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Is ab workout hurting your back?

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  • Is ab workout hurting your back?

    I don't know if this article from the NY Times applies to scoliosis but it caught my eye: http://well.blogs.nytimes.com/2009/06/17/core-myths/?em

    Some new research indicates that some exercises that had been thought of as essential for core strength are now thought to be unsafe. I was relieved to see that the exercises my daughter's PT has her doing are the ones that are considered safe. For years, though, she did sit-ups; lots and lots of sit ups; in gym class and dance classes. She was proud that she could do 50 w/o batting an eye. Now I wonder if that has contributed to her pain.

  • #2
    Hmmm, interesting - thanks for posting that. I started doing fairly standard crunches (like in the very beginning of the video) about a month ago because i figured it would only help my back. I've always been told that strong abdominals help your back be stronger as well. I knew real sit ups were tough on the back, but I never thought normal crunches would be a problem too! Guess I'll have to rethink that...

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    • #3
      Thank you for posting that article. I've known for a long time that sit ups were bad for the back but didn't know that crunches were since they were taught to me by physical therapists a long time ago when I first started having back pain. Since my surgery, my therapist recommends the dead bug exercise - lying on your back, bending you legs at hips and knees at right angles and moving them back and forth in unison with the arms stretched out and moving one up and one down. Eventually working up to three minutes. I sure hope this is considered to be safe. We'll probably know for sure in another twenty years or so.
      Sally
      Diagnosed with severe lumbar scoliosis at age 65.
      Posterior Fusion L2-S1 on 12/4/2007. age 67
      Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
      Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
      New England Baptist Hospital, Boston, MA
      Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

      "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

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      • #4
        If you take a Pilates course, you will be able to learn many safe exercises to get a great abs workout. However, people with back issues need to avoid advanced Pliates exercises, which do require a great deal of hip flexor activity, which can be hard on a more delicate spine.
        Bettina:
        - 34 year old physiotherapist
        - main curve of 3 is mid-thoracic convex, approx 37 d.
        - my goal: to stay as upright, strong and painfree as I can, as long as I can.

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        • #5
          oblique abdominal exercises

          aterry

          Thank you so much for the post.

          One exercise in the NY Times video really stood out.

          The Side Plank specifically hits the oblique abdominal muscles.
          Video: Side Plank

          Sorry to rehash old news but all children with AIS have muscle asymmetry. Put simply one side of the back and one side of the abs are stronger than the other (left vs. right).

          Strength asymmetry of the oblique abdominal muscles might be a critical part of the problem.

          Study: Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study
          Multiple muscle groups are involved in rotating the trunk. Among the most important muscle groups for trunk rotation are the oblique abdominal muscles. It is possible that the measured strength asymmetry is a result of altered biomechanics of the oblique abdominal muscles due to the asymmetrical torso.
          Why might strength asymmetry in the oblique abdominals (and other mucles) lead to trouble?

          According to this study strength asymmetry directly relates to rotation and ultimately cobb angle.
          Geometric and electromyographic assessments in the evaluation of curve progression in idiopathic scoliosis.

          In the natural history of idiopathic scoliosis, SGV (remaining growth) and EMG (strength asymmetry) ratio at the lower end vertebra are prominent risk factors of curve progression. The asymmetric muscle activity is associated with increased axial rotation, which in its turn is associated with increasing Cobb angle and diminishing kyphosis.
          Translation: The more growth that remains + the more that the muscles are imbalanced = more spine rotation which in turn leads to a larger cobb angle.

          Obviously this is an average of 105 kids. Every spine breaks a little differently.

          Dr. Douglas Kiester told me essentially the same thing. First the spine rotates and then growth pushes out the lateral curve.
          Last edited by Dingo; 06-22-2009, 09:40 AM.

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          • #6
            thanks dingo. so, what other ab exercises do you know of that you think are safe aside from the lateral plank? do you know of any versions where you can still lie on the ground in a supine position?

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            • #7
              oblique ab exercises

              MissEmmyF

              do you know of any versions where you can still lie on the ground in a supine position?
              I'm not exactly sure. My son can do the plank but he's probably not coordinated enough to do the next two exercises.

              Katie Bowers - Oblique exercise 2

              Katie Bowers - Oblique exercise 3

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              • #8
                I noticed in the video of the oblique exercise 3, that the instructor calls for pressing the belly button to the spine. Is that the kind of concaving that is warned about in the Times article? I find this all very tricky.

                The side exercise that the PT has my daughter do involves lying on your side with knees bent; arms crossed over chest; and then pulling up like a sit up, except to the side. The PT has her lying over three cushions so she is actually going beyond the 180 degree line. She has her do 20. (I can't even do one.) Now I'm wondering about that.

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                • #9
                  Originally posted by aterry View Post
                  I noticed in the video of the oblique exercise 3, that the instructor calls for pressing the belly button to the spine. Is that the kind of concaving that is warned about in the Times article? I find this all very tricky.
                  Yeah, I don't think you should be pressing the belly button to the spine. To me, I translate this to mean "flatten your back against the floor"...which is the exact opposite of what I was told. Is that what it means?

                  When I asked my Schroth practitioner about ab work, here was his response:
                  "When doing abdominal work you must be careful not to lose your neutral lumbar lordosis. Do not flatten the lumbar spine." He is sending me an ab exercise in the mail that I should be receiving soon...he said it uses a ball. I'll keep you posted on what the exercise is.

                  Confusing...

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                  • #10
                    Generally I tell my patients to "suck in their abs" like they're "putting on a tight pair of jeans" (borrowed from the Pilates people) to recruit the transverse abs, best supposed stabilizer. Then, like in Pilates, we challenge it by doing exercises like "Marching". Sometimes I use a thing called a "Stabilizer" (like a blood pressure cuff) under a patient's back to be sure that the spine stays in neutral with each exercise of increased difficulty. I sometimes use "Side Planks" for strengthening glut. medius, and modified "Bird Dogs" for glut. max., but there are many ways to target the same muscle groups. I often include lat. and hip adductor (inner thigh) strengthening, too. I try to form a protective "box" around the lumbopelvic area. There are exceptions to every rule, though. Some people with advanced degenerative changes benefit from "flattening" their backs to the surface beneath them (old fashioned "Pelvic Tilt"). Can put stress on a young disc, but creates space for a very crowded nerve root. (i.e. deg. disc, arthritic facet joints, thickened ligaments, etc.). The thing is...the lowback is only one consideration with scoliosis. You have to be sure that what you're doing in the lowback doesn't screw up something above it. And fusions, other medical problems, etc. add their own rules to exercise plans.
                    Last edited by gardenjen; 06-30-2009, 08:40 AM. Reason: spelling error :-)

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                    • #11
                      The bellybutton thing is really sucking in your gut, not lowering your back any. And you should really do that with all your exercising-- even walking. At least that is what my PT told me.

                      A long while back I posted some core strengthening exercises that were gentle-- they were ones I did almost one year post-op-- and were very gentle (but I worked up to some of them). Both my surgeon and my PT were quite conservative in what I was allowed to do. I would think that they (the exercises) would be gentle for an unfused spine as well. I DO know that I was told that I should never do bridges or crunches or anything else that puts strain on the spine. And I know that my PT had me use that thing gardenjen mentioned to check and make sure you are not lowering your back when doing some of them. I think we used that when I was raising and lowering my legs-- and he said I did it really well. Anyway, you can suck in your bellybutton without lowering your back any...


                      If you want to see a discussion on abs/core exercises, do a search. Here is a link to the one I was talking about-- post #14 has some exercises in it that my PT had me do. Again, these were after 11 months post-op. http://www.scoliosis.org/forum/showt...ning+exercises
                      71 and plugging along... but having some problems
                      2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
                      5/4/07 posterior fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
                      Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

                      Corrected to 15°
                      CMT (type 2) DX in 2014, progressing
                      10/2018 x-rays - spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

                      Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

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                      • #12
                        Isn't there kind of an old saying or rumor that if you don't suck in your gut/belly button when doing abs (ie when you crunch up you actually see the tummy at the lower portion expand and grow) that you ab muscles will grow out that way and you'll have an ab pooch or something?

                        As far as the belly button to back thing- from what I've learned in PT and pilates that is for your abs only... for me my back is over arched in my rib area so I have to flatten that portion of my back but at the very bottom of it- behind the belly button and the start of your butt- that should always have a slight arch in it since that is the back's natural position. Even when I was doing pilates there was only one exercise in which we actually flattened our entire backs otherwise we were always in "neutral" in which your upper/mid back was flat but the very lower back had its natural arch.

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