Back Extension Exercise
AKA Hyperextension, hyper The back extension or hyperextension is a very basic but very effective exercise for strengthening the extensors of the back to maintain the arch needed in weightlifting. Execution Fix the ankles in a glute-ham bench or hyperextension bench adjusted to place the fulcrum or pad on the upper thighs. Bend at the hip and back to hang straight down from the hip (back relaxed and trunk hanging vertically). From this starting position, extend the hip and back together, actively contracting the glutes and spinal erectors, to bring yourself up to an extended position above horizontal in which the back is extended maximally. Depending on mobility, this may place the chest facing nearly forward. Be sure to arch along the entire length of the back, including the upper back, not just the lower back. For unweighted back extensions, placing the hands behind the head is recommended to help encourage better extension of the upper back. For weighted back extensions, holding the weight in the form of a barbell or dumbbell behind the neck (in the same position it would rest for a back squat) is recommended. Notes Technically, this execution is combined back and hip extension. Back extension can be isolated by fixing the hips in place and flexing and extending only along the spine. This can be assisted by relocating the fulcrum or pad of the bench closer to the hips. Purpose The back extension both trains the activation of the spinal extensors and strengthens their ability to extend the back, which is critical for weightlifting because of the need to maintain a strong and stable back arch during the lifts. Programming Unweighted back extensions can be performed every training day with about 3-4 sets of 10-15 reps. Weighted back extensions can be done 2-4 days weekly. Unweighted extensions and holds in the extended position can also be performed during the warm-up to encourage activation for the training session to follow. Variations The speed of the movement can be changed and a pause in the extended position can be added. See Also Good morning Seated good morning Stiff-legged deadlift Romanian deadlift Straight-legged deadlift
Back Extension Exercise
Study designThis was a single-center, non-randomized, controlled study. Participants who worked on the first floor were assigned to the control group, and those on the second floor to the intervention group. We provided an exercise manual for all participants and a 30-minute seminar only for the intervention group. In the exercise manual, we described how to do a standing back extension exercise ‘One stretch’ (Fig. 1). This exercise is an active extension of the back used as a common technique in physical therapy, and is based on the theory of derangement syndrome proposed by McKenzie and May.14 We also provided some evidence-based information for treatment and prevention of LBP: self-management and risk factors (e.g. psychosocial factors and fear-avoidance). A 30-minute seminar was given by an orthopedist, the author of this article, where he explained the exercise manual and this exercise.Figure 1.How to do standing back extension ‘One Stretch’.Participants were asked whether they were willing to do this exercise. In order to promote regular exercise in the intervention group, we took a group approach and routinely monitored participants’ motivation for the exercise.
Back Extension Exercise
IntroductionLow back pain (LBP) is a major health problem, particularly in industrialized countries, and has affected people’s life and social economy in various ways. The Global Burden of Disease Study indicated ‘low back pain is one of the leading specific causes of years lived with disability (YLD)’,1 and about 85–90% of LBP has been classified as non-specific LBP.2–4 Low back pain-associated disability results in loss of work and huge economic impact with substantial direct and indirect social costs.5–7In Japan, as in other industrialized countries, many people suffer from LBP. Recently, a lifetime LBP prevalence of 83% and a 4-week prevalence of 36% were reported.8 Additionally, LBP was the fifth most common reason for medical consultation among Japanese outpatients,9 and especially in the health care industry, an increasing number of care workers left the job due to work-related LBP.10Some researchers revealed that physical activity at work, such as lifting and rather keeping forward flexion, sustained forward bending, can be associated with increased back symptoms, further aggravating pain (so-called back injuries).11 In fact, frequent lifting during working hours greatly impacts non-specific LBP in Japanese workers.12To deal with the socioeconomic problem of LBP, it is important to prevent LBP from developing in people without symptoms. Physical exercises have been recommended in the prevention of LBP, while there is insufficient evidence against any specific type or intensity of exercise.13 McKenzie, who introduced a subgroup classification method of LBP, recommends extension exercise because posterior displacement of the nucleus by the exercise eliminates or abolishes LBP.14 The McKenzie method is a system that classifies patients into one of the specific subgroups primarily based on symptomatic and mechanical responses to mechanical loadings. Among the LBP population, the largest subgroup where LBP is improved in a short period of time is by back extension loading strategy. Its theoretical explanation is based on the disk model in which posterior displacement of the nucleus can be reduced by deliberate extension loading strategy. This reduction of the displaced nucleus may result in decreasing or abolishing LBP.In this study, we used a simple daily standing back extension exercise ‘One Stretch’, to evaluate the efficacy of this exercise in care workers at risk of developing and aggravating LBP.
DiscussionThe findings of this study suggest that standing back extension exercise ‘One Stretch’ is effective to prevent care workers from developing and aggravating LBP. We considered that daily practice of this exercise would not only improve LBP but also decrease the number of care workers needing medical consultation or leaving work due to LBP. Furthermore, our group approach would encourage better compliance with the exercise.Several other studies have supported the use of extension exercises. Long et al. found that patients randomized to favorable directional preference exercises, consisting mostly of extension exercises, made significant improvements in LBP compared to those randomized to opposite or mid-range movements.18 Furthermore, a novel study of kinematic magnetic resonance imaging (kMRI) demonstrated evidence that slightly degenerated intervertebral disks moved in a posterior direction during flexion and in an anterior direction during extension.19 This may be the mechanism for clinical improvements seen in our study.In a randomized controlled trial in which military conscripts were randomized to extension in lying exercises or a control group, the intervention group saw a significantly lower prevalence of LBP and care seeking for LBP compared to the control group.20 The extension approach inhibited developing back problems in young men. This is similar to our study, even if there were differences in age, sex, and an exact posture of extensions.In this study, there were no significant differences in the baseline characteristics, including the mental health score of SF-36 and the physical activity subscale of FABQ between the intervention and control groups. Previous studies have shown that depression is a risk factor for LBP,21–23 but depression, as noted by the SF-36 mental score, did not seem to affect our results.The intervention group showed a higher improvement of LBP and had better compliance with the exercise than the control group. We also noticed that the subjective improvement of ‘no change’ included both care workers with and without LBP due to the nature of this study design. Indeed, those care workers remained healthy so that none in the intervention group had a first medical consultation or were absent from work by the end of the study period.On the other hand, the study results suggest that a group approach may improve adherence.24 Generally, a population approach is considered to be a powerful preventive strategy that affects causal behavior in health care activity.25 For instance, recommending group exercises for prevention may reduce the prevalence of LBP and save more socioeconomic costs than just treating sick individuals. However, some individuals, such as those having multiple risk factors of LBP or having complaints against small preventive benefits, need an individual approach to preventive behaviors. Both population and individual approaches are required to complement each other.24There were several limitations to this study. First, the questionnaire contained retrospective questions and the participants assessed their condition of LBP 1 year after, and so the possibility for recall bias should be kept in mind. Second, we examined a small sample size and a single population. Owing to the nature of the study, cluster randomized trials with adequate sample size are needed for evaluating intervention. Thus, the generalizability of findings is limited, and the findings should be interpreted with caution. We will perform further examinations through large-scale randomized controlled trials.
This was a single-center, non-randomized, controlled study. Participants who worked on the first floor were assigned to the control group, and those on the second floor to the intervention group. We provided an exercise manual for all participants and a 30-minute seminar only for the intervention group. In the exercise manual, we described how to do a standing back extension exercise ‘One stretch’ (Fig. 1). This exercise is an active extension of the back used as a common technique in physical therapy, and is based on the theory of derangement syndrome proposed by McKenzie and May.14 We also provided some evidence-based information for treatment and prevention of LBP: self-management and risk factors (e.g. psychosocial factors and fear-avoidance). A 30-minute seminar was given by an orthopedist, the author of this article, where he explained the exercise manual and this exercise.