Bending Forward or Bending Backward?

Bending Forward or Bending Backward?

 

Throughout Physical Therapy School, we were taught that a intervertebral disc consists of an outer layer, the annulus, with an inner region, the nucleus.  Upon bending backwards (extension), the nucleus shifts anterior (toward the front of your body), while during flexion or bending forward, the nucleus travels posteriorly (toward your back).  Most patients experiencing a bulging or herniated disc show a migration of the nucleus posteriorly, placing pressure on the posterior annulus. 

I have prescribed the Passive Cobra Stretch to many patients experiencing a bulging or herniated disc.  This passive extension exercise creates anterior shifting to the nucleus, decreasing pressure on the posterior annulus. 

Many times, the nucleus migrates posteriorly due to repeated or sustained spinal flexion.  This causes compression on the disc and if lifting is introduced at this time, even more stress is placed on the posterior aspect of the annulus.  It is recommended to avoid lifting if you have been sitting or stooping for an extended time.  You should instead stand tall and extend your spine to allow the ligaments to become stiff again (they were stretched when the spine was flexed) in order to protect your back. 

 

Drivers and athletes should pay particular attention to this.  Athletes should avoid sitting on the bench for an extended time when waiting to play. 

 

 

 

 

Drivers should use a Lumbar Support pad on their seat to maintain their lordotic curve.  This curve maintains the anterior position of the nucleus within the annulus.