Learning from Two Lower Back Luminaries

In the last month and a half, I've had the opportunity to spend a significant amount of time with two luminaries in the field of low back pain management and prevention.  Last week, I toured the campus of Medical Exercise Associates in Daytona Beach, Florida and met for a few hours with the founding physician, orthopedic surgeon, Dr. Michael Fulton.  About thirty years ago, Dr. Fulton discontinued performing low back surgeries in favor of using clinical strengthening tools designed by MedX to restore patients to normal low back function.
 
Nearing the twilight of his career, Dr. Fulton's message was clear: For the clear majority of manifestations of low back pain, isolated strengthening of low back muscles is more effective in mitigating and managing low back pain over the long haul then surgery or passive modalities. 
In mid-March, Ted Dreisinger, Ph.D., an exercise physiologist with significant experience as both a clinician and a researcher in low back pain gave a keynote presentation at the Resistance Exercise Conference in Minneapolis. 
 
Dreisinger's take home messages included:  
  • "Strength and strength exercises are the most effective and predictable low back pain management tool."
  • "The only way to increase function in chronic disease is through strengthening."
  • "Exercising the lower back muscles to volitional failure is very important."
Dreisinger also outlines a hierarchy of effectiveness for low back exercises.
  1. Superman exercise.  If you have access to nothing else, this will provide effective stimulation for the lower back muscles.
  2. Roman Chair Back extension.  This is a step toward more effective strengthening. 
  3. MedX Lumbar Extension machine.  According to the clinical research, this represents the most effective exercise intervention because it stabilizes the hips and pelvis which allows the lower back muscles to perform the work; the collectively strengthens muscle, increases blood flow, and increases disc lubrication.  
Dr. Fulton and Dr. Dreisinger agree, the very solution that offers the longest-term pain and symptom relief for the majority of back pain patients is the very thing they are most apprehensive about trying: Isolated strengthening of the lower back musculature (utilizing MedX technology). 

Tagged: low back, low back exercise, lumbar strength

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