in the Journal of Strength and Condition-ing Research in 2015 found that individ-uals suffering from mechanical lower back pain who had acceptable levels of lower back endurance could benefit from performing a more complicated exercise, such as the deadlift. Similarly, Welch et al (2015) found that free-weight based resistance training including deadlifts and squats im-proved strength, motor control, and other physiological aspects such as increased cross sectional area in indi-viduals with chronic LBP. Berglund (2016) found that deadlifts may be beneficial for subjects with mechanical low back pain, as they provide clinically relevant points of education including hip hinge patterning, and motor con-trol strategies. These research studies highlight the need for patients to be coached and cued to perform exercises correctly, particularly as the difficulty increases. Although time consuming, being pres-ent to instruct your patients in the performance of their exercises can be very helpful. Otherwise, building a re-ferral network with knowledgeable personal trainers, strength coaches, and other rehabilitation professionals including kinesiologists and athletic therapists can be helpful for both your practice and your patients. From a practical perspective, we can build upon the work established above to develop a solid exercise regimen for our patients. Knowing your patient’s injury history, their personal goals, and previous levels of activity can all be beneficial for prescribing an adequately challenging program. Moreover, a movement evaluation such as the FMS or SFMA is a good starting point to try and identify areas of improvement. Marrying these findings with the re-search surrounding overuse injuries common to an individual’s sports and other daily activities, as well as their relevant injury history can help to offer a truly individualized prehabilitation exercise program. Although we may not be able to prevent all musculoskel-etal injuries, offering our patients a thorough and individualized exercise regime may help them build capacity for their activities. Overall, there are numerous positive effects associated with exercise includ-ing: improving muscular strength and endurance, increased blood flow to affected tissues, maintaining adequate range of motion, neuromuscular re-training, improved aerobic capacity, patient empowerment including in-creased self-reliance and decreased fear avoidance, exercise-induced analgesia, and much more. While the research may be lacking in terms of definitive answers to preventing musculoskeletal injuries, there is no denying the bene-fits of exercise. Many patients entering a chiroprac-tic office can benefit from the gradual and guided introduction to exercise, particularly when it is individualized to their specific concerns. At the end of the day, exercise is medicine. symposium at HOMECOMING May 31 -June 1, 2019 CMCC and the Hilton Toronto/Markham Suites The first event of its kind! Join world class experts on the Prevention and Management of Low Back Pain – The Expanding Role of the Chiropractor, inspired by the Lancet papers and the Global Spine Care Initiative Enjoy an exciting social events program which includes: President’s Welcome Home Barbecue; Governors’ Club Lunch; Grand Reception, Dinner and Awards All classes are welcome. Register today at www.cmcc.ca/symposiumathomecoming www.canadianchiropractor.ca CC_CMCChomcoming_Feb19_CSA.indd 1 February 2019 Canadian Chiropractor 19 2019-01-09 3:04 PM CC_FEB19.indd 19 2019-02-01 10:56 AM
Chiropractic + Naturopathic Doctor February 2019: Page 19
