Advanced Extensor Core Muscle Exercise

4 Responses

1. Isaac Freeman, DC

   February 15th, 2009 at 8:35 am

   1

   Dear Dr. S,

   Great. I love McGill. I would like to see one improvement on your BirdDogs.

   Try it yourself first to feel how importatnt it is. Just “pour the beer” by pronating the hand (in the Bird) and twist the toes (not only toward the nose) but inward. This activates the parispinals much more in the upper thoracics and in the lumbars. You won’t believe how this small change will get you improvements with those pts. who have been doing Pilates or Body Conditioning for years.

   YF, DC (CCC-LA, 87)
   Jerusalem

2. Dr. Snell

   February 22nd, 2009 at 6:52 am

   2

   Good call Dr. Freeman. I’ve recently added those tweaks in addition to serratus anterior terminal pushups while in birddog learned from Dr. Craig Liebenson. Feeling those terminal pushup patterns progressed to plyometrics was enlightening. Perhaps that will be food for future vids. Take care and thanks for the feedback.

3. Stacey Richter

   August 1st, 2009 at 12:50 am

   3

   Dr. Snell! Thank you for these fantastic videos. They are incredibly helpful, and you are good to post them. So, I’ve been trying to convince my physical therapist to follow this protocol (I can’t find anyone in my city who is actually familiar with evidence-based rehab) and he seems to be going along with it. But he wants me to do additional exercises for my weak back muscles other than bird dog–a bridge on the ball (spine in neutral), and an isometric hold on the ball with T-shaped arms, as I am supine-ish–sort of like an airplane. I can’t find any info in my McGill book on any exercises other than bird dog. Do you have any thoughts? Should I stick to the bird dog? The bridge hurts a little when I come down. About me: I got the chronic back pain for a long, long time.

4. Dr. Snell

   August 12th, 2009 at 4:51 am

   4

   Good question Stacey and I’m glad to hear your PT is receptive to working with you on this. I really find that McGill’s 5 step approach to building lumbar stability is incredibly helpful to organize things. So let’s run that down first, to paraphrase…

   1) identify poor/aggravating movements or activities and 2) replace those movements with healthy, painless, sustainable movements or activities,3) build endurance in the lumbar stabililizing (core) muscles, 4) build strength in the core muscles, 5) develop speed, power and agility in those muscles.

   So, make sure that you have worked together to ID offending movements/activities so that you’re not continuing to tweak your back while you’re working on the exercises. Then make sure that your endurance is OK by doing the lumbar FCE. Then address any deficits with safe exercises that don’t overload the spine. The exercises you describe that your PT prescribed are versions of endurance exercise but have been determined to cause very high posterior shear forces on the spine.

   In McGill’s new 3rd edition of Ultimate Back Fitness and Performance (2009), you can find more advanced core work to build strength, speed, power and agility on pages 262-270. These exercises have been evaluated in the lab to determine that, when performed properly, they target the desired muscles but place lower loads on the spine. My favorite might be the kettlebell swings, but they must be performed appropriately or the risk of injury is higher.

   Re: the bird dog…adding the stiffening measures and “box tracing” with the plyometric pop as described in the video is surprisingly challenging for many and is usually enough to get you prepped for the lumbar FCE with less risk of injury. I usually reserve the higher levels of challenge for patients to perform after they demonstrate appropriate endurance with the FCE.