To help answer the question of whether hyper extension exercises on a roman chair are appropriate as part of your spine rehabilitation program, first let me provide some background information on the subject. Then, I will describe the muscle control problems that arise with back pain. Next, we need to establish goals for rehabilitation and determine the specific training requirements to obtain those goals. And finally, I will describe the inherent problems of traditional roman chairs, followed by a solution. Muscle Control during Optimal Health Research has shown that there are two types of muscles: Superficial strength muscles, and deep stabilizing muscles. Each has its own unique characteristics. Think of the superficial strength muscles as "sprinter-type" muscles. These muscles contain the same type of muscle fibers that are highly developed in the legs of Olympic sprinters. They are great for producing speed during a 100 meter dash but poor for endurance during a marathon. In contrast, the deep stabilizing muscles are more like "marathon-type" muscles (superior for endurance but poor for speed). In healthy individuals, the primary role of the superficial strength muscles of the lower back and abdomen is to move the torso. (Torso is defined as: The human body excluding the head, neck, and limbs. This part of the body is also known as the trunk. So, these muscles move the rib cage, lumbar spine, and pelvis.) They are also responsible for controlling trunk posture during high-level activities. These activities may include: lifting, pushing, pulling, jumping, running, and other ballistic (fast) movements of the limbs. In contrast, the deep stabilizing muscles of the back and abdomen are used to provide continuous postural adjustments of the torso throughout the day during low-level activities. Some examples of low-level activities are: sitting, standing, moving from a seated to standing position, walking, and slow (non-ballistic) movements of the limbs. Muscle Control Problems that Arise with Back Pain After experiencing back pain, the brain's strategy for maintaining trunk posture changes to a simplified, inferior strategy. First, the deep stabilizing muscles stop working properly. Second, the superficial strength muscles of the trunk become over-active and their muscle fibers shorten up to restrict trunk range of motion. This over-active/shortening-up response is recognized by experts as the brain's attempt to "lock up" and protect the painful segments of the torso during the acute phase of injury. This compensation pattern typically continues after it is no longer necessary during the chronic phase of back pain (when the injured soft tissue structures have healed). The strategy of using "sprinter-type" muscles to try to maintain trunk posture throughout the day is like forcing an Olympic sprinter to compete in a marathon, instead of the 100 meter dash. Obviously, the sprinter's muscles are built for speed, not endurance. So to say the least, this strategy would not be very efficient. But, other problems arise secondary to muscle fatigue and subsequent muscle spasm which result in disc & joint compression. Goals for Rehabilitation & Specific Training Requirements Just as the goals and specific training requirements for sprinters are different than for marathon runners, there are also vast differences in the goals and specific training requirements for a rehabilitation program versus a core fitness routine. In rehabilitation, one of our goals would be to release the superficial strength muscles. (Remember that they have "locked up" the injured region of the spine.) This is accomplished through slow, low-load, pain-free movement patterns focused on lengthening the superficial strength muscles while relaxed. This is something I describe to my patients as a relaxed muscle release exercise (not to be mistaken as a muscle-stretch exercise). Although it is true that we must stretch the fascia and related non-contractile tissues, it is important to recognize that muscles must be released while relaxed. This is required in order to reset the muscle spindles that control the set-point of resting tone and muscle length. The idea of a relaxed muscle release exercise is definitely a change in mind-set. What it means is that typical hyper extension exercises performed on a roman chair bench are not appropriate for the initial stages of rehabilitation for chronic back pain.

If the superficial strength muscles of the back and abdominal wall are over-active (contracting too much) and the muscle fibers are shortened up to restrict trunk range of motion, then "strengthening" exercises would not be the proper type of exercise for rehabilitation. Our next goal would be to retrain the deep stabilizing muscles in their role as the primary trunk stabilizers during low-level activities. This is difficult to achieve in a person with chronic back pain since the superficial strength muscles are attempting to perform that role by over-contracting and shortening up to restrict motion in the previously injured region of the torso. Therefore, an aggressive exercise utilizing a roman chair that emphasizes the superficial strength muscles of the torso and hips may neglect to activate the deep stabilizing muscles appropriately. A more specific training approach is required. One important deep stabilizing muscle of the back is called lumbar multifidus. This muscle attaches at each segment of the lumbar spine down to the sacrum and pelvis. The specific training that I recommend on a back exercise machine is a slow, low-load extension movement occurring at each vertebra, instead of holding the curve of the lower back in a locked position while moving through the hips. This exercise should be easy enough to perform 30 repetitions without fatigue. The Problem and the Solution The specific training requirements for lumbar multifidus rehabilitation are not likely to be achieved as part of a home exercise program on a traditional roman chair hyper extension bench. The design of the traditional 90-degree exercise angle is too difficult and not properly designed to promote the specific training requirements of spine rehabilitation. This type of roman chair will emphasize the hamstrings, buttocks and superficial strength muscles of the lower back. It is also likely that training on the 45-degree exercise angle will be too difficult and not specific enough. Fortunately, a solution has been developed that may be designated as a hybrid of the roman chair hyper extension bench. It's called the Back Trainer Medic by Kettler (made in Germany). The Back Trainer Medic was designed to assure the correct movement pattern, so the individual segments of lumbar multifidus are trained appropriately. The torso pad is curved and the height of the pad is adjustable so it guides the user through the correct motion of the torso for spinal rehabilitation. The specific exercises that I show my patients to perform on the Back Trainer Medic fulfill both goals that I addressed earlier in this article: First, releasing the superficial strength muscles of the back (via relaxed muscle release exercises), and second, retraining the deep stabilizing muscle of the back, called lumbar multifidus (via a slow, low-load extension movement occurring at each vertebra). The specific exercises are also demonstrated on a DVD video so my patients can watch it at home as an additional guide. The Back Trainer Medic has six levels of difficulty. The easiest level is easier to perform than the 45-degree exercise angle of a roman chair, so it is more appropriate for the initial stages of spinal rehabilitation. This allows the user to progress to higher levels of difficulty while the lumbar multifidus muscles adapt by improving motor control and increasing in size. Another advantage is that this machine virtually eliminates the hamstrings from the exercise so that your efforts are more specifically focused on training the lumbar multifidus muscles.

Dr. Knudsen is a practicing physical therapist who specializes in rehabilitation of chronic back and neck pain at Back Trainer Institute. For more information on the Back Trainer Medic or for other information on related topics, visit http://www.Back-Exercises.com.

One of the first things to do to stop neck pains is to relieve tension and stress. You can also try sleeping with a pillow which keeps your neck in the correct position. If you spend extended periods of time in front of a computer, make sure that the monitor is at a proper level so that your neck is not bent for extended periods. If the angle is wrong for you, adjust the monitor.Reading in bed on your side can also cause tension in the neck, causing neck pains. Stress at work can also cause neck pains. The main thing to remember about neck pains is to stop them before they start whenever possible. Proper position while sleeping, a supportive pillow, proper rest, and proper working angles are all ways to help prevent neck pains in the first place. If you have your neck bent in an unnatural position, you are almost certain to develop neck pains at some point.Tension from many sources can cause neck pains. The pain occurs when the muscles in the neck tighten, and may spasm. If you do a lot of typing and the typing position is not comfortable, causing you to strain, you […]

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The first thing to consider is, "What is the origin of the sharp or sudden pain of a back injury?" To some, it feels like a sharp, stabbing pain; to others, a seizing grip that interferes with breathing. Perhaps it is just that: the seizing grip of muscles going into spasm, causing stabbing back pain and interfering with breathing, nothing more.

Back Pain Treatment and Physical Therapy

Medical practitioners, including physical therapists, face a peculiar quandary with regard to back pain and muscle spasms in general: so often, the pain they encounter in their patients comes from muscular spasticity, so much of their effort goes into ending muscular spasms, and yet so many of their patients return with the same muscle spasms and back pain for which they have been treated in the past. According to one physical therapist, the likelihood of a patient who has had back pain returning again with the same problem is about 80%.

Let's take another look at back pain, in particular.

Overview Of Back Pain And Muscle Spasms

Unless you have had a violent accident, your back pain, whether sudden or chronic, has been coming for a very long time. Muscular tension builds up for a long time before crossing the point of no return and becoming a back spasm. Then, like the straw that broke the camel's back, a small movement is sufficient to trigger a crisis.

We return to the quandary of back spasms. What causes the build-up of tension? What controls muscular tension?

The answer may be obvious to you: your brain controls your muscular tension; your brain causes your muscles to go into spasm.

Why?

Muscle Spasms — Usually a Brain-Conditioning Problem

Here, the answer may not seem so obvious — but obvious it is when you think about it: brain conditioning. Your brain, the master control organ of your muscles, is an organ of conditioning (learning). People acquire their tensions through conditioning: repeated overuse, repeated overstrain, repeated stress. Repetition leads to habit formation and habit formation leads to involuntary habits of tension. Back pain is a nervous tension habit conditioned into you through the repetitive strains of life. At that point, your nervous tension is no longer a reflection of a momentary emotional state, but set in the habituation operation of your brain and muscular system.

So the problem is simpler than you might expect. You probably do not have a medical problem; you probably have a conditioning problem. With tingling or numbness, the muscles of your back are so tight that they are pulling your vertebrae (the small bones of your spine) so close that they are pinching nerves. By relaxing those muscles, you can take the pinch off the nerves.

Fortunately for those using the right methods, a muscular conditioning problem can often be cleared up fairly quickly — past experience notwithstanding.

Perspective on Therapeutic Methods to End Back Pain

The problem with most methods used to relax muscles — mental methods, manipulative methods, therapeutic methods in general –is that they may not adequately teach muscular control. Muscular control has two parts: the ability to create muscular tension and the ability to relax muscular tension. Both abilities are needed; otherwise, you are either musclebound (and prone to cramping) or weak. Such methods also often neglect an important part of control: sensory awareness. Too often, people are given therapeutic exercises but no instructions in how to do them; they're told, "These are strengthening exercises," so people go for strength instead of control; they go for effort instead of sensory awareness. If you can't feel how to regulate your muscular tension, you can't feel how to relax your muscular tension. You feel pain with no connection to the sense of contracting those muscles to the point of fatigue. Progress comes slowly, at best, from working too fast and too mechanically.

So you need to improve both muscular control and the ability to feel your muscles.

Then, you develop freedom of movement, and then, you can relax more completely than you ordinarily do and stay more relaxed without thinking about it. "Freedom of movement" means it's your natural state.

To, show you how do-able this is, I'll present some coordinated movements that can often restore your comfort. Before I do, read and understand the following instructions:

(NOTE: If your problem is severe, (numbness or tingling in your extremities) see your doctor to rule out a medical emergency. That done, find a Hanna Somatic Educator (for fastest results) or use the procedure shown below or other self-help resources found below.)

Simple Somatic Coordination Exercises to Help End Back Pain

• Do these movements as a way of creating sensations of movement.
• Move slowly and smoothly.
• Be gentle, working within the range of sensations you're willing to experience. Done gently, they are safe to do even with disk problems. If in doubt, consult your physical therapist before proceeding.
• Always separate repetitions of a movement with complete relaxation.

   

  No More Back Pain. EBook(R) On Back Pain Relief.

   

If you do these movements mechanically (for example, by counting repetitions instead of feeling movement), if you do them too quickly or too hard, you deprive yourself of the sensations needed to discover your own control over yourself. You may make yourself tighter, instead of looser. You will get better results by doing too little than by doing too much. You will have an easier time if you have somebody read these instructions to you. The movements should feel comfortable to do; if they create pain, do a smaller amount of movement. Move more slowly, more gently.

A: STARTING POSITION:

 

 

• on your belly
• face turned to the right
• right hand under your left cheek (like a pillow, palm down)
• left arm loosely by your side

 

 

1. Slowly lift just your left leg.

    

   Feel the first sensations of muscular effort. Go slowly.

   Tip! Avoid becoming overweight. Overweight increases the risk of back pain.

    

2. Slowly lower your left leg.

    

   Feel the last sensation of relaxation, as it happens. Take a deep breath and let everything go.

   REPEAT THIS LEG LIFT FOUR (4) TIMES AT DECREASING LEVELS OF EFFORT.

    

3. Simultaneously lift your left leg, head, and right arm.

    

    

4. Slowly lower yourself down, take a deep breath and relax all the way.

    

   REPEAT 4 TIMES AT DECREASING LEVELS OF EFFORT, THEN SWITCH SIDES.

    

 

B: STARTING POSITION:

 

• On your back
• knees up
• feet near your buttocks
• Fingers interlaced behind your head.
• Elbows out flat on the floor

   

   

 

 

1. Arch:

    

    

   • Inhale.
   • Gently, gradually turn your tailbone down into the surface (arch your low back).
   • Gently press your elbows down.
   • Tug your heels toward your buttocks and hold.

      

      

    

    

2. Curl:

    

    

   • Begin to exhale.

      

      

   • When you can feel your back tighten, relax your back and gradually press your back onto the surface.
   • Bring your elbows together. (pause)
   • Press down on your feet.

      

      

   • Continue to exhale.

      

     Use equal strength to curl as you did to arch.

      

   • Point your elbows at your knees.

    

    

   • Curl forward and look at your knees.
   • Exhale completely.

      

      

    

   REPEAT THIS "ARCH AND CURL" MOVEMENT FOUR TIMES MORE AT DECREASING LEVELS OF EFFORT.

    

 

 

Do these movements for ten minutes daily for a week or two. Many people get just the results they need.