PREVENTION PLUS CLINIC
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BACK STRENGTHENING PROGRAM

 The human body is an incredible and extremely complex in its' design. In order to support the spine properly, various large muscles of the body work together with tough connective tissues. These muscles of the trunk must be strengthened together. The vertebral column with it's shock absorbers - the discs- lies slightly posterior to the center of the body. In order for the discs to work properly, there must be uniform load on them, i.e., weight must be applied equally to the entire surface. In order for this to happen the muscles of the trunk must be equally strong in all directions. If the muscles of the back are stronger than the abdomen, the spine will be too sway-backed and the posterior portion of the disc will be asked to support the body weight. This leads to degeneration and/or rupture of the disc with it's consequent problems. In order to walk upright, several muscles have developed in the human to facilitate this. There is also a sheet of strong fibrous tissue that encloses the muscles and give them extra strength. Muscles of the upper back and buttock pull these sheets tight in a vertical direction.  In this way the muscles of the abdomen and back support the trunk. The muscles of the sides connect the supports of the front to the supports in the back giving extra strength just like the bands around a barrel give strength to the slates.

The following program is designed to strengthen the muscles that must work in harmony to support the back and prevent back pain and injury. As a result of our sedentary society we have allowed certain muscles to become weak. Also by being overweight especially in the abdominal region, the lack of abdominal strength is magnified. By following the program below a more balanced trunk is achieved and maintained, thereby allowing a more functional life.

The following muscles must be strengthened: the supporters of the spine-abdominals and spinal erectors; the muscles that tighten the sheet of connective tissue- gluteus maximus on the bottom and  laticimus dorsi on top; and the muscles that connect the front support to the back support- the abdominal obliques.

1.   ABDOMINAL MUSCLES- These are the muscles in the front of your stomach. They stretch from the pubic bone to the breast bone. The basic bent knee sit-up is the best method for strengthening. This allows a full range of contraction and relaxation of the muscle group unlike the "crunchie" which focuses on maintained contraction only.

2.   SPINAL ERECTORS- This large muscle group stretches from the pelvis to the ribs and spine. It is best strengthened by hyper-extensions. This is performed by lying on the stomach and arching the back. This will raise the head and shoulders off the ground. This position is maintained for a count  then relaxed.

3.   GLUTEUS MAXIMUS- This is the large buttock muscle. The best exercise for this is the full squat (deep knee bend). Performed properly this does not hurt the knees and serves to strengthen the legs as well. It is very important that the feet be far enough apart that the heels can remain on the ground. (see special handout)

4.   LATISIMUSS DORSI- This is the large fan shaped muscle of the upper back. It stretches from the spine and ribs to the arms. Its strength helps to keep the fibrous sheet tight. The rowing motion is a good exercise for this and can be performed with rubber tubing either in a sitting position or bent over.

5.   OBLIQUE ABDOMINAL MUSCLES- These muscles are on each of your sides. They run diagonally from the ribs and back to the pubic bone and pelvis. These muscles aid in rotating your trunk and are best strengthened by rotating sit-ups. The bent knee format is used but the trunk is kept in rotation from floor to knees and back again. The opposite elbow goes to the opposite knee.

  The following program can be used by everyone to strengthen their trunk. Remember to always start slowly and gradually increase the repetitions as you become more fit. This program can be performed in a short amount of time at home.

  Start the routine with 3 sets (groups) of 5 repetitions in the sit-ups both regular and obliques, squats, and rows. Hyperextensions should be held to a count of 5 then rest this counts as one repetition. When you do not get sore the next day after performing this, increase the repetitions gradually up to a total of 15 per set. This will give you a good workout and help prevent back injury. If you wish to get even stronger you can then progress to using weight, however, it is not necessary for basic fitness.   

  It is normal to feel sore after exercising. This soreness can last several days and it means that your body is responding properly and getting stronger. If you are very uncomfortable use either Tylenol or Advil for relief. Don't stop exercising, merely reduce the number or repetitions.  You will feel better if you actually train through the soreness and your progress will be more rapid as well.