TRX Spine stabilization for Chiropractic Patients

As a chiropractor, I treat a number of people with lower back pain. Often times this is a result of some type of repetitive strain, poor movement mechanics, muscular imbalances (inflexibility or poor strength) and poor joint mobility. Sometimes back pain is a result of spinal joint instability (poor neuromuscular control to stabilize the spine) . I recently stumbled upon an article that I found to be very interesting regarding strengthening the spine for those with a joint instability so I decided to pass it along to all of you suffering from back pain
The interfoveolar ligament, seen from in front.Image via Wikipedia

One of the muscles that is believed to be involved in maintaining spinal stability is the transverse abdominis. Associated with this muscle, and with back pain, are the multifidii. Dysfunction in either of these muscles are associated with lower back pain.  Therefore, finding an exercise that trains these muscles to contract appropriately may help with back pain.

The Research
The researchers of the paper, Differences in Transverse Abdominis Activation with Stable and Unstable Bridging Exercises in Individuals with Low Back Pain, wanted to see which form of the bridge exercise results in the most activity of the transverse abominis. They compared conventional bridge exercises (two leg bridge, one legged bridge, bridge with shoulders on an unstable surface and a one legged bridge while abducting the free leg) while using the abdominal drawing in maneuver with a suspended version with the legs suspended in straps without the abdominal drawing in maneuvver. The researchers of this article took 51 individuals with back pain and separated them into two groups.  They used rehabilitative ultrasound imaging to measure the activity of the transverse abdominis during each variation of the exercise.
What the researchers found was that the conventional and suspended versions of each exercise had similar transverse abdominis activity but there was a trend towards higher activity with the suspended versions.  The only suspended exercise that showed a significant difference to its conventional counterpart was the suspended bridge with both legs abducting.
Practical application

Winnipeg Chiropractor Trx Suspension trainer b...Image by DrNotley.com via Flickr

Here is the exercise that resulted in the best activation of the transverse abdominis with a slight twist of using a TRX suspension trainer.   This is how you should perform the exercise

  1. Lay down onto the floor and side your feet through the feet straps/ring.
  2. Lift your buttocks up off the floor until your thighs are inline with your torso
  3. Open your legs up (abduct) and make sure your keep the hips up
  4. Hold for 10 seconds. Repeat
  5. Make sure you watch your breathing. Make sure you are breathing from the belly

Note: There should be no pain with this activity.  In the research paper all subjects were able to perform the exercise pain free even though they had back pain.

This is what I learned from this paper:

  1. Suspended versions tend towards better activity of the transverse abdominis, especially with movement of the lower extremity.
  2. With regards to the abdominal drawing in maneuver it may not be necessary to teach provided similar benefits can be seen with the suspended method.
  3. I would be curious to see how the conventional bridge variations would compare both with and without the abdominal drawing in maneuver.
  4. I would also be curious to see if performing the abdominal maneuver during the suspended versions would result in superior results
  5. I would like to find out if performing these suspended versions would result in improvement in the subjects’ condition.
  6. What would the results be if we added in different leg movements?

That is all for this week. Until next time feel free and send me a message if you have any questions

Dr Notley

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