New Lumbar Strategies and Techniques for Low Back Pain
Restoring threat/pain free extension is important. It makes the patient more easily and effectively able to self treat. If repeated extension in standing or lying will help centralize and abolish pain, the patient has to dose appropriately to maintain improvements gained in the clinic.
I have been having unilateral left sided low back pain. It responds to some things like H-Wave and repeated trunk rotations, but I'm always looking for more solutions. I'm use isometrics to modulate pain during repeated loading in my courses and with patients, but quickly switch if they don't modulate pain within a few quick reps. I tried a sustained isometric and after 2-3 min, it completely relieved my unilateral pain. The pain did not increase during it, which is probably important, it remained the same until it just abolished. This made my sideglides in standing mostly pain free except mild at end range.
The PT in this clip from a module of my live MMT Seminar is a former elite gymnast who has a hx of 3 lumbar fractures from tumbling. She eventually quit and now several years later, she has painful and limited extension, plus some fear avoidance. I show how simple skin squeezes modulate her pain and improve her extension. The progression to restore end range was isometric resisted extension and then resistance through the range. Afterward, her extension was full and the only side effect was that she felt she needed to flex afterward. I prescribed regular extensions in standing throughout the day and isometric prone extension holds building up to 1 minute.
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