Neutral Spine Theory

The recent cervical operation on one of my students has made me reevaluate the way I see the way I do my everyday activities and also my training.

Given the fact that every nerve in our body exits at some point of our spine, it naturally follows that this intricate miracle of engineering deserves more attention by fitness professionals and martial artists.

One of the prevailing paradigms about the spine is that it is able to attenuate forces and support loads when it is in a ‘neutral’ position. If we observe the spine of a healthy person with a good posture, we’ll notice there are several distinctive curvatures : the cervical and lumbar curves are the ones we’ll be most concerned with. Of course, some people have a lot of curvature in their spines while others have less. The exact amount of curvature which is the optimum is a subject of debate in the medical community, however, everyone has their own unique neutral curvature.

‘Neutral’ refers to the position where the spine can most efficiently and safely support load (such as carrying a bar on your back when squatting) and absorb forces (such as the impact that occurs during running). Even though everyone’s ‘neutral’ is slightly different, we can say that neutral never involves any rotation or side bending. One good example is that very often when performing curls or triceps pushdowns, people look over their shoulder in the mirror. WRONG. Always look straight ahead, no matter what. Another common mistake is when to pick up something off the floor or off the lower part of a shelve, the person flex-rotate while stooping over. This is one of the most hazardous positions for the spine. Instead, face the shelve squarely, and bend the hips and knees to lower yourself. Also avoid stooping over from a seated position to pick up your dumbbells for the next set of presses. Every chiropractor and physical therapist is familiar with compressive load comparison charts that show this very position to be the most precarious possible position to put your lumbar spine into. So instead, stand up, bend your knees, deadlift the dumbbells, sit back down, and resume your workout. Yet another error is the practice of looking upward during stiff-leg deadlifts. WRONG. During any form of squat or deadlift, imagine that you’re wearing a cervical collar (which, in fact, you might be wearing for REAL if you don’t follow my advice here!) during the movement. The head follows the body. On these exercises, looking downward (relative to the trunk) can cause a reflexive shut-down of the lumbar muscles, and looking upward can strain the cervical vertebrae.

Suggestions For Keeping Your Back Healthy

First, if you have back pain, always start with an accurate diagnosis from your chiropractor or physician. Make sure you ask him/her to explain what’s wrong, and then listen carefully to his/her recommendations. Learn as much as you can about your condition.

Low back pain is the most frequent cause of missed work after the common cold— it’s been
estimated that over 90 million people suffer with this debilitating condition. However, with all the knowledge and diagnostic tools that we have available to us today, there is no reason that back pain should continue to plague so many people.

The key to managing low back pain starts with the decision to take an informed, active role
in maintaining your health. Your back needs a little maintenance every day— even when you don’t have pain. When you visit with your doctor, you might spend 15 minutes in an office visit.

However, you spend 24 hours a day, 7 days a week living with your back. Treatment and therapy are important, but it’s what you do for yourself when you’re not having treatment that is most important to help you live free from reoccurring back pain.

Nerve Impingement

Nerves can become impinged or pinched by the disks, vertebrae, or swelling of the surrounding soft tissues. When a nerve is pinched, the muscles of the back can go into spasm, and the pain can radiate away from the spine. There are three degrees of radiation: First degree, which is when pain and/or “pins and needles” radiates to the butt; second degree, which involves these symptoms radiating to the knee; and third degree, which is when the symptoms radiate to the foot.

When a nerve becomes damaged, the muscle that it supplies (or innervates) withers or atrophies because of the lack of nerve supply. If pain radiates down the leg, or if you have numbness, tingling, or loss of muscle function, seek medical intervention immediately— the longer you wait, the greater the chance that you’ll have a permanent injury.

Reducing The Inflammation

The first step in addressing back pain is to “put out the fire.” Inflammation is often the result of the joints, nerves, or soft tissues of your back becoming irritated, raw, and swollen. According to a recent government study done in the United States (AHCPR), the recommended initial medical treatment of choice is usually an oral anti-inflammatory and ice. Exercise caution however, because some people can’t tolerate any type of anti-inflammatory medication. Check with your physician before you use any drug.

While using an internal anti-inflammatory, you should also use an external antiinflammatory, namely ice. Flexible gel packs are best, but crushed ice in a “zip-lock” bag works well also. Crushed ice works particularly well for people who weigh over 200 pounds. Make sure that if you use crushed ice, that it’s really smashed up into a fine pieces — otherwise it’s like lying on rocks. Don’t cover it with a towel because it just won’t penetrate deep enough to work. Instead, use a zip-lock bag. Ice is cold and after a minute or people usually want off! However, the immediate pain of the ice is worth the long term relief you’ll get from the reduction of inflammation and swelling. Ice has to be cold — really cold to be effective. Imagine the thickness of a t-bone steak and how cold you would need to get one side to feel the effect through the other side. That’s about the thickness of the your back muscles. The key to using ice is staying mobile and flexible. One side effect of cold is that it tends to make you a little stiff, so…stretch! Do knee to chest and pelvic rock stretches while lying on the ice. This is called cryokinetics, or “movement on ice.” Not only does it keep you from stiffening up but it literally pumps swelling or inflammatory edema out of the low back as you stretch.