Back Pain Rehab: Axial Isometric Loading

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While spinal flexion can be a common aggravating motion for people recovering from squat or deadlift-related injuries, axial loading (or vertical forces through the longitudinal axis of the spine) should also be assessed as a potential pain-reproducer during the physical therapy clinical examination. Individuals who fall into this category may feel excessive compressive-like pain simply when setting up underneath a loaded bar due to the vertical loading forces upon the spine. Depending on presentation, one may need to consider the possibility of endplate vertebral fracture(s) and to refer out to the appropriate healthcare professional if necessary for further diagnosing. However this is most commonly seen in postmenopausal women, people with osteoporosis, the elderly, or people who've experienced trauma or infection (PMID 23251117). _ You can see from some of my previous posts that I'm a fan of isometric exercises using a barbell as early stage rehab work for powerlifters and weightlifters. They're specific to the demands of their sports by enabling them to generate muscular, isometric tension in relevant positions which can also provide an analgesic effect (PMID 29163981, 25979840). An isometric, axially-directed force through the body can be performed either in the setup when one is preparing to wedge himself underneath the bar, or as a progression, when the lifter is arising out of the hole and is ready to re-acclimate to this bottom position. Just place the J-hooks in the desired position and squat upwards into them, while simultaneously pressing your feet hard into the ground. _ As I mentioned in my previous posts I encourage lifters to breathe through these isometric contractions so as not to rely on Valsalva-generated intra-abdominal pressure for strength, but to rather seek it out through muscular tension alone.

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