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Lifestyle changes
and activities for a
healthy back

According to the American Association ofNeurological Surgeons, The fibrous intervertebral rings consist of 50 to 60% collagen,
75 to 85% of the American population will suffer from low-back providing tensile strength to vertebrae. Less collagen appears in
pain at some point in their lives. Americans currently spend more the lateral and posterior portions ofdisks, particularly in the lower
than $50 billion annually treating back-related conditions, one of back's L4 to SI region, reducing tensile strength and making this
the most common reasons for work absenteeism and the second area more vulnerable to injury (Hamill et al. 1995).
most commoncomplaint at doctor visits. Withstatistics like these, True spinal stability is achieved with balanced co-contraction
personal trainers should arm themselves with modifications and ofthe rectus abdominis and abdominal wall, the quadratus lumbo-
corrective exercises and be prepared, when appropriate, to refer rum, the latissimus dorsi, and the back extensors (longissimus,
clients to healthcare professionals. iliocostalis and multifidus) (McGill 2010).
THE PHYSIOLOGY OF BACK PAIN People with troubled backs often walk, sit, stand and lift using
Back pain can becaused by one or more ofthe following condi mechanics that increase back loads, display more strength than
tions or activities: degenerative or structural changes in the verte endurance in back muscles, and produce faulty gluteal muscle
brae, repeated incorrect lifting technique, excessive sitting and firing (McGill et al. 2003, McGill 2007).
standing, bending, twisting, and falls. The psoas muscle plays a critical role in vertebral stabilization
The vertebral column protects the spinal cord, which relays by preventing vertebrae from rotating in the frontal plane (Hu
sensory or motor information from the brain to the body. There et al. 2011). Because of its myriad attachment sites to the trans
are four natural curves in a healthy vertebral spine. The low back verse processes and the intervertebral disks in the lumbar region, it
(lumbar spine) curves inward (toward the front of the body) and is crucial that the psoas be able to lengthen sufficiently enough to
sacral (at the base of the spine) tilts forward, the middle back allow the spine and pelvis tomove naturally.
(thoracic spine) curves outward, and the neck (cervical spine) Hours in the sitting position detract from the psoas' ability to
curves inward. (Cheng et al. 2010). The lumbar spine consists of extend toa length that will allow for proper spinal and pelvic align
five articulating segments that work to flex, extend, side-bend and ment when standing and walking. Many clients move from a day of
rotate the torso. These lower vertebrae are larger, bearing most of seated work to workouts that further perpetuate shortening ofthe
thebody's weight load. psoas, which can lead topsoas-related issues ofthelow back, pelvis
The spines ligaments, muscles, fasciae and intervertebral disks and hips (Bowman 2012). Lunges using correct alignment can be
provide static anddynamic support tothebody. Back muscles include performed to help stretch thepsoas.
the superficial (trapezius, latissimus dorsi), intermediate (serra- BACK HEALTH RECOMMENDATIONS
tus posterior), and deep (erector spinae, multifidus). The deep or 1. Replace hip flexion-oriented activities, such astreadmill, ellipti
intrinsic back muscles facilitate movements of the vertebral column cal, stepper and bicycle workouts, with activities requiring hip
(Moore 1992). extension, such asoutdoor walking, in-line skating, swimming
48 AMERICAN FITNESS MAY/JUNE 2013 continued on page 50