Everett Chiropractic Center Blog

February 5, 2014

When Is It Ok To Break The Neutral Spine Rule?

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We talk about the neutral spine all the time in our office. In Tai Chi class we refer to it as “The Line.” And if you search the term “neutral spine” here you will find plenty on the subject. (As it relates to back safety and your weight/body mechanics; As it relates to Tai chi, which we hammer on constantly; And as it relates to the Department of Labor & Industries in WA, which doesn’t think that it’s important.)

But when is it Ok to violate neutral spine, if ever?

Well, here are some thoughts that might help you think about it.

First, that strength-to-weight factor that I mentioned recently. The stronger you are the better. I can’t think of any exceptions to that rule. (Which is why we use the latest evidence-based methods to teach our patients how to stabilize and strengthen their spine after they get out of pain. With a stronger, pain-free, back they can work on losing weight and getting into better physical shape safely if that’s important to them.)

Secondly, consider “neutral spine”. Neutral spine is a range. It’s not one static spot of perfect alignment. It’s a range of alignments that are not too far off of the pictures that you see in posters: a little more curve, a little less curve, with as much of a balance of curves as possible. So the more narrow you keep that range and the closer to that range, the better. (Here is a visual that nicely conveys the concept.)

And, your vulnerability based on your own past history of trauma (injury) and trouble is a big issue. Having a past that includes injuries with all the accompanying dysfunction, degeneration and disease that can eventually go with it matters: the more you have the risker it is to now break the rules (any of the rules).

So, if you are strong relative to your weight; if you bend or lift without maintaining a neutral spine; but you have a healthy, undamaged spine, and you are not lifting much of anything heavier than a pencil, you can go ahead and violate the neutral spine rule now and then and get away with it.

Any other time you are asking to be a statistic.

Here is one last thought. There are times when you have to lift something and you are not going to be able to get into a good position: it’s going to be a risky lift and you know it! It’s going to happen. These are the times to know all the tricks: brace like a madman; breathe (or not) as best you possibly can; try the best you can to get a hip hinge going; then lift and get it over with. Putting a battery into the bed of a pick from the side up comes to mind, or putting something awkward and heavy into the trunk of your car, or reaching down into a hole in the ground to pull something up, these are the kinds of moments I am talking about: they are classics, but there are many, many others – especially if you work in construction, nursing, or some other highly physical occupation. Be safe.

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