Back strengthening exercise to prevent spinal fractures

You have probably heard that back strengthening exercise helps to prevent spinal osteoporotic fractures — but are all types of exercises equally beneficial? No, they are not, as clearly documented by an early Mayo Clinic study (Sinaki and Mikkelsen 1984). This study showed clearly that extension-type back strengthening exercise effectively prevented further spinal deformation in osteoporotic women. Flexion-type exercises, on the contrary, actually increased the risk of further spinal compression and wedging.

This landmark 1984 Mayo Clinic study took 59 postmenopausal women (49–60 yrs old) with spinal osteoporosis and/or existing spinal fractures and back pain. The women were grouped into four different treatment programs (1) extension exercise (bending backwards, spine lengthening exercises); (2) flexion exercise (bending forward exercises) (3) both extension and flexion exercises, and (4) no therapeutic exercise. Spinal x-rays were analyzed before and after the mean 1.5-year study period. Although small in number, the study was large in significance. Only 16% of women doing the extension exercise experienced further spinal wedging or compression. On the other hand, a whopping 89% of those doing the flexion exercises had worsened spinal deformities, as did 53% of those doing the combined extension and flexion exercises and 67% of the non-exercisers.

Exercise is a key component of the Better Bones, Better Body approach, and in this regard, a favorite ally is a good physical therapist who can help individuals with back pain and/or existing spinal deformities develop a safe and effective back strengthening exercise program to help prevent a new spinal fracture.

Reference:

Sinaki, M and Mikkelsen, BA. 1984. Postmenopausal spinal osteoporosis: Flexion versus extension exercises. Arch Phys Med Rehabil, 65:593–596.