Not an Excercise Program

In fact, The O'Connor Technique (tm) is not predominately an exercise program at all. Although the value of proper exercise to keep the back musculature in good tone cannot be underestimated as a preventative measure, it is not necessary to exercise pain away. Pain is alleviated by a few simple movements called "MANEUVERS." The only actual exercise advocated in this methodology is designed to preferentially strengthen specific muscle groups to alter the mechanical forces placed upon the involved discs after the pain problem has been solved. For those who can't see themselves being sentenced to perpetual exercise, the exercise component can be ignored and the majority of benefit can still be realized by just doing the MANEUVERSs (some of which are so simple as to be incorporated into the act of exiting a bed or putting on your shoes in a different way.) The reader will not be expected to exhaust him/herself especially while in pain. In that sense, this website can be looked upon as THE LAZY (WO)MAN'S GUIDE TO BACK PAIN.

This method teaches the back pain sufferer a means to capitalize upon simple body mechanics to re-position the discs to relieve acute (immediate, short term) pain and to alter the forces of the spine acting on the discs so that the disc can be re-positioned and eventually made less likely to become painful in the future.

Other programs (especially those in vogue now) would have the participant repeatedly exercise and "work harden" the spinal and associated musculature in order to "stabilize" the Lumbar spine. Their latest advice recommends mobilization as early as possible. The problem is that they fail to elaborate or define specific, safe, effective, and painless mobilization techniques. This method provides those techniques and avoids any muscular stresses to the spine until the mechanical problem is solved. I find it cruel to mobilize an acutely painful back with the traditional methods especially if they make no effort to avoid those movements and postures that serve to increase pain and advance damage. The average physical therapist employing the state-of-the-art work hardening techniques seeks to find (largely through trial and error) a few exercises the back pain sufferer can perform and force them to repeat and increase the intensity of those exercises until exhaustion or pain arrests the process. All the while, they teach the sufferer to keep the back positioned in the "straight" or "neutral" position. The so-called "neutral" position being described as having the upper body directly above the hips with the Lumbar spine in neither flexion nor extension when performing any body movements. This is all well and good in theory; but, in practice, it is nearly impossible for the average person to maintain the degree of muscular energy that is required to keep the back constantly "straight." Later, the muscle tone that they demand cannot be achieved or maintained without exhausting constant daily work-outs. Realistically, the vast majority of people do not have the inclination or time to exercise daily. Those people who do have that inclination and keep their bodies in excellent tone and shape with regular exercise usually don't suffer from back pain anyway. This therapeutic regimen, in that sense, makes no demand for a change in exercise lifestyle.

Adding to that, most other programs and physical therapy regimens ask people who are in or just recently coming out of acute pain to risk further agony by exercising within two days of the injury! Most people are smart enough to avoid exercising because they know that, often, exercise was what brought on the pain in the first place. As you will probably be convinced later, exercising while the disc is herniated or prolapsed really shouldn't be accomplished. As soon as it is "in," is a different story. Any actual exercise intended to strengthen muscles acting upon the spine is too painful to accomplish until the herniated disc has been anatomically re-positioned where it belongs. Even if one were to make a constant conscious attempt to maintain the postures advocated by most programs while sitting and standing, it is largely impossible to accomplish these even most of the time due to the pain accompanying the displaced disc material. The result is that the person's back pain persists; and, when they continue to complain, they are accused of not maintaining the postures and exercise levels consistent with sufficient motivation to get better. What their persecutors don't realize is that the positions that they advocate are realistically impossible to maintain without first insuring that the disc is not still herniated or prolapsed.

This rationale, as you will hopefully come to understand, substantiates a legitimate criticism of The McKenzie exercises. Figure 9 shows the terminal components of several exercise postures advocated by McKenzie that comprise principle elements of his program. In and of themselves, they are not necessarily bad (in fact, you will find similar positions demonstrated in this website); however, the inappropriate sequence of their application, as directed by his method, can make them actually painful and damaging to a large percentage of patients with disc disease a significant proportion of the time. In order for them to be helpful, a person must be able to tell whether the disc is "in" or "out," where the displaced disc material is located (or they might be at best ineffective), and they must be applied at a specific time for rational reasons. To my admittedly limited understanding, McKenzie gives his students and readers none of this; therefore, anyone advocating these exercises lacks the necessary specificity for them to hope to be successful except under limited circumstances.

Please understand, my intention is not to denigrate McKenzie. These exercises do help a certain specific subset of back pain sufferers, giving clinicians limited legitimacy to advocate them; but, it cannot be assumed that patients who don't get relief must not be doing the exercises. If you don't exercise, the psycho-logic of some physicians flows--you must not be motivated to get better. It then follows that the lack of motivation is the source of the problem rather than the pain being too great or the method of treatment being inappropriate and ineffectual.

The logic becomes most damaging to patients with legitimate pain and disability when they interface with "experts" who are so certain that their methods of treatment are without fault that they have come to conclude when a patient fails to get better that it is the patient's fault instead of the disease process or the consequence of inadequate, poorly directed, exercise prescriptions. I have suffered these "experts" parading around conferences expounding the assumption that what they are presenting and practicing constitutes the definitive method. They responded to my inquiries into the logic of their method with defensive indignation and justify their methods with only the implicit superiority of their personalities and credentials. Don't misunderstand me, I have a great respect for medical professionals--except when they fail to accept that their methods may be fraught with inadequacy or refuse to advance their own knowledge by resting upon what they are usually unwilling to acknowledge exists as a grotesquely incomplete understanding. Unfortunately, this attitude inhibits the acquisition of new knowledge; and, in that atmosphere, I am offended by their arrogance.

Article Contents:
You are not alone
The Pain
Contemporary Perspective on Back Pain
Historical Perspective of Back Pain
Science and Art
Alternative Therapeutic Modalities
Back Surgery
Comparative Programs
Not an Excercise Program
Dismissing the "Psychological" Contribution To Spinal Pain
Getting Better as a Process
Become your own Chiropractor
Hope

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