How did I hurt my back - an explanation in 3D

I've been asked a number of times in the past couple of weeks; "How did I hurt my back?  I was only bending over to pick up a pen on the ground and I felt it go." 

I find that when patients look in books or on the internet for answers, they tend to come up with a two dimensional answer.  What I mean by this is that our bodies are not flat like a page,  but are 3 dimensional.  Our body moves in 3 dimensions, and this explains how injuries can occur.

Most people realize that as we reach forward towards our toes, our spine bends.  What we do not think about is the SHEAR, TENSILE (tension) and COMPRESSIVE (compression) forces that are placed on the spine when we do this. 




From a 3 dimensional perspective, as we bend forward, the vertebrae want to also slide forward (SHEAR), and the discs will become COMPRESSED on the front side and will become TENSE on the back side. 

This is where the "core muscles" come into play.  Without support from ligaments (passive) or control from muscles (active), the back can be at risk for injury

If you have any questions about back pain, or the aforementioned explanation, please see my website at www.drmchiro.com for my contact information

Calf Muscle

I've heard this question a few times this week, especially from a few people with calf or gastrocnemius muscle injuries.  Here is my 2 cents on how the three lower leg muscles (gastroc, soleus and tibialis posterior) should be trained.

First we need to discuss what the muscle is primarily used for (if we are going to train it "functionally" then we need to know what it does).  The lower limb muscles are primarily used for propulsion.  Alternatively they can be used for balance and proprioception and stability.  If we are going to train them in a functional capacity, then shouldn't we be training them for propulsion (or balance, proprioception and stability)?  This would include lunging, jumping, power lifting and plyometrics.

Secondly, why would you want to train calves in isolation?  Is there ever any movements that we do in isolation that we would need to train for?  (Feel free to correct me if I'm wrong, but I can't think of any).  Isolation exercises may be a benefit for body builders, but I do not see it being a benefit to the general population.

A huge pet peeve of mine is the seated calf raise machine.  I have a problem with this because it barely activates the calf (gastroc) muscle.  With knee bent (to 90 degrees while seated) almost all of the work is done by the soleus (and tibialis posterior).  My theory as to why this machine is so popular is because a)you can put large weights on it and make it look like you are doing a lot, and b)you can sit while using it!

So in my opinion, lower limb muscles should not be isolated.  Training should involve complex movements designed for whatever movement you do.