Back Basics
The Spine
Michael J. Mullin, ATC, PTA
The spine: The spine is designed to protect the spinal cord (the bundle of nerves that runs down the center of the vertebrae), act as an attachment for muscles and tendons to act upon, support the ribs which protects our vital organs, and support our body weight.
The anatomy: Comprised of 26 bones: 7 cervical, 12 thoracic, and 5 lumbar vertebrae, the sacrum and coccyx. Between the vertebrae are discs which are fluid-filled structures that act as shock absorbers. They function much like a water balloon when pressure is exerted upon it, with the fluid moving in the direction opposite of the motion.
The motion: All these structures move in concert with one another when the spine is in good alignment. Ligaments are the primary stabilizers, muscles and tendons are movers and secondary stabilizers, and the intervertebral discs cushion these movements and aid in their proper function.
The curves: There are four curves that occur naturally in the spine: 2 forward curves called cervical and lumbar curves and 2 backward curves called thoracic and sacral.
The position: Functional neutral position of the spine is the position where all of the vertebrae, ligaments, and muscles/tendons are ideally lined up or in their optimal position. This is generally in the position where one does not feel any form of pressure or tightness anywhere in the back. The pelvis is in mid-position, all the natural curves are present, and the muscles are in their mid-range position. This is most easily found by rotating your pelvis forward and back as far as it will go and settling in to what seems like mid-way, then subtly work your way up your spine to find positions that are most comfortable and least stressful in the given areas. You will feel a bit stiff initially, but maintaining this position throughout training and conditioning will optimize results.
The problem: When the spine is not in a good position during activity and/or when the muscles are not strong enough to maintain optimal positioning, then the forces are exerted onto the spine. In other words, you begin to rely on the joints to do the work, not the muscles. This is what overloads the spine and results in injury.
The posture: Unless the result of a fall or serious traumatic injury, most problems are typically due to repetitive overuse in poor posture causing the involved tissue to break down over time. Although it may be the result of lifting something too heavy or skiing too hard, it is the build up of all the bad mechanics repetitively that actually causes the problem. The mechanism is usually the coup de grace.
The program: Practicing good postural positioning throughout the day and during activities, improving flexibility (specifically of the hamstring, hip flexors, and hip rotators), strengthening the trunk muscles (abdominals, back extensors, and trunk rotators), and making sure to adequately warm-up and cool down are critical for preventative care of the back.
The exercises: It is imperative that functional neutral positioning of the spine be maintained during all these exercises. Good trunk exercises are:
- Crunches--lying on back with knees bent, curl upper body up lifting shoulder blades only
- Diagonal crunches--same but bringing right shoulder towards left knee
- Alternate leg touch downs--lying on back with tight abs, lift one leg off the ground then lower while lifting the opposite leg
- Bent to straight knee rotational touch downs--slow roll side-to-side while extending legs when up in the air and flexing legs when rolling to the side
* For advanced techniques, try performing the same on a foam roller or physio ball
- Prone press ups--lying on stomach with legs and hips relaxed, slowly press upper body off the floor without tightening muscles, then lower
- Prone hyperextensions--lying on stomach, tighten mid-section and lift upper and lower body off the floor simultaneously, then lower. Do not overstrain
- Good mornings--with back straight and legs mostly straight, but not locked, lift and lower a barbell or two hand weights through the hips
- Ski turns prone on a foam roller and/or physio ball--feet and lower legs on the ball, flex and extend legs towards and away from you
- Squats--feet planted, weight back and back straight
- Squats on an uneven surface--try performing on a balance board, trampoline, a couple of fluffy pillows
- Hamstring, butt lifts--lying on back with heel on a chair or bed, lift and lower hips off the floor. Start with two legs and progress to one as able