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10 things you didn't know about your spine.

28/4/2010

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Peninsula Spine and Joint Clinic
  1. Discs don’t slip. They split, bulge, leak or break up but they don’t slip
  2. The spine is made up of 24 vertebra, the sacrum and the coccyx. In between each of the vertebra there is a disc. There are 50 joints that join the spine together called facet joints.
  3. In old age, the bone of the spine can be so soft that a surgeon could leave a finger impression in it.
  4. If subjected to large compressive loads the vertebra will often buckle before the discs do.
  5. The discs in-between each vertebra have very little blood supply; they rely on the movement of the spine to suck the surrounding nutrient rich tissue fluid in and expel waste products of metabolism out.
  6. A muscle called the Latissimus Dorsi attaches to the lower five vertebra in the lower lumbar spine and travels all the up to the front of the humerus (upper arm bone).
  7. In order to touch your toes your low back will only bend for the first 60°- the next 20°- 30°, depending how flexible you are, takes place because your hamstrings (leg muscles) and gluteals (butt) allow your pelvis to tilt forward.
  8. An orthopaedic surgeon called Nachemson measured the pressure in the intervertebral disc of healthy subjects whilst adopting various positions. He found that the compressive pressure in your discs when standing is less than a 10th of that when you are sitting; ie in a normal man about 100kg (expressed as a weight) when standing and about 1000kg  - or 1 tonne – when sitting.
  9. The intervertebral discs swell overnight with rest and there can be as much as a 2cm difference between your height first thing in the morning and at the end of the day. This also accounts for the difficulty in putting on socks for back sufferers in the morning whereas taking them off in the evening is much easier.
  10. When you hear a pop from the joints in your back it is in fact small bubbles of gas created by movement of the facet joints popping and not bones cracking on each other.

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Why Sit-ups are bad for you?

12/4/2010

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Core stability is a buzz phrase in rehabilitation circles and part of the core stability programme for the abdominal muscles often involves doing sit-ups or modified sit-ups (Crunches).

Professor Stuart McGill, a leading biomechanics researcher established that the compressive load on the lumbar spine when doing a sit-up or a crunch is in excess of 3300N (about 730lbs). The USA's National Institute of Occupational Safety and Health has set the action limit for low back compression at 3400N. It has been found that repetitive lifting loads that generate this sort of compressive force on the lumbar spine is linked to higher injury rates in workers.

So should we do abdominal exercises at all? Well, yes probably but it is a case of doing a safe exercise that doesn't potentially do us more harm than good. An example of a safe abdominal raise is demonstrated by the excellent Dr Phillip Snell in the YouTube video below. 

The jury is still out on what type of exercise helps back pain, however it is probably true that keeping active is better than not. Most people would be very surprised at the lack of evidence for any type of exercise as a therapy for back pain. 

From experience exercises help as long as they don't compress their spine considerably as so called flexion exercises do or indeed the traditional extension exercises do. Just keep active without doing any chores - delegation, that's the key!

For more on exercise see my Advice page.

For the National Institute of Occupational Safety and Health click here http://www.cdc.gov/NIOSH/

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    Author

    Keith Walker is a chiropractor and manual therapist . He provides evidenced based care for his patients in Plymouth, Devon.


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