The Cause of Back Pain

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m.e.c.a. THE BACK INSTITUTE

The Cause of Back Pain And the Solution for a Healthy Back Dr. Jeffrey T. Anderson, CSCS

Tuesday, December 21, 2010

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If you have back pain, you are not alone. • Back pain is the second most common reason for visits to the doctors’ office, surpassed only by upper respiratory infections*

• Americans spend at least $86 billion each year on lower back pain**

* Hestbaek L, Leboeuf-Yde C, Engberg M, Lauritzen T, Bruun NH, Manniche C. The course of low-back pain in a general population. Results from a 5-year prospective study. J Manipulative Physiol Ther 2003 May;26(4):213-9. **The Journal of the American Medical Association, 2/13/2008

Tuesday, December 21, 2010


Back Pain: Mechanical in Nature

Sourced from The Back Pain Revolution by Dr. Gordon Waddell

Origin

The graph to the left represents patients that Waddell evaluated for surgery. 94% of his patients’ low back disorders were found to be mechanical in origin.

As we shall soon see, disc issues are also mechanical in origin.

Tuesday, December 21, 2010


Back Pain: Mechanical and Avoidable According to the National Institute of Health:

• 85% of the population will experience a back problem at some point in their lives.

• And by age 50, 85% of the population will also develop degenerative disc disease (a form of arthritis). What we NOW know:

Why we have back pain, and how to prevent it in the overwhelming majority of the population! Tuesday, December 21, 2010


The Evolution of Back Pain

1. The primate (ape) pelvis shown here is in the posterior tilted position, which prevents the animal from standing erect. 2. As humans evolved, the pelvis tilted under the spine forcing a lordotic (or c- shape) lumbar curve, and mechanically allowing for an upright stance. 3. Today, humans are sitting more - and for longer durations of time - which is slowly and constantly creating a posterior pelvic tilt. 4. This posterior tilted position is the predominant cause for mechanical dysfunction in human lumbar spines.

Tuesday, December 21, 2010


Sitting in Chairs

...the cause of our back epidemic! McGill SM, Brown S. Creep response of the lumbar spine to prolonged full flexion. Clinical Biomechanics. 1992; 7: 43-46 Tuesday, December 21, 2010


What? Sitting is the cause of our bad backs?

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Sitting Causes “Creep” What is CREEP? Creep is the elongation of tissue beyond its intrinsic extensibility, resulting from a

constant load over time Creeping gradually lengthens and weakens these

spinal soft tissues (ligaments, disc, tendon, fascia, muscle) Wilhelmi Bj,Blackwell Sj, Mancoll Js, Phillips LG. Creep vs. Stretch: a review of the viscoelastic properties of skin. Ann Plast Surg. 1998;41:215-219

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This slide illustrates where gravity (red line) should pass through the vertebral bodies of a normal lumbar spine. Because of creep, our backs stretch and our lumbar curve flattens. We then lose the natural leverage that supports our own weight. Tuesday, December 21, 2010


How Does it Happen?

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sitting stretches the back of the disc wall, causing it to thin and weaken

increased weight bearing from posterior pelvic tilt

all soft tissues to the right of the pivot point stretch

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Creep Causes Disc Herniation

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Examples

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The Worse the Posture, the Faster the Creep

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Forward Bending Speeds Up the Creep Process Even More

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Riding the pine is wrecking your spine! Not because of the sport, but because of sitting on the bench. Athletes are at a greater risk. Studies show that “bench sitting” negates the benefits of warm up and creates instability in spines. Green, J., Grenier, S., and McGill, S.M., 2002. Low back stiffness is altered with warm up and bench rest; implications for athletes. Med. Sci. Sports Exerc., 34(7): 1076-1081. Tuesday, December 21, 2010


Change in Disc Pressure (by position) healthy disc

“creeped” disc Tuesday, December 21, 2010


How Do We Know We’re Creeping?

*Hedman TP, Fernie GR. Mechanical response of the lumbar spine to seated postural loads. Spine. 1997; 22: 734-743.

Tuesday, December 21, 2010


How Do We Know We’re Creeping? • Stiffness is the first sign • Stiffness leads to disc degeneration and arthritis*

*Hedman TP, Fernie GR. Mechanical response of the lumbar spine to seated postural loads. Spine. 1997; 22: 734-743.

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So, how do we address back issues? Stretch our muscles..? Strengthen our core..?

Tuesday, December 21, 2010


Yes...but how?

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Stretching Pitfalls • Classic hamstring

stretch of toe touching -- rounds the lower back

• Creates more PPT, more pressure in the lower back, more creep

Little, J.S., and Khalsa, S. , 2005. Human lumbar spine creep during cyclic and static flexion: Creep rate, biomechanics and facet joint capsule strain. Ann.Biomed Eng. March; 33(3): 391-401.

Tuesday, December 21, 2010


Strength Pitfalls Studies show up to 730 lbs. of downward force is generated on the lower back from the traditional ab crunch!* Many types of low back exercises create the posterior pelvic tilt. This actually increases the risk by flexing the lumbar joints and loading passive tissues. The recommendation of flatting the lumbar region to the floor when performing abdominal exercise is another version of this ill-founded philosophy.

* Axler,C., and McGill,SM (1997). Low back loads over a series of abdominal exercises : searching for the safest abdominal challenge. Medicine and science in sports and exercise,29 (6):804-811.

Tuesday, December 21, 2010


The Irony of Ab Work

We may be harming our lower back at the same time we are trying to condition it! “Damage to the annulus of the disc (herniation) appears to be associated w/ fully flexing the spine for repeated or prolonged period of time. In fact, herniation of the disc seems almost impossible without full flexion. This has implications for exercise prescription particularly for flexion stretching and sit-ups or for activities such as prolonged sitting , all of which are characterized by a flexed spine.” McGill , Stuart. Low Back Dissorders Eidence-based Prevention and Rehabilitation. 2. Champaign,IL: Human Kinetics, 2007.47

Tuesday, December 21, 2010


There is another solution.

m.e.c.a. THE BACK INSTITUTE

Tuesday, December 21, 2010


Prevention is as easy as knowing how. M obility:

The independent (or individual) movement between spinal joints.

E lasticity:

The resiliency of soft tissue (muscle, tendons, ligaments, fascia and

discs). Elasticity differs from flexibility in that elasticity refers to the pliability of soft tissue rather then just being flexible.

C ore Strength (and Core Stability):

The strength and stability of

core muscles and how that strength and stability are integrated into movement.

A daptability:

The integration of these three elements (Mobility, Elasticity, Core

Strength) improves the ability of our spine to function without deficit or mechanical breakdown, thereby increasing the back’s overall resilience. Like any other machine, our body mechanics is a reflection of the optimized function of its parts and the ability of those parts to work together as a cohesive unit.

Tuesday, December 21, 2010


This new paradigm shift has led to the development of The MECA Back InstituteTM

MECATM is an acronym for three integrated components, that when are acting synergistically, optimize the function of our backs and lead to overall back health.

Adaptability

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The Healthy Back Solution • Increase ELASTICITY of the hip muscles by

stretching daily without PPT or loading spine

• PASSIVELY EXTEND the spine with the MECA Back

Wedge to enhance the natural lower back curve and increase the elasticity of spinal soft tissues

• STRENGTHEN the core without enhancing PPT or incorrectly loading the spine

Tuesday, December 21, 2010


The MECA Back Wedge • Recirculates disc fluids and restores loss of disc height*

• Gradually improves normal lumbar curvature • Increases elasticity of the supportive soft tissues of our spine

• Reverses the creep effect! * The Iowa Orthopaedic Journal: Spine Height and Disc Height Changes As the Effect of Hyperextension Using Stadiometry and MRI. Iowa Orthop J. 2004; 24: 65–71.

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It’s as easy as 10 minutes a day.

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The MECA Back Protocol Pigeon down - 1 minute

Pigeon up - 20 seconds

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Lay on the wedge - 10 minutes Tuesday, December 21, 2010


Protect your back, Strengthen your abs.

Using the MECA back wedge for abdominal exercises prevents the damaging effects of PPT - keeps your spine extended AND protected Tuesday, December 21, 2010


Back Protection + Effective Exercise Using the wedge for abdominal exercises: Makes the effort greater and increases the effectiveness of the exercise.

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Animated Ab Crunch Video Please click here to see the animated video

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Summary • 85% of the population will have a chronic low back complaint by age 50 • Traditional back care does not address back education and prevention, only short-term treatment for back pain Tuesday, December 21, 2010

Origin


Not taking a preventative approach to your back health is the equivalent of going to the dentist to fix a problem... having never brushed your teeth. Tuesday, December 21, 2010


• The MECA Back Wedge is a revolutionary tool to use in the daily exercises that strengthen & condition your back • The general public, and athletes in particular, will benefit from the MECA system Tuesday, December 21, 2010


m.e.c.a. THE BACK INSTITUTE

We are happy to respond to your questions and comments. Please email us at info@mecaback.com or visit our web site: www.mecaback.com Thank you for your attention!

Tuesday, December 21, 2010


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