Low Back Disorders: Evidence-based Prevention and Rehabilitation (英語) ハードカバー – 2007/8/30
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Access the latest research and applications to build effective prevention and rehabilitation programs for your patients or clients with "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition". Internationally recognized low back specialist Stuart McGill presents original research to quantify the forces that specific movements and exercises impose on the low back, dispels myths regarding spine stabilization exercises, and suggests prevention approaches and strategies to offset injuries and restore function. "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition", presents a clear exposition of back anatomy and biomechanics and demonstrates how to interpret the latest research on low back involvement for clinical applications. The text also contains detailed information on injuries associated with seated work and sport and ergonomic issues related to manual handling of materials. With "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition", you will gain valuable information on measured loading of the back during specific activities and apply it to avoid common, but counterproductive practices in back rehabilitation; learn how to analyze each patient's or client's unique physical characteristics and lifestyle factors to tailor preventive measures and treatments to individual needs; learn how to help patients and clients progress through the stages of rehabilitation: corrective exercise, stability or mobility, endurance, and strength; and acquire the information necessary to design an effective injury-prevention program. This fully updated second edition expands knowledge of low back disorders and best practices in several areas. Enhanced algorithms guide progessive therapeutic exercise, and specially designed patient assessment provocation tests aid you in determining the cause of back troubles, guide your choices in the best ways to eliminate problems, and improve the development of appropriate activities for functional gain. Whereas the first edition focused on increasing spine stability, the second edition provides new information on dealing with both regional instability or mobility and regional stiffness present in individuals where most of the motion occurs at a single spinal segment. With an expanded repertoire of pain-free motion exercises and additional information on ways to find and adjust stabilization exercises, "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition", offers you new tools to help your patients and clients achieve pain-free exertion. The text includes exercises and activities that provide a solid foundation of physical work in preparation for more advanced activities in sports and occupations. Also, the process of transitioning into performance exercise is outlined with an explanation of the critical stages of the performance pyramid, including the design of appropriate corrective exercise, building joint and whole-body stability, enhancing endurance, training true strength, and transitioning to ultimate performance. "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition", presents foundational information and corresponding clinical applications in a clear, well-sequenced format. Part I builds your knowledge of lumbar function and injury. Part II demonstrates how to use this knowledge to build evidence-based injury-prevention programs by assessing risks, creating ergonomic interventions, and training personnel. Part III focuses on improving rehabilitation techniques, including specific diagnostic and provocative tests, with specific therapeutic exercises proven to enhance performance and reduce pain through a continuum from corrective exercise to stability and mobility, endurance, strength, and power. Additionally, the text offers practical features to guide your learning and inform your practice: through more than 475 photos, graphs, and charts support the research and the scientific basis for the text's conclusions. More than 50 tests and exercises with step-by-step instructions help you develop successful programs for your patients and clients, special sections highlight how the anatomical, biomechanical, and research results can be applied to clinical situations. Cutting-edge research and evidence-based application strategies from the leading spine specialist in North America make "Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition", the authoritative text for study, care, and treatment of the low back. Its unique approach to back care will guide you in developing intervention, rehabilitation, and prevention programs to address the unique needs of each patient or client and develop a strong scientific foundation for your practice.
""McGill's text on "Low Back Disorders" is one that every treating clinician should have for their own professional library.""-"AAESS News "(Australian Association for Exercise and Sports Science) ""This is a fine blend between science and practical application by a credible author. The author is in a unique position to share his own valuable research and clinical experience to advance the treatment of alleviating low back disorders." "Doody's Book Review Service商品の説明をすべて表示する
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Prof. Stuart McGill is a professor in the Dep't of Kinesiology at the University of Waterloo, Ontario. He is the director of its Spine Biomechanics Laboratory.
This is his famous textbook, "Low Back Disorders", which examines back injuries in the light of biomechanics' scientific knowledge, and prescribes exercises and tests for the rehabilitation of injured backs and the prevention of future injuries.
The book has 241 pages of solid, dense text and extremely valuable information, with a great number of pictures and tables. And it comes in a superb hard cover. You get full value for the money.
"Low Back Disorders" is primarily geared to professionals in back treatment and rehabilitation, who want to become more sophisticated practitioners and learn the scientific facts underlying rehab techniques.
But, in the same light, this book is also essential for any member of the 3F club (Physical Fitness Fanatics) concerned about the impact on the back of fitness training and athletic practices.
Saving one's back from injury is vital, the more so that most physical fitness fanatics are urban professionals who tend to spend a large portion of their lives sitting, not a natural posture for the architecture of the back, and as they grow older, when the back becomes more fragile and vulnerable.
Stuart McGill assumes that most readers are not familiar with the full scientific facts of back architecture and function. So, he starts with the very basics and gives us a primer on "Essentials of the Back 101".
Central to Stuart McGill's tenets is insisting on the importance of
- maintaining the "neutral posture" of the spine,
- respecting the natural lower-back curvature,
- and not imposing extra flexion to the natural curvature of the upper spine.
This leads to the debunking of traditional training exercises, such as the classic sit-ups and all varieties of crunches, which create extreme flexion and high levels of compression in the spine, and undermine back stability.
He insists on
- tensing all the abdominal muscles in an isometric bracing of the abdominal girdle as the fundamental principle of providing stability and protection to the back,
- and using a stable torso solidly linked to the pelvis as a relay of force generated by the hips and shoulders, and not by the back.
In the same vein, the good professor warns against the use of most machines offered in commercial gyms, such as the Roman chair, back twisting machines, leg press-up machines.
He objects to
- the permanent sitting required for these machines,
- and the fact that they limit joint motion to a strict mechanical pattern, depriving all the soft passive tissues of their natural range.
He deplores the perversion introduced by bodybuilding in the current trends of physical training. Very strong men have only hypertrophied muscles, and no overall fitness. Just pull sideways on his sleeve, and the strongman may well lose his balance.
Prof. Stuart McGill's famous motto is "Groove the motion, train the movement, not the muscle".
Prof. Stuart McGill is famous for his preferred "BIG THREE" exercises for the back:
1) the curl-up,
2) the side bridge,
and 3) the birddog,
all of them with stages of increasing challenge and complexity.
There are quite a few more, if not so basic as the "Big Three", all detailed throughout the book, with an abundance of good pictures.
For warm-up of the spine, nothing better than the cat/camel exercice.
Stuart McGill shows how to achieve back stability and spare the low back by
- maximizing the fundamental use of hips (the "hip hinge")
- and recruiting the use of the powerful gluteal muscles (with the clam and one-leg squats).
In general, he recommends:
- use of free weights, dumbbells, cables, stretch bands and resistance tubes,
- preferring one-armed and one-leg exercises as being more challenging than symmetrical exercises,
- avoiding the extreme end range of motion in exercises.
- avoiding being seduced by a misguided conception of "flexibility" for the back,
- being wary of the overuse of "stretching" exercises for their only sake.
- and being very skeptical of many practices of the fashionable vogues, such as yoga, or Pilates.
He insists on
- learning correct motions,
- grooving them to obtain perfect form,
- and only then cultivate ENDURANCE by a SERIES OF SHORT SETS, instead of increasing the number of reps in one long set. Endurance comes before strength, which is developed only once endurance is established.
Only Ch. 13, the last one, analyzes "Advanced Exercises", those for high-performance workers and athletes, putting the accent on low-back exercises to be practiced only by athletes who already have established a solid base of fitness and overall strength.
He wisely warns that Olympic lifting is an expert specialty that should be left to the professionals in this sport. He bemoans the fact that many young lifters, even though aware of his warnings, still manage to damage their backs.
He insists that regular 3F members, ordinary urban physical fitness fanatics, should be very cautious in trying to imitate too eagerly the training programs of professional competitors before they have established enough advanced fitness and strength.
Top professional competitors are not in sports and athletic pursuits for fitness, or good looks, or losing weight, but they enter an arena as modern Samurai or heroic warriors engaged in intense fights where the only goal is pulverizing an opponent and "winning," as a step to gaining fame and riches. In this world of extreme competition, "back fitness" is a secondary consideration, and "back injuries" a professional hazard that's par for the game.
This last chapter is revisited and vastly amplified in Prof. Stuart McGill's other book, "Ultimate Back Fitness AND Performance", especially geared to performers in sports and athletic competitions. This fitness manual is indeed another essential book for any member of the 3F club (Physical Fitness Fanatics) concerned about his/her back.
ALERT: TRY TO GET THE 4TH EDITION OF THE "ULTIMATE BACK FITNESS AND PERFORMANCE", INSTEAD OF THE 3D EDITION, AND DON'T GET CONFUSED BY AMAZING AMAZON'S LISTINGS
Warning! You will find this ULTIMATE BACK FITNESS AND PERFORMANCE book listed on Amazon in two different sections:
1) in the BOOKS section under its original title, which clearly figures in caps on the cover, indicating also in caps, FOURTH EDITION. However, when you examine the details of the book, you read that what is offered is the 3d edition of 2004 (in spite of the cover picture).
2) in the ALL DEPARTMENTS section, the offering is the 4th edition of 2009, but it now is given a slightly different title, with "&" replacing the original "AND". The cover picture remains that of the original cover with its original title, figuring "AND".
So when you search for the book with its original title, you are automatically referred to the listing in the BOOKS section offering the 3d edition. You will never guess that there is also a listing for the 4th edition, since, to find it, you have to know that you have to change the title by replacing "AND" with "&". Even I was not aware of this manipulation.
So the same book is listed in two different sections, offering either the 3d edition (2004), or the 4th edition (2009) of the same book, under SLIGHTLY DIFFERENT TITLES. You have to admire marketing ingenuity, or the art of deceiving the consumer.
This kind of game seems to be pretty unusual, and a tricky marketing gimmick, to keep selling the copies of the 3d edition still available.
However, don't be so sure. For I wonder whether Amazon is not using this trick for other books, or other products, creating new listings in ALL DEPARTMENTS different from their original listings in their respective natural sections, but still offering the same product in slightly different formats. Think of the ethics of the practice, and question whether this does not smack of fudging.
You can also get two DVDs produced by Stuart McGill, which are also helpful, as live illustrations of the two books. They offer good content, but are not professionally polished.
The great value of "Low Back Disorders" is that it is based on a scientific understanding of the basic facts in the anatomy, physiology, and biomechanics of the back.
In spite of some readers' objections, I feel it is extremely valuable to exactly understand how the back works -- basic facts about which most people have not the faintest idea --, and Prof. Stuart McGill does a first-class job in giving us the fundamentals.
- We discover our neglected extension muscles, "Longissimus," "Iliocostalis," and "Multifidus".
- We regain acquaintance with our familiar "Rectus Abdominis", which happens to be one and not a family of six.
- We get a full picture of the Abdominal Wall, with the famous "External and Internal Obliques"
- and do not try to isolate "Transverse Abdominis."
- We get to meet our new friend, "Quadratus Lumborum",
- and acknowledge the vital importance of "Psoas" and "Iliacus" in hip flexion and stabilization,
- while greeting the key contributions of "Gluteus Medius" and "Gluteus Maximus".
Surrounded by all the members of this new family, we are in good shape to absorb Prof. Stuart McGill's instruction. This kind of knowledge should be taught in high school to all children. Knowledge of the musculoskeletal system is fundamental and vital for all sports and the conduct of our daily lives.
Sadly, most people know nothing about the biomechanics of the back beyond the simplistic and popular myths spread by school coaches and commercial fitness trainers for whom the primary interest is making money by joining fads and vogues, and not providing basic scientific information, which they often don't even have.
In that sense, "Low Back Disorders" is an indispensable primer to any fitness enthusiast.
This book is also a joy to use and study. It has been superbly edited by a full technical team at Human Kinetics, which unfortunately was not in charge of producing the companion book, "Ultimate Back Fitness AND Performance," which does not enjoy the same kind of professional presentation.
The critically useful features of "Low Back Disorders" are:
1) a completely detailed table of contents describing all the material and concepts;
2) a complete list of all the exercises mentioned in the book;
and 3) an extensive index at the end allowing the reader to zero in immediately on any item of interest.
All this increases the usefulness and effectiveness of the book, and becomes extremely helpful when you start digging seriously into the text.
- For instance, you can find where the variations of "cable exercises" are mentioned and illustrated.
- Or all the instances of analyzing and illustrating the "abdominal bracing", and " the "neutral spine position", two key concepts of Stuart McGill's doctrine.
- Same for any other kind of research: "Learning to activate the gluteus" or the "hip hinge," and "hip flexion".
You don't have to waste precious time leafing through the chapters. To any professional book user, the three editing features mentioned above are a major convenience.
(Note, and this is one of my many criticisms directed at ULTIMATE BACK FITNESS AND PERFORMANCE, not for its content, but for its physical presentation, that the three critical features of the medical book are not incorporated in the fitness manual, which is a major nuisance to all users.)
The self-references inside the medical book itself could be slightly improved, however (while they are practically non-existant in the fitness book.)
Never educated as a fitness trainer nor a sports team coach, McGill used his lab expertise to compile a fitness manual: ULTIMATE BACK FITNESS AND PERFORMANCE, 4th (2009), 5th ED (2014). For the lure of profits, he regrettably self-published that manual, a poor physical product compared to the professional quality of Human Kinetics in this LOW BACK DISORDERS textbook. See my Comment/Alert about the 5th ed. (2014)
Professor McGill represents the best of the best when it comes to lower back pain, injury, and rehabilitation. After decades of experience performing quantitative experiments as well as having exposure to clinical "tricks of the trade," Professor McGill is the ultimate authority for rehabbing lower back pain.
If you have any concerns about lower back pain and injury, Professor McGill is the ultimate authority on the subject. He continually hungers for more knowledge and analysis of what works and what doesn't, and uses EMG (electromyography) as well as other concrete quantifiable approaches to support many of his assertions in this book.
If you want a healthy back, you can't use your spine for power. Keep it locked and braced in a comfortable netural position, and let you hips and shoulders do what they were meant to do - be mobile. This book explains a lot about anatomy, past approaches that have worked or haven't worked, and Professor McGill's highly influential and important work on the quantification and every day (literally) implementation of spine stability/stiffness.
Professor McGill has helped me understand back disorders and how to treat them conservatively and I know that if you're dealing with lower back pain he can be of great help to you as well.
While this book is very good, it should not be one's only source of info about the low back. I have found that the book applies more to disc herniation problems than other disorders of the spine. While it is true that spinal stability is a good thing to train in general, there are specific lumbar disorders and also certain stages of injury in which the exercises in this book do not work so well in practice. For example, in the acute stages of injury, in which the body already has triggered the protective mechanism of a prolonged contraction of the muscles in the lumbar area, the bracing/isometric exercises only serve to increase the "tone" in the area and this results in more pain. At this stage, the focus should be on relaxing the back and a good way to do this is with gentle, unloaded movement. The take away lesson is that this book has great information but one needs to know when to apply it.
McGill states that the two areas of fitness that I have been pursuing; strengthening and flexibility, are not the primary goals but we should be focusing on stabilization. The exercises that he recommends are ones that I have seen before on my thirty year journey but were never told that these were the safest to do and they were usually a part of a routine that had some unsafe exercises as well. I still cannot believe that the standard single knee to chest exercise is not productive and creates unsafe hip flexion.
Exercise rehabilitation is not the only myths he breaks. I now realize that there is no one best way to sit in a chair. I have learned the proper way to lift things. It is worth going through the entire book because you will learn something but be prepared that the first two sections of the book are technical and may be hard to comprehend. Don't let that stop you. Believe me, you will find something useful throughout the book.
I give this five star review based on the fact that the information is based on concrete studies. I haven't even started the exercises but plan on doing that today. Given the doctor's track record, it would seem that I stand a good chance of improving.