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How do the getback devices work? # 3 The Lumbar Thoracic Flexion Device

Musculoskeletal disorders are the biggest cause of disability. Despite the billions spent, the problem is just getting worse. Latest medical guidelines strongly recommend exercise therapy as the first-line-treatment for musculoskeletal disorders instead of much more expensive surgeries.

By Dilen Samarakoon, Physiotherapist at getback

getback™ devices were developed by Biomechanists and Exercise Scientists to enable targeted and safe exercise for the deep spinal muscles (multifidus) associated with back or neck pain.

In a series of articles, we will look at the specific function of each of the six getback devices.

The Lumbar/Thoracic Flexion Device

The lumbar flexion (bending forwards) device is beneficial for those who present with lower back pain which is aggravated by long periods of standing or sitting, or with repetitive forward bending. 

Patients who come to getback with this type of presentation commonly lack strength in both their deep back extensor muscles (multifidus) as well as general core strength. 

These patients often seek help after attempting core strengthening programs. While the idea behind this training is right, the type of exercise conducted can be ineffective, as it is difficult to isolate the abdominals and disengage the larger hip muscles. 

Most of these programs also don’t include safety locks. Without a specific range of motion in which to perform exercises, there is potential for unintended back injury. 

getback devices enable both isolation of the deep extensor muscles and precise control of the range of motion – these points will be elaborated on later in this blog. 

It is important to strengthen the abdominal muscles and core as well as the deep extensor muscles. The aim is to create a sustainable balance to improve endurance, strength and reduce overall pain levels during previously provocative movements.  

The flexion device isolates and assesses the strength of the rectus abdominis (commonly referred to as the abdominals or abs), and gradually strengthens it through forward and back movement. The device simultaneously stretches the deep back extensor muscles (including the important multifidus between each vertebrae) by encouraging segmental movement of the spine. 

The rectus abdominis is a long muscle found in the front of your mid-torso. It extends from the lower rib cage down to the pelvis, playing an important role in bending forward as well as making a considerable contribution to overall core stability. 

When bending forward, as well as in standing and sitting, the abdominal muscles work in conjunction with the deeper back muscles to increase spinal stability and prevent back injury. 

Ultimately, activating and strengthening both the rectus abdominis and multifidus will support and stabilise the spine, putting less stress on the spinal structures involved in movements of the torso. 

Ensuring that the strength of the abdominal muscles is equal to, or greater than a comparable group of people of your age, weight, height and gender is crucial to ensure that your core, as a whole, is strong enough to support your spine. 

How does the flexion device help strengthen the rectus abdominis ?

Weakness in the rectus abdominis and core has been shown to be a contributing factor to lower back pain. In order to compensate for this weakness, it is common for patients to activate their hip muscles including their glutes (buttocks), hamstrings and hip flexors to assist with the bending motions involved with most abdominal exercises. This is why technique is vital in abdominal exercises – it is very easy to activate the wrong muscles. 

The getback flexion device allows us to disengage these large hip muscles – allowing us to isolate the rectus abdominis while also stretching the multifidus. 

The unique design of the device involves a seat which is angled slightly upwards along with a hip lock mechanism which disengages the gluteals, hamstrings and hip flexors – allowing us to isolate and strengthen the rectus abdominis.  

Setting your individual programme on the device

In your Initial Consultation, your therapist will identify the pattern of your pain, using a questionnaire to collect a subjective history of your individual pain. The therapist will then complete an assessment of your rectus abdominus to collect data on your strength, range of movement, endurance, control and coordination. 

Your responses to the questionnaire and data collected from the assessment allow us to collaboratively make goals – it might be working on your endurance, pain levels, strength, range of motion or a combination of these potential goals. The programme is individualised and goal specific.

The therapist will then create an individual treatment programme for your specific needs – range of motion, load and speed of movement will be tailored to ensure you’re working in a safe and pain-free range on the flexion device.

Initially, the exercise will be gentle – focusing on activating and targeting the rectus abdominis and multifidus eccentrically (by ensuring movement back up after bending forward is slow and controlled) to produce smooth, coordinated movement before gradually increasing the range of motion and weight. 

When exercising on the flexion device, we encourage a segmental movement through the spine when you are curling forward – this will ensure one vertebrae moves at a time and allow the multifidus (located between vertebrae) to be stretched and the rectus abdominus to be contracted.

The device also collects data regarding your feedback. After each exercise you are asked to rate the intensity of the exercise. This feedback ensure you begin with comfortable, gentle exercise before we gradually increase the amount of resistance.

The device also provides feedback on how well you performed the exercise within the set parameters.