View Single Post
 
Old 05-09-2006, 07:42 PM
EricT EricT is offline
Rank: Heavyweight
 
Join Date: Jul 2005
Posts: 6,314
Default

Back Strong & Beltless - Part II

HOW TO BE BACK STRONG AND BELTLESS!

The worst thing someone could do is discontinue the use of a belt cold turkey! If you have been using a back belt or weight lifting belt for more than a month, chances are very good that your abdominal recruitment patterns have been altered. Your TVA and posterior IO are now likely sitting on the couch, relaxing, while allowing your rectus abdominis and external obliques to act as the primary stabilizers of the trunk in concert with the erector spinae muscles.

If you have been using a belt for several months or even years, particularly if you have had or currently experience any low back pain, chances are very good that you have sensory-motor amnesia of the deep abdominal wall. If you remove your belt and go back to your normal Herculean performances in the gym or start packing power tools around the construction site, chances are very good you will be purchasing a new Mercedes for your doctor or orthopedic surgeon, real soon!

When you take the belt off and begin working or lifting, your brain will sequence the muscles as though you were lifting with the belt. When your nervous system recruits the rectus abdominis and erector spinae at the greater intensity as learned when wearing the belt (40,44), you are likely to have increased compression, torsion and/or sheer in one or more segments of your lumbar spine, but without the hoop tension provided by the belt (42,43).

Additionally, a correlation of my clinical findings among athletes that wear belts and have experienced hamstring injury is supported by research. Lander et al. found that while using weight-belts, there was increased EMG activity of the vastus lateralis and biceps femoris (55). This is logical when considering the intimate relationship that exists between the biceps femoris and the TVA via the thoracolumbar fascia system as an integral part of what is called the "deep longitudinal system" by Gracovetsky (7 p. 243-251, 15 p. 58)

Adopted from Gracovetsky (7 p. 243-251, 8) and Lee (15 p. 58) the Deep Longitudinal System illustrates the working relationship between the TVA as a stabilizer of the pelvis (A), the sacrotuberous ligament (B), the peroneus longus and biceps femoris (C) and the erector spinae musculature (D). In the late swing phase of gait, dorsiflexion of the foot in preparation for heel strike generates tension in the peroneus longus. Vleeming (7) indicates that approximately 18 percent of that force is transferred into the biceps femoris, which works to tension the sacrotuberous ligament, stabilizing the sacrum and ilium at heel strike. The erector spine musculature serve to dissipate kinetic energy through rotary action on the spinal column prior to reaching the cranium. This mechanism may explain the high correlation between biceps femoris injury in lifters using belts and sprinters with TVA dysfunction; theoretically, the biceps may be working to tension the thoracolumbar fascia system to compensate for inadequate action of the TVA.

If the belt user has developed the habit of responding to the exteroception provided by the belt by pushing the abdominal wall outward (which will inhibit the TVA), then it is very likely the brain may up-regulate the recruitment of the biceps femoris in an attempt to stabilize the thoracolumbar fascia.

This can be done by the biceps femoris because of its intimate relationship with the thoracolumbar fascia via the sacrotuberous ligament. Having treated numerous biceps femoris injuries in weight lifters and athletes performing in sports requiring explosive movement, I have witnessed a strong correlation between sensory-motor dysfunction of the deep abdominal wall, an inability to stabilize the lumbopelvic region, and biceps femoris injury.

Additionally, a study titled, "The effect of industrial back belts and breathing technique on trunk and pelvic coordination during a lifting task," found that "phase angles" (relationships) between the pelvis and lumbar spine during the initial phase of lifting tasks were altered among belt users (56). The researchers concluded "the change in segmental kinematics was similar to that previously reported for patients with a history of low back pain" (56). What this means is that if you stop belt use cold turkey, or even forget your belt one day, not only will your motor sequencing be aberrant, but the relative timing of joint movements will also be faulty. This is a formula for disaster!

Belt use has been shown to alter the natural recruitment patterns of the abdominal wall, favoring the rectus abdominis (40), erector spinae (44) and potentially disrupting recruitment sequences in the legs (39). It is therefore no surprise that belt users frequently present with aberrant coordination in the abdominal wall when assessed clinically.

It is very common for belt users to have reduced ability to control sacral base inclination, or pelvic tilt. This is another common challenge I must work through with back pain patients. Inability to control sacral base inclination can cause instability of the sacroiliac joints, particularly during forward bending activities (58). Clinically, I have found inability to control sacral base inclination is also commonly related to such spinal pathology as spondylolistheses, spondylolysis, spinal instability and disc herniation.

It is well documented that coordinative patterns of the abdominal wall are task specific (6,12,14,23). For example, one may have normal abdominal wall function during a squat pattern, but not a push pattern. Additionally, loss of abdominal wall coordination is easier to prevent than to restore (61). This should give those of you considering use of a weight belt adequate reason NOT TO!

I recommend trying what I call "the worlds greatest weight belt". It is simply a piece of kite string. Place the kite string around your waist at the belly button level. Exhale and draw your belly button in slightly, just enough to notice that it has moved toward your spine and that you now have more definition along the oblique line. With the string snug around your belly now, tie the string in a knot.

As you perform your exercises in the gym, you should always inhale and draw your umbilicus off the string prior to exerting any force. This teaches the brain to activate the TVA first. If you are lifting any significant load, you will cross the stabilization threshold (23), at which time you will go from segmental to gross stabilization. This will be identified as visually observable activation of the external oblique and rectus abdominis.

When the load is heavy enough, you will notice that no matter how hard you try, you cannot keep the string loose around your torso. If you progressively reduce the weight, you will eventually cross back under the stabilization threshold, which will be identified by your ability to perform the lift and keep the string loose.

It is very important to perform enough low intensity lifting to train the brain to always recruit the deep abdominal wall before recruiting the outer unit, or outer muscles, which function as gross stabilizers.

To best condition your body, it is important to focus first on learning to activate the abdominal wall while performing what I call "Primal PatternsTM". Primal Patterns' are the movement patterns most likely to have been necessary for our developmental survival as dictated by the selective pressures of nature (62). The Primal Patterns are:

Squatting
Lunging
Bending
Pushing
Pulling
Twisting
Gait (walk, run and sprint)
All these patterns, to be true Primal Patterns, must be performed from a standing position. If this is not possible, then you will need the help of an exercise or rehabilitation professional, preferably a C.H.E.K Intern, to assist you in learning how to correctly perform the sequencing and development of the movements.

For those interested in an educational resource that teaches integration of the deep abdominal wall while performing many functional exercises, I recommend "The Gym Instructor Series" (60). This program covers many pushing, pulling and abdominal exercises as well as showing how to restore normal coordination and strength to the inner and outer unit muscles of the abdominal wall and back.

Once you have implemented the training techniques described here, you will be free from training with the belt and have full confidence that your body now works correctly. If you have any orthopedic problems at all, it would be wise to consult a C.H.E.K Practitioner or a skilled rehabilitation professional that understands the science of corrective exercise to aid you in your quest to be "BACK STRONG AND BELTLESS!"

CONCLUSION

In this article I discussed several legitimate considerations regarding chronic use of corsets, back belts, and weight lifting belts. Available research clearly demonstrates that belts are unable to stabilize the spine at a segmental level, therefore only stabilizing the torso. Gross stabilization, as provided by belts, may allow you to lift more weight than you could without the belt, indicating a stabilizer dysfunction within your body. The increased weight being lifted as afforded to the lifter by the belt will likely serve to traumatize the spine due to increased levels of compression, torsion and sheer, increasing the potential for a serious injury.

Caution should be exercised by those using belts to increase "proprioception," as a belt is clearly a form of "exteroceptive stimuli". When the belt is removed, it is likely to have accomplished little in improving proprioception, leaving the lifter with an increased risk of injury secondary to belt usage. My clinical treatment of workers and athletes with spine injuries has shown that chronic use of weight lifting belts and back belts is highly correlated with sensory-motor amnesia of the deep abdominal. Finally, weaning yourself off a belt must be done carefully and in concert with evaluation and treatment of any stabilizer deficit found in the torso.


References:

Waddell, G. The Back Pain Revolution. New York: Churchill Livingstone, 1998.
Ironmind Enterprises (catalog)
Webster, D. The Iron Game. Scotland: John Geddes Printers Irvine, 1976.
Lovett, R. Lateral Curvature of the Spine and Round Shoulders Philadelphia: P. Blakiston's Son & Co., 1912.
Steindler, A. Post-Graduate Lectures on Orthopedic Diagnosis and Indications Charles C Thomas, 1951.
Richardson C., Jull G., Hodges P. and Hides J. Therapeutic Exercise For Spinal Segmental Stabilization In Low Back Pain - Scientific Basis And Clinical Approach. London, New York, Philidelphia, Sydney, Toronto: Churchill Livingstone,1999.
Ed by: Vleeming A., Mooney V., Snijders C.J., Dorman T.A. and Stoeckart R. Movement, Stability & Low Back Pain - The Essential Role of the Pelivs. New York, Edinburgh, London, Madrid, Melbourne, San Francisco and Tokyo: Churchill Livingstone, 1997.
Gracovetsky, S. The Spinal Engine. Wien, New York: Springer-Verlag, 1988.
Dart R.A. The Double-Spiral Arangement Of The Voluntary Musculature In The Human Body. Surgeons' Hall Journal Vol. 10, No. 2. Oct. 1946 - March 1947.
Hodges P. W., Richardson C.A. Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res (1997) 114:362-370.
Aruin S.A., Latash M.L. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res (1995) 103:323-332.
Cresswell A.G., Grundstrom H., Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 1992, 144, 409-418.
Hodges P.W., Richardson C.A. Contraction of the Abdominal Muscles Associated With Movement of the Lower Limb. Physical Therapy. Vol. 77 No. 2 February, 1997.
Norris C.M. Functional load abdominal training: part 1. Journal Of Bodywork And Movement Therapies July 1999
Lee D. The Pelvic Girdle (2nd. Ed.) - An Approach to the Examination and Treatment of the Lumbo-Pelvic-Hip Region. Edinburgh, London, New York, Philadelphia, Sydney, Toronto: Churchill Livingstone, 1999.
Richardson C.A., Jull G.A. Muscle control - pain control. What exercises would you prescribe? Manual Therapy(1995) 1, 2-10.
Bogduk N., Towmey L.T. Clinical Anatomy of the Lumbar Spine (2nd. Ed.).Melbourne, Edinburgh, London, New York and Tokyo: Churchill Livingstone, 1991.
Wirhed, R. Athletic Ability & the Anatomy of Motion. Wolfe Medical Publications Ltd., 1984.
White, A. and Panjabi, M. Clinical Biomechanics of the Spine 2nd. ED. J.B. Lippincott Co., 1990.
Cholewicki, J., Juluru, K., McGill, S. Intra-abdominal Pressure Mechanism for Stabilizing the Lumbar Spine. Journal of Biomechanics 32 (1999) 13-17.
Bogkuk, N. Clinical Anatomy of the Lumbar Spine and Sacrum 3rd. ED. Churchill Livingstone, 1999.
Chek P. Scientific Back Training. (correspondence course) Encinitas, CA: Chek Institute, 1995.
Chek P. Scientific Core Conditioning. (correspondence course) Encinitas, CA: Chek Institute, 1993,1999.
Chek P. The Outer Unit. Published at www.personaltraining.com.au.
Ziglar Z. How To Stay Motivated. (tape series) . Carrollton, TX: The Zig Ziglar Corp.
Lahad A., Malter A.D., Berg A.O., Deyo R.A. The effectiveness of four interventions for the prevention of low back pain. JAMA 1994;272:1286-91.
Majkowski G.R., Jovag B.W., Taylor B.T., Taylor M.S., Allison S.C., Stetts D.M., Clayton R.L. The Effect of Back Belt Use on Isometric Lifting Force and Fatigue of the Lumbar Paraspinal Muscles. Spine Vol. 23, No. 19, pp 2104-2109, 1998.
National Institute for Occupational Safety and Health. Workplace use of back belts: Review and recommendations. Rockville, MD: Department of Health and Human Services (National Institute of Occupational Safety and Health) Publication No. 94-122, 1994
Mitchell L.V., Lawler F.H., Bowen D., Mote W., Asundi P., Purswell J. Effectiveness and cost-effectiveness of employer-issued back belts in areas of high risk for back injury. J Occup Med 1994 Jan;36(1):90-94.
Thomas J.S., Lavender S.A., Corcos D.M., Andersson G.B. Effect of lifting belts on trunk muscle activation during a suddenly applied load. Hum Factors 1999 Dec;41(4): 670-6.
Reyna J.R., Leggett S.H., Kenny K., Holmes B. and Mooney V. The Effect of Lumbar Belts on Isolated Lumbar Muscle Strength and Dynamic Capacity. Spine Vol. 20 No. 1 pp 68-73, 1995.
McGill S.M., Norman R.w., Sharratt M.T. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics 1990 Feb;33(2):147-60.
Hodgson E.A. Occupational back belt use: a literature review. AAOHN J 1996 Sep;44(9): 438-43.
Ciriello V.M., Snook S.H. The effect of back belts on lumbar muscle fatigue. Spine 1995 Jun 1;20(11):1271-8; discussion 1278.
Cholewicki J., Juluru K., Radebold A., Panjabi M.M., Magill S.M. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. Eur Spine J 1999;8(5): 388-95.
Smith E.B., Rasmussen A.A., Lechner D.E., Gossman M.R., Quintana J.B. The effects of lumbosacral support belts and abdominal muscle strength on functional lifting ability in healthy women. Spine 1996 Feb 1;21(3):356-66.
Zatsiorskii V.M., Sazanov V.P. A Waist-Corset For Decreasing The Risk Of Injury To The Spine When Lifting Weights And Doing Strength Exercises. Teoriya I Praktika Fizicheskii Kultury 3:15-17, 1987.
Bourne N.D., Reilly T. Effect of a weightlifting belt on spinal shrinkage. Br J Sports Med 1991 Dec;25(4): 209-12.
Lander J.E., Simonton R.L., Giacobbe J.K.F. The effectiveness of weight-belts during the squat exercise. Medicine and Science In Sports And Exercise Vol. 22, No. 1 Feb. 1990 pp 117-26.
Miyamoto K., Iinuma N., Maeda M., Wada E., Shimizu K. Effects of abdominal belts on intra-abdominal pressure, intra-muscular pressure in the erector spinae muscles and myoelectrical activities of trunk muscles. Clinical Biomechanics, Feb. 1999 14(2): 79-87.
Drechsler A. The Weightlifting Encyclopedia: A Guide To World Class. Whitestone, New York: Performance A is A Communications, 1998.
Axelsson P., Johnsson R., Stromqvist B. Effect of lumbar orthosis on intervertebral mobioity. A roentgen sterophotogrammetric analysis. Spine 1992 Jun;17(6): 678-81.
Miller R.A., Hardcastle P., Renwick S.E. Lower spinal mobility and external immobilization in the normal and pathologic condition. Orthop Rev 1992 Jun;21(6):753-7.
Bauer J.A., Fry A., Carter C. The Use of Lumbar Supporting Weight Belts While Performing Squats: Erector Spinae Electromyographic Activity.
Hodges P. Richardson C., Jull G. Evaluation of the relationship between laboratory and clinical tests of transversus abdominis function. Physiother Res Int 1996;1(1):30-40.
Cholewicki J., Juluru K., McGill S. Intra-abdominal pressure mechanism for stabilizing the lumbar spine. Journal of Biomechanics 32 (1999) 13-17.
Keith A. Menders Of The Maimed - The Anatomical & Physiological Principles Underlying The Treatment Of Injuries To Muscles, Nerves, Bones & Joints. Robert E. Kreiger Publishing Co, 1975.
Abreu B.C. Physical Disabilities Manual. (pp 137) New York: Raven Press, 1981.
Fortin J.D. Weight Lifting (Ch. 45, p. 496) In: Watkins R.G., The Spine In Sports St. Louis: Mosby, 1996.
Brownstein B., Bronner S. Functional Movement - In Orthopedic And Sports Physical Therapy New York, London, Edinburgh, Melbourne, San Francisco, Tokyo: Churchill Livingstone, 1997.
Gill K.P., Callaghan M.J. The Measurement of Lumbar Proprioception in Individuals With and Without Back Pain. Spine Vol. 23, No. 3, pp 371-77.
Steadman's Medical Electronic Dictionary. Baltimore, MD: Williams & Wilkins, 1996.
Hanna T. Somatics: Reawakening the Mind's Control of Movement, Flexibility, and Health. Cambridge, Massachusetts: Perseus Books, 1988.
Chek P. Corrective and High-performance Exercise Kinesiology Certification Manual - Level II (four year internship program course manual) Encinitas, CA: C.H.E.K Institute.
Lander J.E., Hundley J.R., Somonton R.L. The effectiveness of weight-belts during multiple repetitions of the squat exercise. Medcine and Science In Sports and Exercise 1992 May;24(5):603-9.
McGorry R.W., Hsiang S.M. The effect of industrial back belts and breathing technique on trunk and pelvic coordination during a lifting task. Spine 1999 Jun 1;24(11):1124-30.
Chek P. Equal But Not the Same - Considerations for Training Females (correspondence course) Encinitas, CA: C.H.E.K Institute.
DonTigny R.L. Function of the Lumbosacroiliac Complex as a Self-Compensating Force-Couple with a Variable-Dependent Transverse Axis: A Theoretical Analysis. Journal of Manual and Manipulative Therapy Vol. 2:3, 87-93.
Janda V. Muscles, Central Nervous Motor Regulation and Back Pain. (27-41) In: Korr I.M. (Ed.)The Neurobiologic Mechanisms in Manipulative Therapy. New York and London: Plenum Press, 1978.
Chek P. Core Conditioning Volume 1 Part 1 - The Gym Instructor Series Encinitas, CA: C.H.E.K Institute, 1997.
Kegel A.H. Progressive Resistance Exercise In The Functional Restoration Of The Perineal Muscles. American Journal of Obstetrics and Gynecology August, 1948.
Chek P. Advanced Program Design (Correspondence Course) Encinitas, CA: C.H.E.K Institute, 1998.
__________________

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.



To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
or
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.


If you act sanctimonious I will just list out your logical fallacies until you get pissed off and spew blasphemous remarks.
Reply With Quote