The 30-second article
The highest disc pressure was measured while sitting
with 20 degrees of forward leaning and with 20kg of
load in arms (such as sitting and picking up children)
• Lack of exercise. Sedentary behaviour results in a loss of trunk
muscle/core strength and diminished spine support.
• Work activities. Long periods of sitting, lifting or pulling heavy
objects, frequent bending or twisting, heavy physical exertion,
repetitive motions, or exposure to constant vibration can add
stress to the spine.
• Smoking. This habit limits the flow of oxygen-rich blood and
nutrients needed for disc repairs.
• History. A personal history of back injury, previous herniated
disc, or prior back surgery increases the risk of experiencing a
bulging disc.
Identifying potential problems
Prior to starting an exercise program, all your clients need to be
questioned regarding any physical problems they have experienced,
so that you can tailor a program to suit them. Your current pre-
activity questionnaire for clients may include the question ‘Have you
experienced back pain?’ If your client ticks ‘Yes’, I highly recommend
asking the following two questions to clarify things further:
1. What activities aggravate your back pain?
2. What activities ease your back pain?
Most personal trainers do not know which postures are more suitable
for their client following injury and which postures may be potentially
harmful. Each person is different. Remember, you are not diagnosing
an injury, you are simply gathering information about your client that
will be incredibly beneficial in terms of reducing the risk of further
pain and helping them achieve their fitness goals.
CASE STUDY
One weekend three months ago, Jack, a 40-year-old male who works
at a desk job, moved house. As he was lifting a box from the ground,
he experienced intense back pain with some referred pain down the
back of his leg. After initial acute injury management for a suspected
acute disc injury, Jack has been visiting his physiotherapist regularly
to gradually build up function and strength. He is now returning to
his gym after this 3-month recovery to re-start his fitness program.
Previous to his injury, Jack enjoyed cycling, rowing and performing
a circuit-style weights program that included seated row, seated
bench press, seated shoulder press, lat pulldowns and leg press.
His abdominal strength work included a range of sit ups and he
would cool down performing a few stretches. Would you allow him to
resume this program?
A diligent fitness professional would ask what postures aggravate,
and what postures ease, his back pain. Jack tells you that his
aggravating factors are: sitting at work for more than 30 minutes,
sitting in a soft lounge, and driving to and from work. The postures
that make him feel better include lying flat on his back, standing
42 | NETWORK WINTER 2018
• The intervertebral discs that sit
between the spine’s vertebrae act as
shock absorbers and allow the spine
to move
• A disc bulge occurs when the softer
middle part of the disc bulges out
through a weakness in the outer layer
and presses on surrounding structures
• A disc injury will generally result in
lower back pain, but can also cause leg
pain, numbness, pins and needles or
weakness in areas of the leg supplied
by the affected nerve
• Risk factors for a bulging disc include
ageing, genetic predisposition, obesity,
inactivity, repetitive motions and
smoking
• A number of amendments can be
made to a client’s training regime in
order to reduce the pressure exerted
by specific exercises on the
intervertebral discs.
upright and walking. Knowing this critical
information, there is no way that Jack should
return to his pre-injury program.
Body positions affecting the spine
and discs
So, what exercises would you recommend
for a client like Jack that has experienced
a disc injury? First, we have to know how
different postures can increase pressure on
the discs.
• The lowest disc pressures have been
recorded in people that are lying in supine
position.
• There is approximately 100kg of pressure
on the discs in standing upright in good
posture.
• There is approximately 150kg of pressure
while standing in slight forward leaning
posture (brushing the teeth posture).
• There is 220kg of disc pressure when
holding a load and leaning forward (such
as picking up weights off gym floor).
• The highest disc pressure (275kg) was
measured while sitting with 20 degrees of
forward leaning and with 20kg of load in
arms (such as sitting and picking up
children).