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Spines are pretty spineless

Back Stability: Christopher M. Norris. Human Kinetics 2000. 272 pages hardback, £24.50. ISBN 0-7360-0081-X

One morning in Spain, twenty-five years ago, I found myself completely incapacitated by agonising back pain. The prescribed cure – lying on my back by the pool for ten days – was not the hardest thing I've ever done, but I'd rather not have had the pain. It went as mysteriously as it had come.

Back pain is on the increase. In 1989 46 million working days were lost to it in the UK; in 1994-5 it was 116 million days. The figures, and consequent cost to health agencies and industry, are much higher in the United States.

We might assumed (as most people do) that the causes are structural – disc degeneration and the like – but degeneration is exactly as common in those who suffer no pain. It becomes apparent that the perception of disability is itself disabling. Awareness that this is the case has prompted new ways of managing the problem. The traditional rest cure is being replaced by approaches in which exercise is at the forefront.

Spines are pretty spineless, really: it's the deep abdominal muscles which are most effective in stabilising it and keeping it up. The spine of a corpse, stripped of muscle (there may be career openings here) buckles under a load of 5 lbs. So much for backbone. The answer is to strengthen the muscles in a balanced way. Even a few sit-ups each day are better than nothing.

This book presents such a programme of treatment, in which the patient is active. The key is lumbar stabilisation. Part I, the first quarter, provides the anatomical basis, a detailed and fairly scientific account of how it works and what can go wrong; Part II a hundred pages of techniques and exercises; Part III is aimed at those with special needs, like sports persons and illustrates another 50 or so exercises; and Part IV gives guidelines for building exercise programmes

The book is aimed at therapists (Chapter 4 is 'Teaching your Clients the Basic Skills'). The average person would need no more than the 100 pages of Part II, the exercises. A coach may not aspire to therapy, but prevention is better, and a coach who added this book to his library ought to find a lot of use for it

Ramin Minovi

Copyright © Association of British Cycling Coaches 2001

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