Backs Clicking During Exercise

Two blogs in two days!

Today I just thought I’d share a really quick clinical Pearl.

In the past I had several clients who’s lumbar spines would make an audible or at least palpable click during hip extension in their lumbar spines. I’ve also seen it during rotation and flexion but only rarely. I’ve never noted it during side flexion but I’m sure it occurs.

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Initially, I regressed the exercises, addressed gut issues and gradually progressed the clients back to the same exercises over time as they got stronger and this worked well. However, later I found that using balance drills such as a “deadbug” or lower abdominal 2a would activate what Paul Chek calls “survival reflexes” and turn on local stabilisers that aren’t firing. Using this short of fatigue and then going straight in to doing the original exercise eliminated the “click” for the duration of the set in most cases.

More recently Jon Bowskill suggested I use the inchworm exercise for the same purpose. I’ve found this even more effective and it has allowed people to do more advanced lower abdominal conditioning than they otherwise would.

Moving forward I’m sure using the correct modality at the right time with the right patient will be ideal.

As always if you have any questions do not hesitate to email me and if you have any area of special interest you’d like me to look in to or to debate on please ask!

Kieran Macphail

clicking, clicking in low abck, inchworm, kieran macphail, low back pain, survival reflexes

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