Could incorporating standing lumbar flexion exercise into a daily routine help decrease pain and improve overall spinal mobility for individuals with low back pain?
Standing Lower Back Flexion Exercise
A chiropractic physical therapy team visit can help determine which exercises are best for an individual’s injury or condition and teach them what to stop doing if they have low back pain. Exercise and proper posture can decrease discomfort and improve mobility for individuals with low back pain. (Suh, J. H. et al., 2019) Sometimes, exercises that bend backward are recommended, while other times, flexion or forward bending movements are the best way to manage lower back pain. Many find the standing Williams lumbar flexion exercises maneuver helpful for low back pain. (Amila A, Syapitri H, Sembiring E. 2021)
Benefits
Individuals with certain diagnoses may benefit from spinal flexion. These diagnoses include:
Be sure to speak with a healthcare provider to understand the diagnosis and low back symptoms, and work with a physical therapist to be sure that forward flexion of the spine is the correct exercise for your back.
When To Avoid Lumbar Flexion
Some should avoid excessive forward bending, which could cause further damage or injury to the spine. Reasons to avoid flexion include:
Neurological signs such as difficulty urinating or controlling bowel movements (Howell E. R. 2012)
Before starting this or any other exercise program for your spine, check with a healthcare provider or physical therapist.
How to Perform
Gradually progressing with other gentle lumbar flexion exercises before full-standing lumbar flexion is recommended. These include performing a week or two of lumbar flexion lying down, followed by a couple weeks of lumbar flexion seated. Once these exercises are easy to perform and pain-free, progress with lumbar flexion standing postures.To perform, follow these steps:
Stand with your feet shoulder-width apart.
Slowly bend forward by sliding your hands down the front of your thighs.
Reach down as far as possible and let your lower back bend forward.
Grab your ankles and gently pull into more forward flexion to increase the backstretch.
Hold the end position for a second or two, then slowly return to the starting position.
As you exercise, be sure to monitor changes in symptoms. Pain worsening in the back or traveling down your leg indicates that you should stop the exercise (Spine-health, 2017). If the pain decreases in your leg or centralizes to your back, continue the exercise. Standing lumbar flexion can be repeated for 10 repetitions a couple of times daily. It can help decrease low back or leg pain symptoms and stretch tight hamstrings and back muscles. (Montefiore Pediatric Orthopedic and Scoliosis Center, 2003)
Injury Medical Chiropractic and Functional Medicine Clinic
Exercise can also prevent future lower back problems. Standing back flexion, postural correction, regular physical activity, and exercise are tools for keeping the spine healthy. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
What Causes Disc Herniation?
References
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173
Amila A, Syapitri H, Sembiring E. (2021). The effect of William Flexion Exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv., 4(1), 28-36. https://doi.org/https://doi.org/10.35654/ijnhs.v4i1.374
Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. https://doi.org/10.1136/bmj.h6234
Sfeir, J. G., Drake, M. T., Sonawane, V. J., & Sinaki, M. (2018). Vertebral compression fractures associated with yoga: a case series. European journal of physical and rehabilitation medicine, 54(6), 947–951. https://doi.org/10.23736/S1973-9087.18.05034-7
Howell E. R. (2012). Conservative management of a 31 year old male with left sided low back and leg pain: a case report. The Journal of the Canadian Chiropractic Association, 56(3), 225–232.
Spine-health. (2017). Exercise with lower back pain: Should you work through the pain? Spine-health
Knowledge from Veritas. https://www.spine-health.com/blog/exercising-lower-back-pain-should-you-work-through-pain
Montefiore Pediatric Orthopedic and Scoliosis Center. Center, M. P. O. a. S. (2003). Low Back Strain. https://www.cham.org/File%20Library/Global%20Navigation/Expertise%20And%20Programs/Pediatric%20Expertise/Orthopedics/Monte-LOW-BACK-STRAIN-WITH-EXERCISES.pdf
The Adams forward bend test is a simple screening method that can help with scoliosis diagnosis and help in developing a treatment plan. The exam is named after the English physician William Adams. As part of an examination, a doctor or chiropractor will look for an abnormal side-to-side bend in the spine.
Scoliosis Diagnosis
The Adams forward-bend test can help determine if there are indicators for scoliosis.
It is not an official diagnosis, but the results can be used as a starting point.
The Adams test will reveal signs of scoliosis and/or other potential deformities like:
Uneven shoulders
Uneven hips
Lack of symmetry between the vertebrae or the shoulder blades.
The head does not line up with a rib hump or the pelvis.
Detection of Other Spinal Issues
The test can also be used to find spinal curvature issues and conditions like:
Kyphosis or hunchback, where the upper back is bent forward.
Scheuermann’s disease is a form of kyphosis where the thoracic vertebrae can grow unevenly during a growth spurt and cause the vertebrae to develop into a wedge-like shape.
The Adams test by itself is not enough to confirm scoliosis.
A standing X-ray with Cobb angle measurements above 10 degrees is required for diagnosing scoliosis.
The Cobb angle determines which vertebrae are tilted the most.
The higher the angle, the more severe the condition and the more probable it will produce symptoms.
Computed tomography or CT and magnetic resonance imaging or MRI scans can also be used.
Forward Bend Test
References
Glavaš, Josipa et al. “The role of school medicine in the early detection and management of adolescent idiopathic scoliosis.” Wiener klinische Wochenschrift, 1–9. 4 Oct. 2022, doi:10.1007/s00508-022-02092-1
Grossman, T W et al. “An evaluation of the Adams forward bend test and the scoliometer in a scoliosis school screening setting.” Journal of pediatric orthopedics vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025
Letts, M et al. “Computerized ultrasonic digitization in the measurement of spinal curvature.” Spine vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009
Senkoylu, Alpaslan, et al. “A simple method for assessing rotational flexibility in adolescent idiopathic scoliosis: modified Adam’s forward bending test.” Spine deformity vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2
Golfing Back Injuries: Golf is an enjoyable game that can be played at all ages. It involves the foundation of the body’s range of motion, the spine. Because of the repetitive nature of a golfer’s unique swing, the repetitive rotating/twisting of the spine slowly degrades the integrity of the spinal discs causing them to bulge, herniate, or rupture. The slightest shift causing misalignment can leave the spine vulnerable to further injury. Non-surgical motorized decompression combined with chiropractic musculoskeletal adjustments can restore and maintain optimal health.
Golfing Back Injuries
Golfing involves muscle memory. Going through the walk, bending to tee the ball, recoiling for the swing, swinging and following through, walking to the hole, and bending down to retrieve the ball are all repetitive motions that can lead to:
Soreness
Inflammation
Back, hip, leg, and foot pain.
Strains
Other injuries to the muscles and discs.
The bending and twisting are the least tolerated motions by the spine. More than half of injuries sustained involve the back and/or neck. Having the spine correctly aligned is vital to retaining accuracy, power, and injury prevention. Common injuries include:
Sacroiliac Joint/SI Joint Dysfunction
The sacroiliac joint is located between the spine and the hip. Symptoms of sacroiliac joint pain include:
Low back pain.
Hip pain
Pain in the buttocks.
Pain radiating down the legs.
Groin pain
Pelvis pain
Burning sensation in the pelvis.
Numbness and weakness in the pelvis and legs.
SI Joint Pain Causes
The sacroiliac joint requires supported stability when transferring a load from the torso to the legs, specifically during the swing.
If there is compression, misalignment, or weakness, the motion will begin to wear away this stability and leave the sacroiliac joint open to further injury.
Sacroiliac joint injuries often occur from minor multi-incidents and not one major trauma.
With time the SI joint becomes misaligned, exposing the cartilage between joints, causing inflammation known as Sacroiliitis.
Facet Joint Syndrome
The facet joints are located between two vertebrae, allowing the ability to bend and twist.
Healthy facet joints have cartilage all around them, allowing the vertebrae to move smoothly in all directions.
Facet joint syndrome causes pain between the vertebrae.
Facet Joint Syndrome Causes
The leading cause of facet joint syndrome is excessive and repetitive swing movement.
Misalignment can expose and irritate the joints, causing pain, swelling, and inflammation.
Multi-micro-traumas and not one major trauma are often the cause of injury/s.
Muscle spasms are common.
Symptoms
Highly reduced range of motion
Muscle pain
Numbness
Weakness
Cervical Facet Syndrome affects the neck, shoulders, arms, and hands.
Lumbar Facet Syndrome affects the buttocks, legs, and feet.
The treatment is computer-controlled to provide gentle and painless decompression.
The therapist enters the program cycle.
The decompression table goes through brief moments of pulling and relaxing.
The spine’s bones are stretched slowly and methodically.
As the vertebrae are separated, a vacuum is formed, pulling the gel-cushion center of the disc back inside, removing the pressure on the spinal nerves and alleviating pain and disability.
The vacuum also draws oxygen and nutrients into the injured and degenerated discs to optimize healing.
DRX 9000
Long Term Success
References
Cole, Michael H, and Paul N Grimshaw. “The Biomechanics of the Modern Golf Swing: Implications for Lower Back Injuries.” Sports medicine (Auckland, N.Z.) vol. 46,3 (2016): 339-51. doi:10.1007/s40279-015-0429-1
Dydyk, Alexander M., et al. “Sacroiliac Joint Injury.” StatPearls, StatPearls Publishing, 4 August 2021.
Hosea, T M, and C J Gatt Jr. “Back pain in golf.” Clinics in sports medicine vol. 15,1 (1996): 37-53.
Lindsay, David M, and Anthony A Vandervoort. “Golf-related low back pain: a review of causative factors and prevention strategies.” Asian journal of sports medicine vol. 5,4 (2014): e24289. doi:10.5812/asjsm.24289
Smith, Jo Armour, et al. “Risk Factors Associated With Low Back Pain in Golfers: A Systematic Review and Meta-analysis.” Sports health vol. 10,6 (2018): 538-546. doi:10.1177/1941738118795425
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