Low Back Disorders: Evidence-Based Prevention and Rehabilitation / Edition 1

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Low Back Disorders: Evidence-Based Prevention and Rehabilitation provides professionals with the foundation to make the best clinical decisions for building the best prevention and rehabilitation programs. The author's unique research results quantify forces that specific movements and exercises impose on the low back. The text identifies commonly prescribed practices that are, in fact, contraindicated in promoting back health. Additionally, it provides appropriate strategies to offset injuries and restore function. Low Back Disorders will build your understanding of the science behind appropriate practices so that you can use them effectively with clients and patients.

The book presents a clear exposition of back anatomy and biomechanics. It also provides the evidence to dispel myths regarding spine stabilization exercise and various prevention approaches. For example, the quantification of stability will show which muscles are important and which exercises groove motor patterns to ensure spine stability. With Low Back Disorders, 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 rehab;
  • learn how to analyze patients' and clients' unique physical characteristics and lifestyle factors and tailor treatments and preventive measures to their individual needs;
  • learn how to help patients and clients achieve the low back stability required to prevent future damage; and
  • acquire the information necessary to prescribe effective exercises clearly and easily.

Low Back Disorders is well organized and easy to understand. Part 1 provides a solid foundation on how the back works and how the back becomes injured. Part 2 shows you how to use this foundation to build evidence-based prevention programs by assessing risks, creating ergonomic interventions, and training personnel. Part 3 focuses on improving rehabilitation techniques, and specifically, quantification of spine stability to determine which exercises are important for spine stability for each person.

The text offers practical guidelines for developing optimal exercise regimens and over 40 tests and exercises for diagnosis and prevention, carefully selected or developed based on measured biomechanical factors. Low Back Disorders addresses in detail the ergonomic issues related to manual materials handling and injuries associated with seated work and sport, and throughout the book it reinforces their application in functional activities.

About the Author

Stuart McGill, PhD, is a professor at the University of Waterloo in, Ontario, Canada and an internationally recognized lecturer and expert in spine function and injury prevention and rehabilitation. He has written more than 200 scientific publications that address lumbar function, low back injury mechanisms, investigation of tissue loading during rehabilitation programs, and the formulation of work-related injury avoidance strategies. He has received several awards for his work, including the Volvo Bioengineering Award for Low Back Pain Research from Sweden. Dr. McGill has been an invited lecturer at many universities and delivered more than 200 addresses to societies around the world. As a consultant, he has provided expertise on assessment and reduction of the risk of low back injury to government agencies, corporations, professional athletes and teams, and legal firms. He is one of the few scientists who consults and to whom patients are regularly referred.

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Editorial Reviews

Doody's Review Service
Reviewer: Christopher J Hughes, PT, PhD, OCS, CSCS (Slippery Rock University)
Description: This book reviews the functional anatomy of the lumbar spine and applies the latest research findings in this area to the prevention and rehabilitation of low back dysfunction.
Purpose: The author's intent is to provide the reader with "the best available scientific evidence to optimize injury prevention and rehabilitation" for low back function. The author attempts to bridge the gap between research findings and clinical application in this area. This is an admirable objective and the author has done an excellent job in stating his case for using an evidence-based approach for preventing low back pathology and also providing guidelines for effective exercise prescriptions for this problem area.
Audience: This book is applicable for a wide audience of professionals including, therapists, athletic trainers, ergonomists, strength and conditioning professionals, and others who work in the area of low back injury prevention and rehabilitation. The author is an award-winning scholar and academician who is well published in the area of lumbar spine mechanics and ergonomics. He also consults for a number of agencies and corporations in the area of risk reduction and injury management. The author's unique background makes him well-suited for publishing in this area of study.
Features: Three major sections are included in the book. The first section is comprised of six chapters that cover the scientific aspects of understanding low back pain. The second section consists of four chapter and is dedicated to injury prevention and also discusses various biomechanical models and the NIOSH approach to risk assessment. There is also a discussion on the use of back belts. The final section covers rehabilitation and exercise considerations based on the evidence presented in the previous sections. This section is unique and very useful in mapping out a strategy to apply the didactic information presented in the previous sections.
Assessment: This work is an original contribution to the field of rehabilitation of the lumbar spine. The author successfully blends science and clinical application and has presented this information in an easy-to-read format. Very few books have been able to present such a balance of practical information that compiles scientific facts and dispels dogma in the process. The book is hard to put down and provides enjoyable reading if one desires evidence-based information on the rehabilitation and prevention of injuries of the lumbar spine. I highly recommend the book for clinicians who routinely prescribe exercises for low back pain.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780736042413
  • Publisher: Human Kinetics Publishers
  • Publication date: 1/28/2002
  • Edition description: Older Edition
  • Edition number: 1
  • Pages: 312
  • Product dimensions: 8.20 (w) x 11.40 (h) x 0.76 (d)

Table of Contents

Why and How You Should Read This Book
Part I: The Scientific Foundation
Chapter 1. Introduction to the Issues
Legislative Landscape: Unfortunate Adverse Impact on Bad Backs
Deficiencies in Current Low Back Disorder Diagnostic Practices
Inadequacies in Current Care for Low Back Disorders
Mechanical Loading and the Process of Injury: A Low Back Tissue Injury
A Final Note
Chapter 2. Scientific Approach Unique to This Book
In-Vitro Lab
In-Vivo Lab
Chapter 3. Epidemiological Studies on Low Back Disorders (LBDs) Multidimensional Links Among Biomechanical, Psychosocial, and Personal Variables How Do Biomechanical Factors Affect LBD?
What Are the Links Between Personal Factors and LBD?
What the Evidence Supports
Chapter 4. Functional Anatomy of the Lumbar Spine
The Vertebrae
Intervertebral Disc
Lumbodorsal Fascia
Clinically Relevant Aspects of Pain and Anatomic Structure
A Final Note
Chapter 5. Normal and Injury Mechanics of the Lumbar Spine
Kinematic Properties of the Thoraco-Lumbar Spine
Kinetics and Normal Lumbar Spine Mechanics
Dubious Lifting Mechanisms
Other Important Mechanisms of Normal Spine Mechanics
Injury Mechanisms
Biomechanical and Physiological Changes Following Injury
Chapter 6. Lumbar Spine Stability
Stability: A Qualitative Analogy
Quantitative Foundation of Stability
Stability Myths, Facts, and Clinical Implications
Part II: Injury Prevention
Chapter 7. LBD Risk Assessment
NIOSH Approach to Risk Assessment
Snook/Psychophysical Approach
Lumbar Motion Monitor (LMM)
Biological Signal-Driven Model Approaches
The Challenge Before Us
Chapter 8. Reducing the Risk at Work
Lessons From the Literature
LBD Prevention for Workers
LBD Prevention for Employers
Injury Prevention Primer
Chapter 9. Reducing the Risk in Athletes-Guidelines
Reducing the Risk in Athletes
What Coaches Need to Know
Chapter 10. The Question of Back Belts
Issues of Back Belts
Scientific Studies
Summary of Prescription Guidelines
Part III: Low Back Rehabilitation
Chapter 11. Building Better Rehabilitation Programs for Low Back Injuries
Finding the Best Approach
Three Stages of Patient Progression
Guidelines for Developing the Best Exercise Regimen
Chapter 12. Evaluating the Patient
First Clinician-Patient Meeting
Specific Tests
Chapter 13. Developing the Exercise Program
Preliminary Matters
Exercises for Training the Stabilizing Muscles
Beginner's Program for Stabilization
Chapter 14. Advanced Exercises
Safely Increasing Challenges
Occupational and Athletic Work Hardening
Looking Forward
List of Tests and Exercises
Flexor Endurance Test
Lateral Musculature Test
Back Extensors Test
Manual Testing for Lumbar Joint Shear Stability
Challenged Breathing Test
McKenzie Posture Test
Sitting Slump Test
Fajersztain Test
Hip Flexion and Rotation Tests
Curl-Up, Beginner's
Isometric Exercises for the Neck
Curl-Up, Intermediate
Curl-Up, Advanced
Side Bridges, Remedial
Side Bridge, Beginner's
Side Bridge, Intermediate
Side Bridge, Intermediate Variation
Side Bridge, Advanced
Birddog, Remedial
Birddog, Beginner's
Birddog, Intermediate
Birddog, Advanced
Curl-Up, Highest Level
Side Bridge, Highest Level
Birddog, Highest Level
Advanced Exercises for Back Strength and Endurance
Establishing Spine Stability in Elevated Breathing
Training for Torsional Capacity
Special Prescription for Those Whose Back Is Worse With Sitting and Then
Have Trouble Standing
Star Exercises
About the Author
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Sort by: Showing all of 2 Customer Reviews
  • Anonymous

    Posted September 19, 2003

    Inspiring and educational yet humbling

    I took a few weeks out of my busy schedule to read Dr. McGill's Book. I'm a PTA and a Personal Trainer. I was looking for ways of continuing to not hurt my clients, and keep improving their health and function.

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  • Anonymous

    Posted December 27, 2002

    Help for sufferers of low back pain

    This is a superb book that is useful for both clinicians and patients alike. Using methods based on electromyographic measurements published by McGill and his colleagues in many scientific journals, he ascertains which muscles are activated in a variety of exercises. This becomes important for patients who have low back problems and must avoid heavy spine loads both in the fitness center and at work. He lists a variety of commonly prescribed exercises that should be avoided by persons with low back problems: sit ups, pelvic tilts, leg raises, low back extension exercises on machines and hip flexion exercises using the Roman chair. He then recommends a series of exercises that are designed to strengthen back muscles and stabilize the spine while at the same time minimizing spinal compression that could exacerbate back problems: the curl-up, side bridges and "bird dog" leg extensions. This book should be recommended reading for all physical therapists and strength trainers with clients having low back problems and is a must for those suffering from low back pains.

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