Some years ago I seem to recall an article which concluded that loaded
hyperextension of the spine was potentially less harmful to the lumbar spine
than unloaded hyperextension such as that encountered in throwing and jumping
sports. Possibly someone else can locate that reference. This might explain
why the incidence of hyperextension injuries in Olympic weightlifting appear
to be far less common than in sports such as cricket and gymnastics.
Many have militated against all spinal hyperextension, but they seem to
forget that McKenzie techniques (as variants of the ancient yoga Cobra asana)
actually comprise controlled forced hyperextension of the spine in a posture
which does not allow the lower body to sway and dissipate stress as in the
standing Olympic Press. Sure, we have pointers such as the
peripheralisation or centralisation of pain symptoms to guide us to the
suitability of McKenzie, but why are many folk adamant about avoiding all
forms of hyperextension, irrespective of such guidelines?
Then, we also must distinguish between the strictly controlled hyperextension
of the spine in the sagittal plane during the Olympic Press, compared with
the complex lumbar hyperextension, trunk rotation, lateral pelvic tilting and
asymmetric foot impact actions involved in cricket bowling, tennis serving,
gymnastics and so forth. Are we justified in comparing simple hyperextension
in one plane with complex trunk actions in several planes?
All too often, it seems to be forgotten that even small torque about the
vertebrae can produce more strain in the peripheral annulus of the disk than
far more extensive flexion or extension. This tends to reflect itself in
training and rehabilitation programs drawn up for athletes and workers – the
(often machines-controlled) movements and stretches very rarely involve
significant use of rotatory actions, especially under progressively
increasing conditions of resistance and range. Yet, all physical therapists
have been exposed to the well-known patterns, pacing, procedures and
principles of PNF with all of its emphasis on the regular use of spiral and
diagonal patterns.
This may well explain why the incidence of injuries associated with forceful,
sudden, ballistic or large range rotation of joints may be so rife in sport -
witness for instance, the mainstays of sports therapy with its epidemic of
rotator cuff, ACL and similar injuries. Machine training and even free
weight training seems to concentrate largely on linear or uniplanar actions,
and if rotation is involved in training, it takes place only in the sport
itself or in the gym via the use of gentle yoga-like stretches and warmups.
It is not only exposure to a stressful action that can cause injury, but also
religious avoidance of so-called dangerous actions (which might occur during
actual sporting conditions). One cannot expect the body to cope with the
immense structural and functional demands placed on the body in sport unless
one methodically conditions the body to cope with progressively greater
structural and functional stresses.
Dr Mel C Siff
