TRX suspension trainer and back pain: challenging the spine

stop back pain
This is a continuation of my previous blog post, Core Training: Back Pain Rehabilitation and Rowing Exercise. 

If you don’t feel like reading the previous post, the research paper compared the load on the spine between three rowing exercises (inverted row, one arm standing row, and bent over row). The inverted row had the lowest load on the spine. The one arm row had the highest torsional challenge (the core resisting rotation). The bent over row had the highest load on the spine.

Since I love using my TRX suspension trainer I wondered how I could apply this tool for spine rehabilitation. When incorporating a core strengthening program to a back pain patient it is important to start with low spine loads and increase the challenge as they are capable.

Here is how I figure you can control the load on your spine while doing rowing exercises with the TRX suspension trainer.

TRX Inverted Row: Minimizing spinal load

As I said before, the inverted row was the exercise that had the least load on the spine.  It just so happens, that the researchers used suspended handles to perform this exercise.  The same exercise can be easily applied to the TRX suspension trainer as you can see in this video.

TRX Low Row

A dramatic increase in resistance can be achieved to the inverted row by performing the straight legged version of the row called the TRX low row.

If you are horizontal to the ground both the resistance and the load on the spine will increase. This horizontal position may result in spinal loads greater than the inverted row. As you move your feet further backwards, thus making your body closer to vertical the resistance will decrease.  There may come a point that, where you are nearing vertical, that the resistance will be less than the inverted row and may also result in a lower load on the spine. This may be an appropriate place to start especially if arm strength doesn’t allow you to perform the inverted row correctly or if you are early in your back pain rehabilitation.

TRX One Arm Row: Challenging rotation

Training the core to resist rotation is also important.  This strength allows the spine to transfer the energy from the hips up to the arms during  activities like the golf swing and the slap shot in hockey. The TRX one arm row is an ideal exercise to use.

The research paper found that the pulley one arm row provides more load to the spine (when resistance is the same) and requires greater core strength to resist rotation. The one arm TRX row is very similar to this exercise.  The nice thing though is that the resistance can be lowered, earlier on in your spine rehabiliation, to lower the load on the spine and also to ensure core stability is maintain.  As the spine strengthens resistance can be increased. If technique becomes faulty the resistance is too high for the core and it should be reduced. The nice part about the TRX is that by simply moving further from the anchoring point of the TRX you can lessen the load.  If technique perfect then moving your feet closer to the anchoring point will make it harder.

So when considering my chiropractic patients, who have lower back injuries, the TRX may be a great exercise tool to help them train their core and adjust the amount of load on their spine during their rehabilitation.

I hope this post was interesting.

If you have any questions feel free and email, post on my facebook or message me on twitter.

Dr Notley

Treating people from Winnipeg with back pain since 2000

Core Training: Back Pain Rehabilitation and Rowing Exercises

stop back painCore training is a very common word in both the fitness/sports performance industry and the back rehabilitation industry.  The reason for training the core is to improve stiffness and stability of the spine.  Stability is defined as, how well the spine can maintain or recover from a change from its original position.  The greater the ability to coordinate muscle contraction to keep the spine stable results in greater stability.  The importance to core training for back care is that “individuals with higher muscle activation had a higher “margin of safety” in terms of stability than individuals with lower muscle activation.”

But how can a person who has had back pain train their core without over stressing the spine? When choosing exercises during a rehabilitation program we need to consider where the back pain sufferer is at in their stage of healing.  It would make sense that the more acute the injury the less load that the spine can handle. Therefore we need to choose exercises that provide lower spinal loads.  I found a research paper from the Spine Biomechanics Laboratory  at the University of Waterloo which compares stiffness and load of the spine with three different rowing exercises.  I thought it was very interesting so I decided to share with you.

The researchers applied EMG electrodes to several different  muscles around the core and video taped seven (7), untrained, individuals performing the inverted row, bent over row and one arm standing row.  The resistance for all exercises was standardized.  They were able to determine the muscular activation of each muscle, the shear and load on the spine and the degrees of rotation of the spine

Exercise highlights 

Inverted row

The inverted row tends to have the most activation of the gluteus maximus, gluteus medius and hamstring (biceps femoris) muscles.  The bent over row has less activation of these muscles and the standing one arm row has the least activation. The researchers found that the compressive forces and front to back shear forces on the lumbar spine is similar to the bird dog exercise but there is more muscle activation of the hamstrings and gluteal muscles.  The inverted row also tends to result in more activation of the erector spinae muscles in the mid back region. The inverted row had the least amount of flexor (front side of the body)  stiffness.

One arm row (right arm pronated grip)

The left external oblique and right internal oblique had higher activation levels as compared to the other exercises (only the right hand was used for the research).  This resulted in this exercise being the best challenge to torsional rotation and torsional muscular stiffness.  This exercise also demonstrated the most rotation of the spine (7.6 degree rotation) compared to the other two exercises (2-3 degrees)

Bent over row

The standing bent  over row had the most muscle activation of the lumbar erector spinae, followed by the inverted row and lastly the standing one arm row. It
also had the highest spinal compression as well as the largest challenge
to flexion and extension stiffness.

Compressive and shear forces on the spine 

The bent over row has the highest compressive forces on the spine, followed by the 1-arm standing row and the inverted row having the lowest compression.

Front/back shear forces on the spine was the same for all exercises but the side to side shear forces was the most with the 1-arm standing row.

ConclusionSo when considering conditioning exercises we have to make sure we look at the stage the chiropractic / athletic therapy patient is at and then choose the appropriate exercise. Starting with exercises that don’t stress the spine as much and then increasing the challenge on the spine as the condition improves. I would likely start my patients off with bird dogs and the inverted row to minimize excessive spinal loads.

If you have any questions feel free and ask.

Dr Notley
Serving Winnipeg as an Athletic Therapist and/or Chiropractor since 2000

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 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

Dr Notley performing TRX 40/40 challenge update #2

It has been seven and half weeks since I last performed the TRX 40/40 challenge.  At that time I had managed to perform 27 TRX low rows and 29 TRX atomic pushups.  I am pleased to say, after this past weekend’s attempt, that I managed to complete 29 TRX low rows and 41 atomic pushups.  This is definitely an improvement in the pushups department but not so much in the low rows.  This still means I have not reached the 30/30 club, yet, but I am almost there. Actually, I don’t think it will be long before I am at the 40/40 club. Check out my video performing the TRX 40/40 challenge


It is evident that my training has helped with improving my atomic pushups.  I will now be switching more of my focus on improving the row.  I will put more emphasis on different forms of rowing including exercises like the T’s Y’s and I’s and well as high rows and single arm rows using the TRX. I will perform more rowing exercises with my kettlebells as well. I will likely alternate between strengthening exercises and endurance exercises.

I will perform another test in about a 2 months

Until next time,

Dr Notley

Winnipeg’s only dual credentialed Chiropractor and Athletic Therapist

Related articles

Shoulder stability training

A while back, when I first started the TRX 40/40 challenge I noted, during the TRX atomic pushups, that my arms were wobbling too much.  My shoulders have always been my Achilles’ heel. The weakness in my shoulders may explain why I have often had aches and pains when performing different exercises that emphasis the shoulders (shoulder press, lateral raises and bench press).

I know that by strengthening my rotator cuff muscles, as well as my scapular muscles, my performance on the atomic pushup should improve.  Strong stabilizing muscles means that more of your energy can be put into performing the task at hand.

Here are the exercises that I have been doing to help strengthen my rotator cuff muscles and my scapular muscles:

  1. TRX body saw
  2. TRX side plank with reach under 
  3. TRX T’s, Y’s and W’s – Aka Letters
  4. Kettlebell Turkish Get-up
  5. Kettlebell Windmill 

    I often treat patients with shoulder problems.  Addressing their stabilizing muscles is often a key component to their treatment success. These are more advanced exercises and I do not prescribe my Chiropractic patients these exercises until they have developed better control of their scapular stabilizers and rotator cuff muscles.  I prescribe non-TRX and Kettlebell versions of these exercises unless my patients are considering purchasing a TRX and kettlebell.  If they are interested I send them to the Fitness Anywhere website or to another trusted seller (there are fake TRX’s out there).

    I hope you enjoyed this post. Until next time,  make a concentrated effort to develop a healthy change in your life.

    Dr Notley
    Winnipeg’s only duel credentialed Chiropractor and Athletic Therapist