Osteoporosis: spare or train back? Strangely enchanted, but also first and second option do not solve the problem. “Why?”, Asks any officer in the EXERCISE or fitness trainer with experience: a large number of publications on this issue with the claim that “a good muscular” or “trained back” is the Foundation of a healthy spine. Certainly have trained the muscles surrounding the spine, is better than a weak, however there are a number of questions that allow you to look at this from another angle.
Firstly, why do periodically spin hurts those who play sports of the higher achievements? About these people you will not say that they have “weak” muscles.
Secondly, what the pain is just another problem in a number of other diseases, such as heart disease, vascular hypertension, thrombophlebitis? After all, any increase in the intensity of the load, which is accompanied by a power training, may cause deterioration and worsening of the disease?
And thirdly, how to correctly associate pain with the largest load provided by exercise on the body?
Let’s try to sort out this problem and consider it from different sides. First of all you need to know, which caused pain, or as they say in medicine, etiology. The fact is that pain can be the result of osteochondrosis, intervertebral hernia, diseases of the joints of the spine inflammation in muscles and tendons, tumors, and the consequence of problems of internal organs: heart, kidneys and others. The list goes on and on, moreover, in some cases, localization of pain is perceived by the people the same, but the underlying cause of her origin can vary significantly. Therefore the conclusion first: accurate diagnosis of doctor-specialist is the basis of the choice of means and methods of physical activity. One of the most common problems of the spine in an age of high-speed Internet and space tourism is low back pain. Scientific papers and publications of the scientists are full of statistics about what osteoporosis is practically each person after 30 years, not to mention professional athletes, who are in pursuit of the results expose your musculoskeletal system a test result that is easily separated from the part of your health, changing it to the medals, titles and deeds. Degenerative disease of the spine that is accompanied by structural changes in intervertebral cartilage and bodies of vertebrae, with subsequent formation of bone growths (osteofits). Subsequently, the bony growths, increasing in size, causing narrowing (stenosis) of intervertebral channel and start to put pressure on the nerve roots, which increases with the shifting of the vertebrae relative to its anatomical position (Figure 1). Fig. 1 Spinal intervertebral channel due to the overgrowth of osteofìts. It is in moments when there is even a minor, but the dramatic displacement of the vertebrae, the pressure on the nerve roots of the spinal cord, which, apparently, has not been provided by the “creator”, because any compression of the cells of the nervous system (neurons) is regarded by the body as a possible threat of biological integrity, and he, of course, to reflexively defend themselves. An effective method that uses the human body, able to quickly limit the motion in any joint, is a pain. By definition, physiologists, pain is psychophysiological human condition, reflecting the most integrative feature of the body, which mobilizes a variety of systems it protection from exposure to harmful factors (Anohìn, p. k., Orlov, n., Yerokhin l. g., 1976). Slight pain is a signal about what kind of “detail” in the body gives crashes. Sharp, sharp pain-this is not a signal, and stating that the “detail” is close to the “serious damage” or, worse yet, “broke down.” And the more this kind of “failure”, so, naturally, the pain is stronger and more tangible. So, make a second conclusion: pain is a signal that the body is not all right, and the constant, does not pass the pain is reason to see a doctor. Another effective way, which uses the body, to prevent further displacement of the vertebrae is a spasm of the muscle near spline that creates the natural mobilization around the vertebrae. It follows the third conclusion: increased muscle tone around the spine is a sign of disturbance of the anatomical position of the segments of the spine and the harbinger of the damage, as the signal may already be pain. So, from the above it follows that changing the anatomical position of the vertebrae can cause increasing of compression of nerve roots osteofìtami, created by as a result of degenerative disc disease, and cause pain in the muscles and organs, which are innervated by the data side binding, the so-called pain of neurological nature. Therefore, ensuring the anatomical position of the vertebrae (image stabilization) in daily, work, and sport and recreational activity is a necessary condition for the normal functioning of the entire body in General and to guarantee the absence of exacerbation of the disease. It should be noted that the process of rehabilitation of the person has the disease or injury, implies not only the maximum recovery of anatomic integrity and function of systems and organs, but also to restore the quality of life. Moreover, in situations where fully restore structure and function is not possible, conservative means and methods aimed at minimizing factors that promote repeated sharpening and deepening problems come to the fore.
Overseas long ago got the distribution system called School back, which participants get skills of daily physical activity in terms of the existing problems of the spine. Thus, the issue of physical activity in General, and necessary exercise in particular, osteochondrosis it is necessary to watch for the following positions:
1) Kinaesthetic activity and exercise should contribute to maintaining normal levels of functioning of all body systems for full implementation of the vital task facing the man within his household, work, sports activity, i.e. its society. What traditionally used aerobic and strength training, stretching, etc. However, the implementation of these programs need to consider a number of rules:-during physical activity necessary to limit or exclude the impact load on the spine, such as running, jumping, etc.., as well as repeated shock force pulposus the core of the disc will extrude it aside, in terms of degenerative changes in the intervertebral cartilage can lead to protrusion and intervertebral hernia. -For the same reason when doing physical exercises necessary to limit or exclude-depending on the State of the spine-axial load on the backbone of more than 3 kg, which used the original position while lying, sitting, reclining on a sloping surface, in the water and etc. -During the sessions, aimed at the development of mobility in the joints, it is necessary to limit the excessive flexion, extension and stretching of the spine, as this kind of exercises (bridge, plow, free hanging o on the crossbar and etc.) contribute to stretch vertebrae the connection and as a result, destabilize the vertebrae relative to one another.
2) in the case of an existing pain exercise program should include a number of special exercises designed strictly individually and aimed at eliminating the consequences of the compression of the nerve roots. For example, postisometric relaxation of spasmed muscles, unloading and spine on special devices, reflex-segmental massage that improves the trophism of tissues and organs, innervated to side binding.
3) Studies human skills of stabilization of the spine in the face of the emergence of external and internal forces that can lead to misalignment of the vertebrae, increasing the compression on the nerve roots and thus, emergence or increased pain. Based on the foregoing, it can be concluded that the person who “regrets” back, rather than to improve the quality of life, on the contrary, it acquires a poor blood supply to the muscles surrounding the spine, reducing their functionality, etc. On the other hand, the training of surface muscle flexor and extensor at their training wearing polarization amplitude, also lead the aggravation of the problem, because this kind of movement is not possible without displacement of the vertebrae. Where is the problem? In the formation and strengthening of the experience of the stabilization of the anatomical position of the spine due to the improvement of the between muscle coordination, with the following his transfer in motion activity in everyday life, work, playing sports. In order to understand what is skill, try to do the test for assessing the skill of stabilization of the spine when sets the voltage. To do this, lay down on his back, bending the legs at knee joint at an angle of 90 degrees. Place the foot on the floor at shoulder width apart. Hands lying on the floor along the trunk. When rolled across the plain cuff twice put the mechanical tonometra for measurement of pressure (picture a). Inflate the cushion up to 40 mm Hg. art. and on the exhale strain the muscles of the entire body with an intensity of 60-80% of the maximum possible, gradually increasing tension. The criterion for pressure reaching 60-80% is the delay. (picture) assessment of skill sets at the spine stabilization the pressure. Maintaining pressure cushion in the range of 30-50 mm Hg When the pressure indicates the skill of stabilization of the spine (figure b) if it took place increased pressure on the pillow, which expressed itself in the shifting of the arrows gauge, in a large 40 mm Hg. art. side, it means that the pressure was flattening of the lumbar lordosis. In this case, you can talk about the presence of functional muscle asymmetry due to the absence of between muscle coordination between straight muscle of the abdomen, and the muscles that unbends the spine or due to low muscle tone of the spine (figure). If there was pressure on the pillow, which expressed itself in the shifting of the arrows gauge, the smaller of 40 mm Hg. art. side, it means that happening increase in lumbar lordosis. In this case, you can talk about the presence of functional muscle asymmetry due to the absence of between muscle coordination between straight muscle of the abdomen, and the muscles tha unbends the spine or due to low tone direct muscle of the abdomen (figure g). After that, try to repeat the test with the control gauge. If you keep the pressure within a 30-50 mm Hg When the Visual control of the dial gauge, it means: you have a so-called “skill” stabilisation of the spine, which significantly cuts down the time of the acquisition of skills. How important this is? The fact is that in any situation, when there is a one moment isometric muscle tension secondary stabilizers, for example, when trying to preserve balance on the slippery surface, the lack of between muscle coordination will save physiological bends and some segments of the spine in the anatomical position, ensuring that in the presence of neurological diseases of the spine, as already mentioned earlier, is an important factor for ensuring the quality of life and prevent the exacerbation of the disease. Certainly, stabilizing exercises not cleared from degenerative disc disease, however, and other physical features, but they will give the opportunity to fully live and enjoy the opportunity to move. Author: Dmytro Erdenko-specialist in physical rehabilitation and physiotherapy, the head of the Methodics of the Department of EXERCISE, massage and rehabilitation RGUFKSìT, Methodist of physiotherapy Research Institute of Rheumatology.