important question is why are people training their spinal erectors in the first place?  If people understood cross fix patterns along with facilitation/inhibition patterns, it&#039;d become apparent soon enough that on this basis alone, extension exercises are foolish.  Bottom line:  you don&#039;t strengthen muscles that are too short/ have reduced ability to stretch.  The spinal erectors fall into this category.

When you treat back injuries, you see the injuries and the patterning.  Someone here wrote that he doesn&#039;t see injuries with squats or situps...well, that&#039;s obvious...if you&#039;re in a gym, those people are going to disappear for a while and end up in a doctor&#039;s office. Injured people don&#039;t tend to continue exercising or doing the things that hurt them.

Consider this one point.  When people really hurt their back, how do they present?  Straight up, flexed, extended???  They present in a flexion position (sometimes to one side or not dependent on the position of the disc)....they do not present in extension...why is this?...it is because the body needs to be in a flexion state to create negative disc pressure, even when upright.  This begs the question as to why so much emphasis is put on extension movements when all they really do is damage spinal structures...we can say that everything is fine in moderation, but I disagree...there is no proper extension training for those with lower cross fix patterning...all it leads to is damage.

I could go on for hours here...if you treat neuromusculoskeletal injuries, you get a much better perspective of the injuries, how they occur, and how to prevent them.  When you are on the front line of fitness in a gym environment, you&#039;re not privy to medical histories, diagnoses, and treatment protocols for back injuries.  

As far as rehabilitation and stabilization goes, extension can be added into a program, but it&#039;s the last thing to be added...this is the same whether you&#039;re rehabilitating someone who has lumbar or cervical spine disc pathology.</description>
		<content:encoded><![CDATA[<p>The bottom line with supermans and the like is that the amount of force driven into the lumbar spine cannot be tolerated.  When you read x-rays and MRIs, you see subtle changes or serious degenerative changes, based on many reasons, of course.  However, someone with facet hypertrophy and/or disc bulging who is performing extension exercises is really not doing the right activities&#8230;there is no way around this.  Just because you don&#8217;t hurt doesn&#8217;t mean you aren&#8217;t creating a problem&#8230;on that note&#8230;</p>
<p>Most people have no idea what is going on with their spine until they hurt it&#8230;then they find out the damage they&#8217;ve been causing.</p>
<p>In regards to Newton energy into the lumbar spine, this simply cannot be discounted.  I guess if someone wants to believe that a certain group of people can get away with biomechanically flawed movements, they&#8217;re going to believe that no matter what.  That&#8217;s fine&#8230;it keeps the physical therapists, physiatrists, orthopedists, and chiropractors quite busy.</p>
<p>Simply put, you need to understand bone deformation, disc function, and the piezoelectric effect to comprehend what is going on when you put pressure on bone that isn&#8217;t meant to take the pressure. </p>
<p>You also cannot compare standing up and bending backward as it creates nowhere near the pressure of supermans, roman chair extensions, etc&#8230;</p>
<p>You can get away with poor biomechanical movements for a while, but sooner or later, you&#8217;ll feel the effects.</p>
<p>The more important question is why are people training their spinal erectors in the first place?  If people understood cross fix patterns along with facilitation/inhibition patterns, it&#8217;d become apparent soon enough that on this basis alone, extension exercises are foolish.  Bottom line:  you don&#8217;t strengthen muscles that are too short/ have reduced ability to stretch.  The spinal erectors fall into this category.</p>
<p>When you treat back injuries, you see the injuries and the patterning.  Someone here wrote that he doesn&#8217;t see injuries with squats or situps&#8230;well, that&#8217;s obvious&#8230;if you&#8217;re in a gym, those people are going to disappear for a while and end up in a doctor&#8217;s office. Injured people don&#8217;t tend to continue exercising or doing the things that hurt them.</p>
<p>Consider this one point.  When people really hurt their back, how do they present?  Straight up, flexed, extended???  They present in a flexion position (sometimes to one side or not dependent on the position of the disc)&#8230;.they do not present in extension&#8230;why is this?&#8230;it is because the body needs to be in a flexion state to create negative disc pressure, even when upright.  This begs the question as to why so much emphasis is put on extension movements when all they really do is damage spinal structures&#8230;we can say that everything is fine in moderation, but I disagree&#8230;there is no proper extension training for those with lower cross fix patterning&#8230;all it leads to is damage.</p>
<p>I could go on for hours here&#8230;if you treat neuromusculoskeletal injuries, you get a much better perspective of the injuries, how they occur, and how to prevent them.  When you are on the front line of fitness in a gym environment, you&#8217;re not privy to medical histories, diagnoses, and treatment protocols for back injuries.  </p>
<p>As far as rehabilitation and stabilization goes, extension can be added into a program, but it&#8217;s the last thing to be added&#8230;this is the same whether you&#8217;re rehabilitating someone who has lumbar or cervical spine disc pathology.</p>
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		<title>By: Jukka</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1599</link>
		<dc:creator>Jukka</dc:creator>
		<pubDate>Fri, 05 Mar 2010 16:27:53 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1599</guid>
		<description>One thing that I see being missed here is that a lot of the times (and I&#039;d bet in 99% of the cases) back pain is caused by many conditions combined. Not ALL the back pain is aggravated or caused by crunches, hyper extensions or supermans. Nor will leaving them out ultimately make your spine invulnerable. The human spine is an extremely complex system and we actually now very little of it. We actually know very little on back pain as well, which is proven by the researches of the frequency of &quot;unspecified back pain&quot;. A lot of times we do not even know what is wrong, so for someone to say that this is right and this is wrong in EVERY case is just a little short sighted in my opinion.

If a person has an instable spine, works in a warehouse and has his workout routine built on extensions and sit ups, is he in danger? I&#039;d say yeah, maybe. So would this person benefit from removing the &quot;dangerous exercises&quot;? My guess is yeah, maybe. We can&#039;t do a lot to the spine instability itself, sure we can tell the person to find a new job, but how many times is that the best or easiest option? So what is left or the easiest to change? The workout routine.

Take another case: A 22-year-old student athlete, who has nothing wrong in his spine, does hypex&#039;s and crunches along as a part of his usual workouts. Is he/she in danger? Most likely not, especially if the muscle balance is there.

Everything is dangerous if you do too much of it. Jumping is great for your cartilage, but too much jumping is not.</description>
		<content:encoded><![CDATA[<p>One thing that I see being missed here is that a lot of the times (and I&#8217;d bet in 99% of the cases) back pain is caused by many conditions combined. Not ALL the back pain is aggravated or caused by crunches, hyper extensions or supermans. Nor will leaving them out ultimately make your spine invulnerable. The human spine is an extremely complex system and we actually now very little of it. We actually know very little on back pain as well, which is proven by the researches of the frequency of &#8220;unspecified back pain&#8221;. A lot of times we do not even know what is wrong, so for someone to say that this is right and this is wrong in EVERY case is just a little short sighted in my opinion.</p>
<p>If a person has an instable spine, works in a warehouse and has his workout routine built on extensions and sit ups, is he in danger? I&#8217;d say yeah, maybe. So would this person benefit from removing the &#8220;dangerous exercises&#8221;? My guess is yeah, maybe. We can&#8217;t do a lot to the spine instability itself, sure we can tell the person to find a new job, but how many times is that the best or easiest option? So what is left or the easiest to change? The workout routine.</p>
<p>Take another case: A 22-year-old student athlete, who has nothing wrong in his spine, does hypex&#8217;s and crunches along as a part of his usual workouts. Is he/she in danger? Most likely not, especially if the muscle balance is there.</p>
<p>Everything is dangerous if you do too much of it. Jumping is great for your cartilage, but too much jumping is not.</p>
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		<title>By: Low Back Pain and Lumbar Flexion &#171; Boddicker Performance</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1585</link>
		<dc:creator>Low Back Pain and Lumbar Flexion &#171; Boddicker Performance</dc:creator>
		<pubDate>Thu, 04 Mar 2010 23:14:36 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1585</guid>
		<description>[...] with the &#8220;anti-flexion&#8221; camps arguments.  Please head over and check it out what Nick Tumminello had to [...]</description>
		<content:encoded><![CDATA[<p>[...] with the &#8220;anti-flexion&#8221; camps arguments.  Please head over and check it out what Nick Tumminello had to [...]</p>
]]></content:encoded>
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		<title>By: Allen</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1576</link>
		<dc:creator>Allen</dc:creator>
		<pubDate>Thu, 04 Mar 2010 07:04:54 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1576</guid>
		<description>First of all, your assessment of McGill&#039;s pig models is inaccurate.  The models are used to assess herniation patterns, not much more than that.  For this area of study, they are quite accurate.  Just as mice and rats are used for medical research, animal models are accepted for structural considerations.  Comparing a pig and a human in regards to weight bearing, stability, spine buckling, etc... is silly.

I recommend everyone read McGill&#039;s 140+ studies...and I don&#039;t mean only the abstracts...McGill is the top spinal biomechanist in the world...period...he has contributed incredible material...the Aussie/New Zealand researches have contributed much as well, but I side with McGill as his work is more relevant in a true clinical setting.  For those who think it&#039;s not important to know how many newtons (or pounds) of energy are slammed into your back with certain foolish activities, just keep doing what you&#039;re doing...you&#039;ll learn soon enough when you go beyond the threshold.  

As a rehabilitation specialist, I can assure you that improper loading and lots of extension exercises will damage your back..period!  People can fool themselves and do &#039;supermans&#039; and whatever other hyperextension exercises they want...sooner or later, they&#039;ll be in trouble...why is this?  It revolves around the issue of facilitation/inhibition patterns and of course, imbalances to core stability.  You do not want to strengthen your long &#039;strap&#039; muscles...they are too short and tight to begin with...training and shortening muscles that are short and neurologically impaired when it comes to stretching is not a good idea.  To train the intersegmental muscles, a good understanding of proper core exercises is needed.  

How many here treat musculoskeletal injuries as a profession?  How many teach biomechanics, kinesiology, injury prevention, etc...?  How many have conducted research and have been immersed in such?  I have my doctorate and over 10 years of post doctorate training and still I can never know enough...as soon as you think you&#039;re up to date, more information comes out and you have to modify your approach...many fitness resource locations are simply out of date...they can&#039;t keep up.  My point is that many feel as though they are specialists without having the proper training and/or experience...too many trainers go out and end up hurting their clients and have no idea they&#039;re doing so...this is really unfortunate.  I teach trainers...many cannot even name the major muscles in many regions of the body...

A deep understanding of anatomy, kinesiology, physiology, etc... is needed to fully appreciate what occurs when you work out in the gym.  

From my own observations, I&#039;d say that about 75% of people in a gym setting &#039;work out&#039; improperly.  From things as simple as knowing where your energy comes from (do you do anaerobic or aerobic exercise first?) to proper biomechanics with particular exercises, and more...most people in a gym setting are not properly educated about the body and how it works.  Just as you wouldn&#039;t work on a car without a good knowledge of mechanics, people shouldn&#039;t exercise unless they have been instructed by well-trained individuals.

In regards to core stability, I could go on forever here...I&#039;ll just say this...you do not want to make tight muscles tighter and weak muscles weaker...this should be obvious but most people end up furthering imbalances.  The idea is to create balance and take pressure off of the spine.  The core is composed of your diaphragm to the pelvic floor and the abdominal wall to the paraspinal musculature...and everything in-between.  Any spinal weakness due to disc, ligament, or other tissue is going to affect your brain&#039;s perception of function...and you will end up with pain and dysfunction.  You can&#039;t just push through a back problem...you have to know what problem you have and the proper way to address it.  I&#039;ve seen too many people in my practice who have tried fix their own problems or have sought care from the wrong type of provider.  

Unfortunately, most individuals truly do not know what they are doing and this is why there are so many spine injuries.  Most are easy to rehabilitate, thank goodness, but sometimes surgery is required.  Most all back injuries can be prevented if the focus of exercise is on proper form and proper muscle balance...hence the need for core stabilization in a functional capacity.</description>
		<content:encoded><![CDATA[<p>First of all, your assessment of McGill&#8217;s pig models is inaccurate.  The models are used to assess herniation patterns, not much more than that.  For this area of study, they are quite accurate.  Just as mice and rats are used for medical research, animal models are accepted for structural considerations.  Comparing a pig and a human in regards to weight bearing, stability, spine buckling, etc&#8230; is silly.</p>
<p>I recommend everyone read McGill&#8217;s 140+ studies&#8230;and I don&#8217;t mean only the abstracts&#8230;McGill is the top spinal biomechanist in the world&#8230;period&#8230;he has contributed incredible material&#8230;the Aussie/New Zealand researches have contributed much as well, but I side with McGill as his work is more relevant in a true clinical setting.  For those who think it&#8217;s not important to know how many newtons (or pounds) of energy are slammed into your back with certain foolish activities, just keep doing what you&#8217;re doing&#8230;you&#8217;ll learn soon enough when you go beyond the threshold.  </p>
<p>As a rehabilitation specialist, I can assure you that improper loading and lots of extension exercises will damage your back..period!  People can fool themselves and do &#8216;supermans&#8217; and whatever other hyperextension exercises they want&#8230;sooner or later, they&#8217;ll be in trouble&#8230;why is this?  It revolves around the issue of facilitation/inhibition patterns and of course, imbalances to core stability.  You do not want to strengthen your long &#8216;strap&#8217; muscles&#8230;they are too short and tight to begin with&#8230;training and shortening muscles that are short and neurologically impaired when it comes to stretching is not a good idea.  To train the intersegmental muscles, a good understanding of proper core exercises is needed.  </p>
<p>How many here treat musculoskeletal injuries as a profession?  How many teach biomechanics, kinesiology, injury prevention, etc&#8230;?  How many have conducted research and have been immersed in such?  I have my doctorate and over 10 years of post doctorate training and still I can never know enough&#8230;as soon as you think you&#8217;re up to date, more information comes out and you have to modify your approach&#8230;many fitness resource locations are simply out of date&#8230;they can&#8217;t keep up.  My point is that many feel as though they are specialists without having the proper training and/or experience&#8230;too many trainers go out and end up hurting their clients and have no idea they&#8217;re doing so&#8230;this is really unfortunate.  I teach trainers&#8230;many cannot even name the major muscles in many regions of the body&#8230;</p>
<p>A deep understanding of anatomy, kinesiology, physiology, etc&#8230; is needed to fully appreciate what occurs when you work out in the gym.  </p>
<p>From my own observations, I&#8217;d say that about 75% of people in a gym setting &#8216;work out&#8217; improperly.  From things as simple as knowing where your energy comes from (do you do anaerobic or aerobic exercise first?) to proper biomechanics with particular exercises, and more&#8230;most people in a gym setting are not properly educated about the body and how it works.  Just as you wouldn&#8217;t work on a car without a good knowledge of mechanics, people shouldn&#8217;t exercise unless they have been instructed by well-trained individuals.</p>
<p>In regards to core stability, I could go on forever here&#8230;I&#8217;ll just say this&#8230;you do not want to make tight muscles tighter and weak muscles weaker&#8230;this should be obvious but most people end up furthering imbalances.  The idea is to create balance and take pressure off of the spine.  The core is composed of your diaphragm to the pelvic floor and the abdominal wall to the paraspinal musculature&#8230;and everything in-between.  Any spinal weakness due to disc, ligament, or other tissue is going to affect your brain&#8217;s perception of function&#8230;and you will end up with pain and dysfunction.  You can&#8217;t just push through a back problem&#8230;you have to know what problem you have and the proper way to address it.  I&#8217;ve seen too many people in my practice who have tried fix their own problems or have sought care from the wrong type of provider.  </p>
<p>Unfortunately, most individuals truly do not know what they are doing and this is why there are so many spine injuries.  Most are easy to rehabilitate, thank goodness, but sometimes surgery is required.  Most all back injuries can be prevented if the focus of exercise is on proper form and proper muscle balance&#8230;hence the need for core stabilization in a functional capacity.</p>
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		<title>By: Susan Birch</title>
		<link>http://nicktumminello.com/2010/03/low-back-pain-the-negative-side-of-current-spine-research/comment-page-1/#comment-1571</link>
		<dc:creator>Susan Birch</dc:creator>
		<pubDate>Wed, 03 Mar 2010 20:42:39 +0000</pubDate>
		<guid isPermaLink="false">http://nicktumminello.com/?p=1315#comment-1571</guid>
		<description>This is certainly an interesting topic.  Personally I stopped my clients doing ab crunches about 10 years ago when I completed my a low back pain intervention for my Masters degree. It is not just Stuart McGills opinion that flexion increases the risk of disc herniation - all the orthopeadic surgeons I worked with during my intervention agreed that flexion coupled with rotation played a significant role in disc herniations. There is a lot of research out there discussing this, check out Nik Bogduk and de Rosa and Portersfield to start with.  

I also studied the populations who had significant back problems and amongst the nurses and shearers were Yoga instructors and dancers.  I find it interesting that most of the Pilates instructors I know suffer back pain - anecdotal evidence I know, but interesting.  

I think just because one athlete or person says I have done ab crunches all my life and don&#039;t have problems is not a reason to dismiss how the exercise may affect the population in general.

Aside from the back issues, the negative side of crunches is the mind set that goes with it.  I believe it contributes to postural issues that are aggravated by those who insist on training all the mirror muscles.  I work in a gym based in an international hotel and find the quality of workouts by most guests to be shocking, with many variations of ab crunches as the basis.  These people walk around with forward heads, caved in chests and rounded shoulders.  They look terrible and perform terribly.   My clients only do ab crunches when they are strong enough and if it is necessary for their sporting or working situation - which is not very often.  We do a range of other ab exercises including dynamic and static.

While on the topic, I have no evidence but from my studies and experience I don&#039;t believe in holding the planks for extended periods of time.  The maximum hold in a static position I use is 10 sec.  I increase the demands with limb movements rather than time.  I find that during long holds clients just hold their breath and hang off the ligamentous system.  I don&#039;t know what the research will tell us in the future and I might have to change my mind about this one - but it doesn&#039;t seem to make sense to hold these positions for 3 minutes with heads hangining and hip flexors overactivated.

Interesting topic and I look forward to learning more.

Susan</description>
		<content:encoded><![CDATA[<p>This is certainly an interesting topic.  Personally I stopped my clients doing ab crunches about 10 years ago when I completed my a low back pain intervention for my Masters degree. It is not just Stuart McGills opinion that flexion increases the risk of disc herniation &#8211; all the orthopeadic surgeons I worked with during my intervention agreed that flexion coupled with rotation played a significant role in disc herniations. There is a lot of research out there discussing this, check out Nik Bogduk and de Rosa and Portersfield to start with.  </p>
<p>I also studied the populations who had significant back problems and amongst the nurses and shearers were Yoga instructors and dancers.  I find it interesting that most of the Pilates instructors I know suffer back pain &#8211; anecdotal evidence I know, but interesting.  </p>
<p>I think just because one athlete or person says I have done ab crunches all my life and don&#8217;t have problems is not a reason to dismiss how the exercise may affect the population in general.</p>
<p>Aside from the back issues, the negative side of crunches is the mind set that goes with it.  I believe it contributes to postural issues that are aggravated by those who insist on training all the mirror muscles.  I work in a gym based in an international hotel and find the quality of workouts by most guests to be shocking, with many variations of ab crunches as the basis.  These people walk around with forward heads, caved in chests and rounded shoulders.  They look terrible and perform terribly.   My clients only do ab crunches when they are strong enough and if it is necessary for their sporting or working situation &#8211; which is not very often.  We do a range of other ab exercises including dynamic and static.</p>
<p>While on the topic, I have no evidence but from my studies and experience I don&#8217;t believe in holding the planks for extended periods of time.  The maximum hold in a static position I use is 10 sec.  I increase the demands with limb movements rather than time.  I find that during long holds clients just hold their breath and hang off the ligamentous system.  I don&#8217;t know what the research will tell us in the future and I might have to change my mind about this one &#8211; but it doesn&#8217;t seem to make sense to hold these positions for 3 minutes with heads hangining and hip flexors overactivated.</p>
<p>Interesting topic and I look forward to learning more.</p>
<p>Susan</p>
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