Introduction by Louie Simmons
Reverse Hyper™ CURRENT ACTIVE PATENTS 6491607(b2 – (2002) 7435207-(2007) 7473212-(2009) 8,529,413-(2013)
I fractured my 5th lumbar vertebrae in early 1973 while doing good mornings. I had just deadlifted 670lbs at 180lbs in February of 1973. I also had sciatic nerve damage in both legs that I could not straighten them out without severe pain. After being on crutches for most of ten months with no help from a variety medical experts. I could no longer do any exercises.
One day I tried to do a back extension, but I would experience extreme pain in the lower back as soon as I applied force into the toe plate. It was very painful in the glutes and the back of my legs. I was desperate, I could not work, and certainly not powerlift. No one was helping. One day I thought what if I did a back extension in reverse? I built a platform in my power rack so my torso is suspended and supported while my legs were hanging downward (face down). As I held onto the front of the rack I raised my legs upward with no pain. I was also able to lower my legs past 90% again with no pain.
For the first time in almost a year I felt blood flow or a pump in my lower back. At the same time, my sciatic pain was lessened. I could not believe it, was it just in my head? The next day I repeated the exercise with the same results. I continued the exercises several times a week and eventually the pain was gone. How? Much later I realized I was using decompression while strengthening all the muscles, ligaments and tendons of the lower back. As my abdomen was suppressed it increased the IAP which lessened the load on the intervertebral discs. I was able to resume lifting and ranked 4th in 1978 and 5th in 1979 in the 198 weight class. In 1980 I made the 3rd largest total of all time at 220lbs. Unfortunately, I broke my L5 again in 1982. A surgeon advised me to remove two discs, fuse my back and remove several bone spurs. I refused. I repaired my back once, why not again? For seventeen weeks I stretched, used acupressure, acupuncture and light reverse hypers for high reps, 20 – 25 per set, 4 sets per day. I once again regained full back strength and rose back into the top five rankings.
After complete rupture of the patella tendon I found it hard to do my job as an iron worker. The reverse hyper exercise was a complete secret to myself, as I trained in my private gym. I hired a patent attorney to do a service and in 1994 I was granted my first patent. My motive was helping others with chronic back issues. I later made several improvements in 2004-2007-2009 and 2013 and am now working on a much improved model for Drs., Therapist, and Chiropractors. The reverse hyper will work the muscles of the lumbar region (specifically), the epaxial muscles such as the inner spinals connecting adjacent spacious processes or the intramuscular salis. Connecting adjacent traverse processes of the vertebrae are difficult to activate in most exercises. What’s the answer? The Reverse Hyper™ made it possible to squat 705, bench 505 and deadlift 675 at 63 years old.
To prove this I placed the machine in the DMX x-ray thanks to Dr. Jerome Rerucha and can be seen within the above Youtube Video.
Pain Described by Dr. Jerome Rerucha
One of the most important considerations in physical training is to first remain injury free or in the event of prior injury, to promote recovery so the individual can maintain training. This is true when working with a novice, a collegiate athlete, a professional competitive athlete, a fitness enthusiasts or even the general public trying to maintain an active lifestyle. Whatever your role: a personal trainer, strength and conditioning coach or clinician, pain and injury is a component that needs to be understood.
Pain is categorized as either acute (generally from a known cause or immediate trauma leading to injury) or chronic (long lasting). There are many subcategories or diagnoses under each of these main categories. We may feel the pain in our toes when we stub them, however the recognition, interpretation, and reaction to the pain occur in the brain; not at the symptomatic area. Awareness of pain happens when sensory neurons (special nerves throughout the body) react to pressure, vibration, trauma, heat, cold, and other stimuli. These neurons also respond to prostaglandins, histamine, and other chemicals released by injured or inflamed body tissue. The level of the sensation depends upon the strength of the stimulus and the total health (or lack thereof) of the body. When sensory neurons are stimulated, the nerves fire sending off messages that travel along the nervous system to the brain, then the pain information is rapidly evaluated, and sensations are interpreted. This complex reaction in the communication systems of the body protects us when there is a stressor (danger is a lil intense);when the protection due to the stress has passed, the brain is told to turn off the feeling of pain. If there is a problem in the communication system of the body; all of the neurological, chemical and emotional communication systems may not be able to tell the pain to stop.
Acute pain makes you aware of many problems in the body from torn ligaments to gallbladder attacks. At low levels, pain can motivate you to rest the injured area so that tissues can be repaired and additional damage can be prevented. Acute pain lets out a three-alarm warning when you accidentally put your hand on a hot stove or when it forces you to rest a sprained ankle. Frequently, traumatic pain is dealt with properly because the cause of trauma can be accurately identified and eliminated at which time the natural healing of the body can begin. Rest, Ice, Compression, and Elevation is commonly used effectively. For faster healing cold laser therapy, chiropractic care, acupuncture, Rolfing, soft tissue and other modalities can speed healing significantly and provide long term correction from some of the trauma that was encountered to the nervous system, skeletal system, fascia and muscles. Rehabilitation is very beneficial once the body can handle the excess physical stress of exercise.
Not all pain serves a useful function. While acute pain can alert us to a problem that needs immediate attention, in some cases pain lasts long after an injured area has healed. In other instances, pain may be in the form of a recurring backache, migraines (or other types of headaches), arthritis, and other disorders. This is referred to as chronic pain. Chronic pain may be a dull ache, sharp, stabbing, radiating, throbbing pain or any combination of these that seem to never subside or it may be experienced during certain times of the day and is lasting for more than six months. Pain may be localized at the site of an injury, or “referred” to another part of the body. Chronic pain may occur after a physical injury or surgery and continues after the normal healing period. Chronic pain can accompany many disease conditions such as fibromyalgia, headaches, neuropathy, depression, PMS, post-surgical pain syndrome, the accumulation of training stresses and many others. Chronic pain is a complex condition with a variety of causes. Remember, pain is only interpreted by the nervous system and identified by the brain. When pain persists, there is a lot of attention placed on the area of symptomatology, in a variety of ways depending on the type of specialist seen. Little effort is directed toward the retraining of lower motor neurons in order to ultimately change upper motor neuron activity in the brain which inhibits the reflex pathways and Type C fibers that have become incorrectly programmed.
“Neuroplasticity” is a modern term to describe the remodeling of brain patterning; this includes pain. Neuroplasticity, also known as brain plasticity, referring to changes in the neural pathways and synapses which affect changes in behavior, environment and neural processes, as well as the changes resulting from bodily injury. Neuroplasticity has replaced the formerly-held position that the brain is a physiologically static organ, and explores how and in which ways the brain changes throughout life based upon what you do; this can be regenerative or degenerative.
Neuroplasticity occurs on a variety of levels, ranging from cellular changes due to learning, to large-scale changes involved in cortical remapping in response to injury. The role of neuroplasticity is widely recognized in healthy development, learning, memory, and recovery from brain damage; but I also recognize the correlation with elite fitness; not just clinical pathology.
During most of the 20th century, the consensus among neuroscientists was that brain structure is relatively immutable after a critical period during early childhood. This belief has been changed by findings revealing that many aspects of the brain remain plastic even into adulthood. Decades of research have now shown that substantial changes occur in the lowest neocortical processing areas, and that these changes can profoundly alter the pattern of neuronal activation in response to experience. This why you can train your body to be strong, which can only happen after your nervous system is trained to be strong, within those pathways. This also applies to pain and visceral patterns. Neuroscientific research indicates that experience can actually change both the brain’s physical structure (anatomy) and functional organization (physiology). Neuroscientists are currently engaged in a reconciliation of critical period studies demonstrating the immutability of the brain after development with the more recent research showing how the brain can, and does, change throughout life. Later on in this paper a brief explanation of patterning will be described. Many of you who are strong and injury free will say “I already do that” and that is not a coincidence.
Chronic pain is one of the most costly conditions in North America. Although pain is a major problem in this country, it is not treated compassionately or efficiently, and it is not just pain that is the problem. The side effects of chronic pain illnesses caused by a sedentary lifestyle, seclusion and depression and, in some cases, addiction to pain killers can be just as devastating as the pain itself. The estimated costs of direct medical expenses, lost income, lost productivity, compensation payments, and legal charges, are approximately $90 billion a year.
• 48 million Americans suffer from chronic pain. Over 21 million Americans routinely take prescription painkillers and also spend $3 billion on over the counter analgesics.
• Over 13 million Americans cannot perform routine activities because of pain.
• As many as 45 million Americans have chronic, severe headaches that can be disabling.
• Arthritis pain affects more than 40 million Americans each year.
• The majority of patients in intermediate or advanced stages of cancer suffer moderate to severe pain. More than 1.2 million new cases of cancer are diagnosed each year in the United States, and more than 550,000 people die from the disease.
• Fourteen percent of employees take time off from work because of pain.
• According to the National Institutes of Health (Harris et al. 1999), lower back pain is one of the most significant health problems in the United States, with back pain being the most frequent cause of physical impairment in people younger than 45 years of age: 65-80% of all people have back pain at some time in their life.
Although there are numerous types of injuries caused by countless circumstances, affecting the general public and athletes alike, we will concentrate on the #1 neuro-musculoskeletal injury in the world; back pain. The same principles apply when addressing any “systemic” weakness, asymmetry, inflexibility or improper functional (neurological) movement.
Back pain is the number one musculoskeletal problem in the world and the second most common reason for all visits to the doctors’ office (#1 reason for the orthopedist). Low back pain primarily effects adults, ages 35-55, but may occur in children and adolescence. Approximately 75 % of people in developed countries will experience low back pain at some time in their lives. The annual prevalence of low back pain in the U.S. is 15%-20% of the population. Back pain is the second leading cause of absenteeism from work, after the common cold, and accounts for 15 % of sick leaves. Back injuries cause 100 million lost days of work annually, and is the most costly for employers. Approximately 1% of the U.S. population is chronically disabled due to back problems and another 1% is temporarily disabled.
Signs and symptoms are centralized in the low back area and vary dependent upon the severity of the injury. Acute or chronic back pain symptoms can give indications as to the cause of the pain. Many common symptoms are;
• Paraspinal muscle spasms
• Possible radiation of pain to the buttocks and into the lower extremities (sciatica)
• Limited range of motion
• Pain aggravated by motion and alleviated by rest
• Severe pain leading to change in posture
• More common in men than women
• Common in those with high labor intensive jobs with a lot of repetitive bending
• Anatomical short leg (causing pelvic unleveling and spinal torqueing)
• Trauma such as fractures, herniated discs, ligament sprain, muscle strain
• Non-traumatic causes such as degenerative disc disease, inflammatory arthritis
• Facet Syndrome
• Sacral misalignments
• Lumbar subluxations
• Spinal Stenosis
• Muscle imbalances
• Visceral conditions (female cycle, colon, prostate, kidney, bladder)
There are many causes of low back pain, from predisposed risk factors to acute injuries. These conditions can be divided into the broad categories of traumatic and non-traumatic.
•Micro traumas (jogging on hard surfaces, etc.)
•Macro traumas (car accident, impact traumas)
•Soft tissue sprain (ligaments), strain (muscular)
•Subluxations and dislocations
•Overexertion, fatigue (improper lifting)
•Degenerative disc disease
•Side effects from medication (cholesterol lowering drugs)
•Sedentary life style
•Spinal structural imbalances (poor posture)
Low back pain can have many variables. Although, many individuals complain of localized symptoms, a successful program takes into account the health of the entire neuro-musculoskeletal-fascial system. Identifying weaknesses are important; however exercise or stretching isolated areas has proven to be ineffective, especially for long term relief. The body works together as a unit. Training the core strength of the body to achieve the ideal neutral posture, proper intersegmental motion, activating the nervous system and muscles synergistically to perform flexible, symmetrical functional movement creates a strong, healthy and pain free structure is the most effective method to reduce the incidence of low back pain (or any other injury) and also for those working for optimum performance.
Research has shown that those who suffer from back pain have a common imbalance throughout the musculoskeletal system. A normal spine has an ideal center of gravity from head carriage to the center of gravity over the pelvis. When people have a forward head tilt; for every one inch forward the head is held, there is a 100% increase in the weight of the head.
A publication in Spine, the most renowned orthopedic medical journal in the world, September 15, 2005; 30 (18): 2024-9 “The impact of positive sagittal balance in adult spinal deformity”, explains this concept accurately. The study used lateral full spine x-rays and measured overall spinal alignment using
reference points from the center of the 7th cervical vertebra and the posterior-
superior corner of the 1st sacral segment. A plumb line was then used to
determine center of gravity and measure overall displacement and how this
directly related to patients severity of symptoms of pain and overall decrease
in health by also using (the standard form), the SF 36.
• “All measures of health status showed significantly poorer scores as the C7 plumb line deviation increased (forward head carriage / body).”
• “There was a high degree of correlation between positive sagittal
balance and adverse health status scores, for physical health
composite score and pain domain.”
• “There was clear evidence of increased pain and decreased function as the magnitude of positive sagittal balance (forward head carriage / body) increased.”
This study shows that although even mildly positive sagittal balance is somewhat detrimental, severity of symptoms increases in a linear fashion with progressive sagittal imbalance (forward head carriage) per every 1 mm).”
In addition to anterior head carriage the pelvis commonly becomes “tipped” forward (referred to as lower cross syndrome) which creates further abnormal biomechanics and pressure and eventually leads to increased stress to the facets, injuries to the discs, vertebrae, ligaments and muscle imbalances. These mechanical stresses create pain signals throughout the nervous system and lock in a pattern of back pain (or injury to any area due to involvement throughout facial planes.
Poor daily habits promote an unhealthy lifestyle pattern beginning in childhood and continuing throughout the adult years. The flexor muscles of the body are overworked and the extensor muscles are severely under used. This cycle is created by young children in school sitting for extended periods during the growth and formative years. Children are not as active as in previous generations, relying on television and video games rather than proprioceptive dynamic activities. In early adulthood we are “flexor conditioned”. Many spend long hours sitting in the college classroom or at the desk jobs of corporate America. We have a labor force that performs repetitive bending (flexion) activities for many hours every day and who spend extended periods of time sitting in cars, commuting while doing nothing to offset this imbalanced lifestyle and promote proper health or recovery from injury. The physical imbalances are amplified by chemical imbalances of increased sugar / carbohydrates, energy drinks, supplements loaded with high fructose corn syrup, improper ratios of essential fatty acids (ideal EPA 1.5: AA 1 ratio) all amplifying systemic inflammation; further load the body up with artificial sweeteners (sucralose causes pain and stiffness and aspartame is a documented neurotoxin) and you have a physical and chemical crystal ball for pain, suffering and reoccurring injury.
Many patients/athletes report their acute injury was caused by a sneeze, or “throwing their back out tying their shoe” or “picking up a pencil off the floor”. Although the injury effects are real and severe, taking a history and proper (functional) examination reveals many precipitating stresses and physical imbalances that led to the weakened condition that created the buckling injury. Even in the case of true acute injuries, such as car accidents and impact trauma, the focus of restoring spine stabilizing patterns to the whole musculoskeletal and nervous system is necessary for full, long term recovery.
Poor biomechanics and repetitive stress also place an abnormal load on the muscles and the spine that leads to injury. Remember it is the muscles that stabilize and protect the spine and nervous system (all synergistically working together) drives proper communication. The spinal stabilizer muscles require;
• Endurance to withstand the task of standing for hours and performing labor intensive, daily and athletic duties.
• Strength to stabilize the core of the musculoskeletal system.
• Flexibility to perform dynamic motion.
• Balance to properly displace stress throughout the musculoskeletal system in an ideal weight bearing position
• Increase in circulation accelerates tissue regeneration and recovery by bringing in nutrients and taking away metabolic by products.
A multidimensional evaluation and progressive program is optimum for any individual however, for the purpose of this publication, we will only include some important points.
Ideally each individual needs to be evaluated and a specific plan designed depending on asymmetry, injury or injuries involved.
Solutions; “If it is good for a strong person, it is good for a weak person. You just have to decrease the intensity so it is appropriate for the individual.”
The body is designed to move; to perform the normal activities of daily living. Elite athletes require more strength, endurance, balance, flexibility, mitochondrial output of ATP than the average person. Proper structural alignment is required to perform a task successfully and injury free. The average individual can perform normal daily activities with physical functional measurements far below those of the elite athlete. If either individual is physically unprepared (over time), the weakness will create an acute and possibly a chronic injury pattern.
Initially, in my professional career I was in the strength-coaching field where I gained valuable experience that gave me indispensable insight as I continued my education as a clinician. I have extensive background training both novice and elite athletes in a variety of sports and I became a competitive power lifter for 14 years. Understanding different body types, designing individual and team programs for specific physiological outcomes has helped me, as a clinician, to provide any necessary variable to help competitive athletes or the general public. Every day in practice or as I lecture to other clinicians, I use my extensive background in exercise physiology and the strength field.
Clinicians receive an extensive education in the basic sciences, which enables them to diagnose, within the scope of their license, and to use tools, such as x-ray, MRI, the knowledge to perform ortho/neuro exams etc. and to interpret clinical findings. All clinical exams are neutral exams, out of gravity. Some may want to claim that ortho/neuro tests are functional and that they are beneficial to a person with a physical injury. These exams are completely worthless when evaluating an uninjured individual and therefore cannot provide the benefit of being able to measure progress or to prevent a problem, in the first place, if you cannot detect predispositions to an injury. Once a detailed analysis has been completed, as a clinician, it is your responsibility to “manage” the patient and to design a program for recovery. Some clinicians merely concentrate on and “manage” just the diagnosis, overlooking many possible contributing factors, or minimally, some clinicians just “manage” the symptoms, often times achieving only a temporary solution to the overall condition. The majority of care relies on passive treatment applications; lying on a table to get adjusted, Rolfed, massaged, acupuncture or being hooked up to a variety of electrical stimulation devices, ice, heat, take this medication or a surgery is performed. I could write a book on patient success and the benefits and life changing results from many of these passive modalities that are appropriate and effective for treatment. There is no substitute for proper chiropractic adjustments for injured individuals or athletes training for peak performance with absolutely no injuries. The point to be made is; passive treatment is only as good as the strength of the organism, injured areas have a compromised metabolism at the mitochondrial level. Many patients only want passive care and are unwilling participate in progressive activity for full recovery or better yet be proactive to prevent the predisposition in the first place. I have taught thousands of practitioners, from a variety of health specialties, over the years and the reality is many clinicians have “zero” experience or knowledge of movement let alone the knowledge of safe, effective exercises and stretches and other modalities to help correct the many problems seen by clinicians.
I compliment practitioners for the great work they currently perform; however a great advancement for the future of any medical care is for clinicians to be aware of the benefits provided by the strength and conditioning industry and to integrate programs into their current services. There is a limit to the success from passive care. Without the knowledge of what can be achieved when integrating these various modalities of treatment, the next step (activation of proper movement) in the progression of treatment will not be achieved.
Strength and conditioning coaches and personal training have little to no experience in managing clients with a medical diagnosis, however, many are experts in movement and activation and teach proper exercise technique. For clinicians to have knowledge of strength, flexibility training, kettlebells, bodyweight exercises, Olympic lifting etc. would be invaluable in evaluating the injured patient.
Time and time again for every millimeter of flexibility improvement (to promote symmetry) and every small increment of strength that is gained, there is a linear progression of improvement even in the many individuals with chronic conditions. These positive results are greatly amplified when combining specific adjustments, low level laser therapy, soft tissue work or a wide variety of therapeutic options. When you have had the opportunity to work extensively on both average patients as well as elite athletes, it is amazing how physically incapable people become; being unable to even walk up stairs or get up off the floor unassisted. When entire professions are incapable of identifying improper functional movement and these imbalances and asymmetries are not addressed for a long period of time, they inevitably will manifest into chronic degenerative pathologies; even with common proper passive treatments being performed.
There are many beneficial strength exercises and rehabilitation variables; let us focus on the pelvis and the importance that center mass and how it applies whether you are picking up a sack of groceries or you are an all pro offensive lineman; your center strength and function matters; and it effects the entire organism. An example of combining information between my personal and professional strength and conditioning career and clinical career is the use of the Reverse Hyperextension to produce significant physical improvement in those with debilitating conditions as well as use for elite athletic performance. I was first made aware of the Reverse Hyperextension in the early 1990’s. I was already competing at the national level, saw an article written by Louie Simmons in Powerlifting USA; the information made sense, our gym got one and I have used it ever since. Already being a nationally ranked strength athlete, the first workout with the Reverse Hyperextension proved that all the good I was already doing did not achieve the results the Reverse Hyper did. Since that time it has become a standard part of all my training and treatment programs. It is an incredibly safe exercise in the hands of a qualified practitioner or strength and conditioning instructor.
I have had severe pain patients with lumbar fusions and herniation’s perform the exercise achieving long term clinical success. While filming the lumbo –pelvic area with Digital Motion X-Ray using the reverse hyperextension, patients and clinicians can see what is happening at the spinal level, in real time, with these significant injuries and chronic post-surgical pain patients. These examples can be seen on my YouTube page on my website www.performancechirowellness.com. I have used this exercise with many people with similar histories and have numerous testimonials how it literally changed their life. The Reverse Hyperextension is something individuals can continue to do for themselves, without the need to rely on another person; self-empowerment is important for any long term success. As beneficial as this has proven to be, it amazes me how many personal trainers, strength coaches and self-proclaimed serious lifters / bodybuilders have never even heard of the Reverse Hyperextension and will try to defend what they do as working better. The explanation and x-ray graphics of the exercise speak for themselves, but the uniqueness of the exercises can only be experienced by using the Reverse Hyperextension machine itself (not re-creating the movement on an exercise ball or counter-top and definitely not a hyperextension exercise). By placing appropriate resistance for the individual on the Reverse Hyperextension and performing the motion within the patients’ initial capabilities, the clinical and performance potential becomes apparent.
The information below may benefit you in further understanding the injury process and some additional modes of treatment.
Static Decompression machines have been used for decades and have shown benefits to those suffering for back pain and who already have spinal degeneration.
Active Decompression The reverse hyperextension exercise takes the benefits of static decompression and includes the benefits of activating the nervous system, improve circulation and many tissue regeneration factors.
Many people have been through complete rehab sessions and even have had surgery and continue to have back pain. Others have their quality of life limited because they “know their limits” or were told “its old age and you will have to learn to live with it” and are destined for consistent degeneration and weight gain because they are unable to be active for fear of hurting themselves. In the majority of these pain patients, a proper understanding of the total problem was not identified, let alone explained, and no solution is provided.
Everyone has their weakened areas due to accumulated trauma from falls, car accidents, repetitive stress, sports injuries, muscle asymmetry, inflexibility, and dysfunctional movement patterns. A clinician can consider further metabolic factors such as improper EFA ratios, mitochondrial damage, chemical toxicities that tear down the physical structure and more. In every injury, every time, it is important to remember that it is the muscles stabilize joints and are involved locally and globally by a neuro-musculo-skeletal-fascial system. If the muscles are not working properly, the joint is predisposed to an injury. If there is an existing injury, it promotes an inflammatory pain response throughout the nervous system (due to down regulation of muscle spindle fibers and lack of inhibition of Type C pain fibers). Muscles affect structure and structure affects muscles; prolonged stress on either of these systems fatigues (injures) the nervous system: specifically at the mitochondrial DNA level (Mitochondrial DNA in Aging and Disease Scientific American; Aug 1997 page 40). When the nervous system can no longer compensate, physical breakdown of the body occurs. This breakdown is revealed by acute and chronic pain with degeneration to ligaments, cartilage, joints, triggers points and pulled muscles. All of these contributing factors apply to science of “Mechanobiology”.
Mechanobiology and Diseases of Mechanotransduction
Annals of Medicine 2OO3;35(8),pp.564-77
Donald E Ingber, MD, PhD from the Vascular Biology Program, Departments of Surgery and Pathology, Children’s Hospital and Harvard Medical School
The main goal of the article is to help integrate mechanics into our understanding of the molecular basis of physical and visceral disease. This article first reviews the key roles that physical forces, extracellular matrix and cell structure play in the control of normal development as well as in the maintenance of tissue form and function. The article explains insights into cellular mechanotransduction, the molecular mechanism by which cells sense and respond to mechanical stress [for many of us is the application of proper exercise]. Re-evaluation of human pathophysiology in this context reveals that a wide range of diseases included within virtually all fields of medicine and surgery share a common feature: their etiology or clinical presentation results from abnormal mechanotransduction. “These new insights into mechanobiology suggest that many ostensibly unrelated disease share a common dependence of abnormal mechanotransduction.
There are many more important concepts that are described throughout the entire article which apply, not only to physical and visceral pathology, but describe taking a proactive approach in developing healthy athletes.
We can begin to safely and effectively correct the muscular imbalances, which will correct the global structural problems and therefore allow the nervous system to heal the pain response via retraining lower and upper motor neurons (neuroplastic changes). The Reverse HyperExtension is an invaluable asset toward building strength in the posterior kinematic chain, correcting muscular imbalances, remodeling fascia, increasing circulation and increasing intersegmental motion.
The muscular pattern that commonly needs to be corrected, starting from the pelvis:
Short Muscles (need to stretch) Lengthened Muscles (need to contract)
Iliopsoas Gluteus Maximus
Quadriceps Hamstrings/Gluteus Maximus
Tensor Fascia Latae Gluteus Medius
Adductor group Gluteus Medius
Erector Spinae Transverse abdominalis, internal oblique
Gastrocnemius, soleus Anterior Tibialis
The muscle imbalances and postural distortion extends to the upper body;
Short Muscles (stretch) Lengthened Muscles (contract)
Pectoralis Major Rhomboid Group
Pectoralis Minor, Levator Scapulae Lower Trapezius
Teres Major, Upper Trapezius Serratus Anterior
Anterior Deltoid Posterior Deltoid
Subscapularis, Teres Major Teres Minor, Posterior Deltoid
Latissimus Dorsi Infraspinatus
Sternocleidomastoid, Scalenes Longus Coli, Longus Capitus
It is the total pattern of all muscles working synergistically that determine spine stability, position, neurological patterning and ultimately functional movement and performance capabilities. Another point that needs to be made is that intermuscular coordination between muscles groups is a must. The column on the left directly affects the column on the right and vice versa (agonist / antagonist relationship). When the right iliopsoas (hip flexor) is contracting, lifting the right leg up, the right gluteus maximus (buttock) is supposed to be relaxed or inhibited. When the right gluteus maximus is contracting, extending the right leg backward, the right iliopsoas is supposed to be relaxed or inhibited. This patterning is necessary throughout all the above muscle relationships. Those who have chronic and/or recurring pain commonly have anatomical imbalances as well as the muscle fascilitory and reflexive pathways firing improperly which leads to muscles constantly turned off, others constantly spasm and then maintain instability and injury. The agonist / antagonist pattern above is further extended to the right upper quadrant and the left lower quadrant; neurological inhibition. The body’s motor learning pattern must be trained and strengthened! A chiropractor that is trained in resetting neurological patterning can provide an accurate evaluation and correction with proper adjustments, soft tissue work, low level laser therapy and ultimately a strength and conditioning program retraining and strengthening the optimum pattern.
Proper motion is necessary to recover from chronic injuries. Many prescribed exercises place too much compression on the injured area or try to isolate an area of involvement instead of strengthening an entire area that works together naturally.
The Reverse Hyperextension has numerous advantages for those suffering from back pain.
1. There is no compression to the injured spine and discs. The motion of the reverse hyperextension actually “de-compresses” the spine and opens up the joint space on the forward swing phase.
2. The exercise is performed as an “active”) therapy so there is an action potential throughout the nervous system and activation of muscle spindle fibers on the swing phase and the contraction phase. This action is retraining the nervous system to “close” the pain gate.
3. The reverse hyperextension increases circulation to the injured area by pumping cerebral spinal fluid, lymphatic fluid and blood to the area. Circulation is necessary to bring in repairing nutrients and eliminate waste products. This process is necessary for the muscles, tendons, ligaments, cartilage and the nervous system to heal.
4. Imbibition – The Inter-Vertebral Disc is an important component of the spinal column. Together the discs compose one third of the height of the column. The disc itself is made of collagen, and cartilage. An important aspect of the disc is that it has a very poor blood supply. The only process by which it can receive nutrients is via imbibition. Imbibition refers to the exchange of fluid via movement. The reverse hyperextension “active decompression” exercise provides imbibition more than anything else I can provide my patients and clients with.
If you are suffering from back pain, your body has been in a degenerative and injured state for some time. The reverse hyperextension will help retrain and regenerate your body, no matter what your condition level is when you begin. Consistent use of the reverse hyperextension will allow progress to be made and will result in a decrease in symptoms if you follow these helpful guidelines.
1. Start out cautiously! The reverse hyperextension is a very safe and effective exercise; however, your weak and injured low back is not used to having the joints, muscles, ligaments and bones move through normal range of motion or work together properly. Initially you are retraining the body and helping it relearn this process. This takes repetition, consistency and conservative progress. Beginning at a conservative level ensures long-term success and recovery.
2. Initially, the full range of motion may not be possible with the reverse hyperextension in the forward swing phase. In addition, you may not be able to extend your legs up to the full extension (muscle contraction) phase. It is recommended to start with a short range of motion and gently increase as you warm up.
3. In the beginning, patients and clients may feel muscle fatigue and some mild discomfort. This is normal and should not be mistaken for injury to the weakened area. As people age or for those with chronic back conditions; bone strength and muscle elasticity and tone tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to properly distribute weight-bearing forces. Additionally, scar tissue does not have the strength or flexibility of normal tissue. A small effort performed more often is safer and more effective than too much effort in the beginning!
4. Revaluate yourself at the end of every week, for the first four weeks. You may be surprised at your progress and the general improvement in your symptoms; seeing increases in your range of motion, the number of repetitions and sets performed, the amount of weight resistance being used during the exercise.
A rehabilitation program using the reverse hyperextension is based on your current condition, consistency of use and continued increases in repetitions, sets of performing the exercise, and by adding increased resistance to continually build your core strength and achieve a more healthy, pain free life. For those who are doing a complete strength and conditioning program you don’t fix the roof when it is raining. Implementing the reverse hyperextension into your program is one of the most beneficial, unique exercises you can ever do.
If you do have a diagnosed condition it is always beneficial to have a practitioner than can coordinate a complete program and provide services that you cannot do for yourself. Chiropractic adjustments are proven to be one of the most beneficial treatments even when used only by themselves for people with chronic pain. Chiropractic is a form of treatment that seeks to return proper function to the nervous system: not just for putting bones back into place. There are numerous studies that prove chiropractic is one of the most effective and the safest treatment for the elimination of pain. This is due to the fact that the spinal column has sensory receptors at the joints of the vertebrae (spinal bones) that transmit pain signals to the brain. If the bones are misaligned or not moving properly this creates improper neurological communication (subluxations) locally and globally throughout the body. Pain is a normal response to injury and instability of joints. The below research paper validates the effectiveness of the chiropractic adjustment, acupuncture compared to commonly prescribed drugs individually. NOTE: Spine is the #1 orthopedic journal in the world.
Chronic Spinal Pain: A Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation
Spine, July 15, 20O3;28( L4): 149O-150
KEY POINTS OF STUDY
In this study, the medication group had more patients’ experienced adverse side effect (6.1%) than recovered from their spinal complaints (5%).
Even though the chiropractic treatment group was the most chronic (8.3 years), 27.3 % recovered with 18 spinal adjustments over a period of 9 weeks, or less. This means that better than every fourth patient became asymptomatic with 9 weeks or less with chiropractic adjustments, even though they had been chronic for more than 8 years.
Chiropractic adjustments not only had the largest improvement in pain but also had the largest improvement in removing any symptomatology (indigestion, headaches etc) of all standardized measurements of health status.
Because the patients had chronic spinal pain syndromes, it is unlikely that improvement resulted from “self-limiting” spinal pain, as could be the case with acute spinal pain.
Chiropractors are the only health care specialists that are trained in administering specific adjustments (not gross manipulations) to restore proper biomechanics and communication to help reduce and eliminate pain related to mechanobiology stresses.
Another unique modality worth mentioning is Low Level Laser Therapy (3LT), commonly known as LLLT. Most people are familiar with hot lasers that used for surgical precision; low level lasers (cold lasers) are used for healing precision. Low Level Laser Therapy (3LT) is a form of phototherapy which involves the application of low power coherent light (below 25 mw qualifies as true LLLT) to injuries and lesions to stimulate healing. Low Level Laser Therapy (3LT) is not to be confused with Led Emitting Diodes (LED’s) or “Infra-Red Light Therapy Devices. Erchonia Laser is the most researched and validated Low Level Laser in the world, having numerous FDA clearances and is published in many peer reviewed medical journals.
The effects of Low Level Laser Therapy (3LT) are photochemical / photobiological (cold), not thermal. During treatment of the tissue with the laser beam, an interaction between cells and photons takes place—a photochemical reaction. A very short explanation as to how this benefits athletes and patients is a photon provides an electron that passes through the electron transport chain of the mitochondria and increases the production of ATP (adenosine tri-phosphate). A further explanation involves how the process effects the valence electron and utilizes integrins that ultimately can have numerous physiological benefits throughout the body for recovery of athletes as well as a variety of needs of patient care. Since every cell in the body has mitochondria and the biological effects are well documented for a variety of uses (just type in low level leaser therapy into www.pubmed.gov). Low Level Laser Therapy (3LT) works when used alone but if combined with exercise such as the Reverse Hyperextension, chiropractic and more the results are even more apparent.
Dr. Jerome Rerucha is an expert in the field of Cold Laser Therapy. He lectures throughout the US and internationally on the use of Erchonia Lasers, Adjustors and Percussors. His laser and integrative protocols have helped doctors enhance their treatment skills, while improving the health and recovery of patients and elite athletes. In his role as Erchonia Multidiscipline Clinical Support, Dr. Jerome has provided protocols and training for 1000’s of Erchonia Client Healthcare Practitioners that include: Chiropractors, Rolfers, Acupuncturists, Physical Therapists, Occupational Therapists, Veterinarians, Naturopaths and Medical providers.