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The spine: load bearer and buffer
7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, sacrum and coccyx – that’s it when it comes to the body’s support system. Not quite: we must not forget our intervertebral discs, ligaments and muscles without which the spine would be a wobbly assemblage of 24 vertebrae. The spine only functions properly and muscles only provide the required stability if all components work well together.
Its double S-shape gives it elasticity
The spine is not straight. If we look at it from the side, the cervical and lumbar vertebrae curve slightly towards the front of the body whereas the thoracic vertebrae curve to the rear. This double S-shape gives the spine its elasticity: it acts as a flexible shock absorber by distributing the mechanical stresses caused by movements such as running or jumping by tightening or loosening the “S”. A slight lordosis (hollowing of the back) is therefore desirable and is not in itself harmful.
Vertebrae – load bearers
The body of each vertebra is permanently fixed to its neighbouring intervertebral discs. As you get lower down the spine, the vertebrae become larger because the lumbar spine has to support heavier loads than the cervical or thoracic spine.
A series of vertebral arches form a vertebral canal, through which runs the spinal cord and from which the spinal nerves exit. Muscles must be capable of leverage and so each vertebral arch has a spinous process, which is the point of origin or insertion for many back muscles.
Ligaments, muscles and facet joints for stability
In addition, vertebrae are connected to each other by numerous ligaments and muscles, which keep the vertebrae firmly lashed together. In addition, each vertebra is connected to the one above by small facet joints, which together form the chain link that allows movement. It means the body can rotate around its spinal axle, bend forwards, backwards and sideways. Muscles provide the stability required for these movements and the ligaments and discs the necessary support.
Intervertebral discs cushion the spine
Intervertebral discs account for about one-quarter of the spinal column’s length. Discs consist of fluid-rich nucleus pulposus, which is held in place by an annulus fibrosus, a fibrous ring that absorbs pressure and impacts. The disc is restrained above and below by two fixed plates consisting of hyaline cartilage. However, very high pressure can stretch the fibrous ring so that in certain circumstances it can tear. This is known as a herniated disc (popularly also known as a “slipped disc”). If the nucleus pulposus reaches the vertebral canal or the intervertebral foramen, the result is pain, sensory problems or even a motor dysfunction. However, if the nucleus pulposus does not press on the nerves, a herniated disc may go unnoticed.
What effect does Kieser Training have on …
… the spine?
Strength training keeps discs healthy
First we need to get a preconception out of the way. It’s not loads that damage the spine. Quite the reverse, they actually prevent back pain, etc. If a load is exerted on the spine, this triggers an exchange of nutrient rich fluids through the collagenous fibres of the intervertebral discs rather than just blood. This is a continuous process, which alternates between load and non-load and can be likened to the action of a sponge. When you squeeze a sponge, it immediately absorbs more fluid. With strength training, this happens automatically, e.g. when you train on E1 (neck press), this exerts a load on the discs whereas training on D7 (seated dip) releases that load.
Photo: © Michael Ingenweyen
Back pain as a result of a lack of strength
The spine is stabilised and moved by the muscles that run to the right and left of the spinal column from head to pelvis and that straighten the torso. These muscles are also known as the erector muscles of the spine. The shorter erector muscles form what is known as the “local system”. Its role is to provide a direct connection between individual vertebrae. The longer erector muscles together with other torso muscles are known as the “global system”. Its prime role is to facilitate more extensive movements. Back pain often occurs if the local system in particular is overloaded, i.e. the connection between individual vertebrae is unstable. In addition, untrained muscles are more susceptible to injury and take longer to regenerate than trained muscles. If the response to minor symptoms is the avoidance of certain movements, the symptoms can soon become more serious.
Muscle training as prevention
Effective machine-based strength training helps prevent back pain as it provides targeted training for the deep back muscles and stimulates muscle metabolism. Strength training increases the stability of the spine making it less prone to wear and tear and reducing the risk of symptoms. In addition, training eliminates imbalances and improves posture. Strength training also stimulates the process of bone metabolism in the vertebrae, helps retain a compact bone structure and so prevents the loss of bone density typical of osteoporosis.
Doctor’s Tip:
In most cases you can prevent back surgery with targeted strength training.
Many of the back-pain patients who attend our practice have already tried numerous other treatments in their long quest for an end to their suffering including acupuncture, physiotherapy, massage and injections to name but a few. However, these therapies treat the symptoms and can only bring short-lived relief. In principle, any change to the spine – unless congenital – is caused by a weakness in the erector spinae muscles. The culprit in terms of pain is the increased pressure on spinal joints and intervertebral discs resulting from muscle weakness. To compensate for this lack of stability, the spine tends to ossify, which in turn leads to spinal stenosis (narrowing of the spinal canal) and facet joint arthrosis (wear on the vertebral body).
Dr. Florian Alfen
We conducted a study of 1,200 patients for whom surgery was indicated. The results were conclusive: thanks to Medical Strengthening Therapy 89% of them no longer needed surgery, i.e. only 11% still needed it.
However, surgery is not always avoidable. Indications for lumbar surgery include paresis (partial paralysis) of the muscles that lower and raise the foot, paresis of the quadriceps but also bladder/rectum problems and intolerable pain over a long period. However, numbness or tingling sensations are not initially surgical indications.
There are two simple tests that you can do to determine whether surgery is required:
1. Keeping one hand held firmly onto something for stability, stand on one leg. Raise your foot until you are standing on your toes and then lower it and stand on your heel. Repeat with the other leg.
2. Sit on a chair in front of a table and with both hands placed on the table stand up, firstly with the left and then with the right leg.
If you can do both exercises, surgery is likely to be contraindicated.
Of course, a DIY test is no substitute for a specialist examination. However, my tip is clear: Don’t put up with the pain for too long! Build up the strength of your autochthonous back muscles by doing Medical Strengthening Therapy at Kieser Training. You will soon notice the benefits; the pain quickly declines and with every additional session, the risk of surgery will also decline.
Dr. Florian Alfen
Orthopaedic Specialist, Spinal Surgery
