Shrigiridhari Physiotherapy Center

"Back Neck and Joints"

India's Only Certified Mckenzie Clinic

Diplomated McKenzie Clinician

Dr. Asha Menon (P.T.), Dip. MDT

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As the facility provider

Accredited From The McKenzie Institute International, New Zealand 

A Non-surgical superspecialisation center for Back, Neck and Joint pain.

What does research say on Core stabilization, Pilates, and various other strength programmes, what role do they have to prevent recurrent attacks of low back or neck pain.

There are some who have been doing vigorous strength programmes for months, with no results to their symptoms and have been unable to prevent recurrences. Why?

Lederman E in 2008 discussed various studies which concluded a fall out of the postural–structural–biomechanical model in manual and physical therapies.  It was apparent from the studies, that the spine can undergo profound physical changes that are well tolerated without the development of a symptomatic condition. What is observed here is that biological systems contain reserve capacity to accommodate for loss without failure/symptoms. 


So does it matter, for example, that patients with CLBP may have localised wasting of the multifidus at L4–L5 (Hides et al., 2008)?


Probably not, .......


During standing and walking the trunk muscles are minimally activated (Andersson, 1996).


In standing the deep spinal erectors, psoas and quadratus lumborum are virtually silent. In some subjects there is no detectable EMG activity in these muscles. During walking rectus abdominis has an average activity of 2% maximal voluntary contraction(MVC) and external oblique 5% MVC (White & McNair, 2002).


During standing “active” stabilisation is achieved by very low levels of co-contraction of trunk flexors and extensors, estimated at < 1% MVC rising up to 3% MVC when a 32-kg weight is added to the torso. A back injury is estimated to raise these values by only 2.5% MVC for the unloaded and loaded models (Cholewicki et al., 1997).


During bending and lifting a weight of about 15 kg co-contraction increases by only 1.5% MVC (van Dieen et al., 2003). This means that an individual will have to lose substantial muscle mass and force production ability before such daily activities will be adversely affected. However, the biological reserve allows for such losses without a negative effect on spinal function or the development of a condition. Indeed, men tend to naturally lose 25% of their muscle mass between the ages 50 and 75 years without any detrimental effect.

So, would you still think you need to do vigorous stabilization exercises and core muscle strengthing to achieve pain free functions and prevent recurrence of your back or neck pain?


This does not mean that strength programmes have no use. They are useful, in some small percentage of patients. And this is what a McKenzie therapist would do, examine, do you feature in this small percentage who would require to be functionally restored by doing strength programmes. 


Come and experience what a Certified McKenzie Clinic can offer you.