As the grimacing gentleman above and to your left, world record holding powerlifter Chris Duffin, can attest, a well trained lumbar disc can manage outrageous load. Premium Members to FixYourOwnBack can see Chris in action on Chapter 9 of The Plan where we discuss thoughtful loading of the disc in powerlifting. While all of us might not aspire to these endeavors, it’s worth seeing one end of the loading spectrum as you’re navigating the ability to progressively load a previously injured disc.
As the subjects of FixYourOwnBack.com are the problems associated with injured discs that are loaded to the point of injury, it is easy for us to become hypersensitive about ANY loading in the discs. This, of course, is faulty reasoning because we know that exercise load helps with tissue growth and repair throughout the body. We are at a point in the literature these days (May, 2012) where we are still learning how much load and what vectors of loading might be health promoting. We are also still learning about the timing of that loading, as in how long recovery and repair stages are for injured and uninjured discs. Contributing to our understanding of healthy loading is the work of Tapio Videman and Michele Battie.
Their study, Challenging the cumulative injury model: positive effects of greater body mass on disc degeneration (citation below), was drawn from a cohort of twins in Finland. The found 44 pairs of twins that had at least 8kg (17.6 lbs.) difference in body weight and put them through some tests and questionnaires. They found that the heavier twins had:
- Higher bone mineral density in the lumbar spine
- More robust discs
- Less evidence of disc degeneration as the twins aged
The things to remember here are that that extra weight the heavier twin carried may have corelated to other health risks like diabetes and heart disease, and that this speaks to the rate of loading too. Weight gain over time represents a cumulative loading which allows the bones and discs to remodel to a more robust status to manage the loads across them. In our own exercise plans, we should remember this as we load discs in healthy vectors and allow for recovery between workouts.
The surprising finding was that the extra weight in the twins did not automatically confer to worsening disc health over time. Indeed, it seemed to improve the health of discs. We still have much to learn in how to control all of these variables to predict better recovery from disc injury, but this seems to indicate that resistance loading in sensible manners, has a place in the management of disc health. A caution though from someone who treats disc injuries daily…leave the situps and crunches out of the workout and do planks instead. More on that in future weeks…
Dr. Phillip Snell