In August, I had the privilege of attending a class taught by the physical therapist for special operations groups in the U.S. Air Force. Our instructor was recently involved in developing guidelines for return to activity for those with back pain.
It is clear that the first step in recovery is to to build strength and endurance in a neutral position where the spine is not moving. The next step is to get the back to move. The spine should move forward, backward, side to side and it should rotate. Additionally, resistance should be added to build strength in all planes.
A healthy spine is a spine that moves. If the spine was not meant to move, we would have a big rigid long bone, like a femur, for our back. Instead, we have twenty-four vertebrae, five in the lumbar spine, that allow for movement in all planes. There is no such thing as a “bad” movement for the spine. A healthy spine moves well in all directions. An integral part of rehabilitating a painful spine is restoring all movement.
