RJR Backward stretch

Treating back of spine with RJR backward stretch

Treating the back of the spine for back pain is a common practice.  As a physical therapist, I worked for years on spines using massage, joint mobilizations, electrical stimulation, heat, ice, and ultrasound. While some people have found these techniques to be beneficial, I found for my back pain that using Releasing Joint Restriction (RJR) protocol or Strain and Counter Strain (SCS) was the most effective treatment.

 

Back of the spine is the culprit

When back pain is an aching pain that is difficult to pinpoint and improves with flexion such as sitting, bending forward, or curling into a fetal position this means source of the pain is coming from the front of the spine.  People with a problem on the front of the spine still feel the pain in the back.  I have found in the clinic that most people have back pain coming from the front of the spine.  However, people with a problem on the back of the spine feel it in the back but it is typically a sharp, stabbing pain that is easy to pinpoint with your fingertip.   The back of the spine is the culprit when being in extension is more comfortable.  This means that the pain improves with standing, bending backward, or lying down with the legs straight (extension).

RJR mechanics to unlock an extended spine

When the spine is held or stuck into extension (bent backward) it requires more extension to unlock it. This photo shows pinched Pete with a safety pin holding his back into extension looking from the side.

spine held in extension

The next photo demonstrates what has to happen to unlock the safety pin which is holding Pete into a backward bend or extended position.  To release the pin, Pete has to bend back even farther to put slack on the tissue to allow it to unlock.

Unlocking safety pin on extended spine

This photo shows the easiest way to bend the spine backward to unlock this extended spine.  By dropping the leg off of the bed the lumbar or lower spine is bending backward.  By bringing an arm overhead the thoracic or mid-spine is bending backward.  And by tilting the chin backward the cervical spine or neck is bending backward.  Adding tilting to the side and twisting or rotating helps to release the joints that are restricted even more effectively.

Unlocking extended spine using backward bend

Finally, this photo shows Pinched Pete's spine returned to neutral after unlocking the extension dysfunction.

 

 

 

 

Neutral spine extension unlocked

 

This photo shows Pinched Pete's spine stuck in extension, or bent backward, in standing.

 

 

 

 

 

 

 

 

 

 

 

 

Standing spine stuck in extension

 

This last photo shows Pinched Pete's spine in a neutral, unlocked position in standing.

 

 

 

 

 

 

 

 

 

 

 

 

 

Pinched Pete in standing neutral spine

Standing preferred rather than sitting

 

When I am teaching a class, I can always tell the people who need to do a backward bend stretch because they are standing in the back of the room.  They are in too much discomfort or pain to sit in a chair for very long.  When standing is more comfortable, the pain is easy to pinpoint, and it is a sharp/stabbing sort of pain, it is likely coming from a spine that is held into extension.  To unlock it more extension is required.  I find myself wanting to stop the people I see around town who clearly are locked into extension.  They are missing the normal curves of the back that we consider neutral and they look like they are standing at attention but on steroids.  They have literally bent backward their spine is so straight.  It is very rare that I see this type of back, but someday I am going to be brave enough to ask one of them if I can have a photo.

I find back pain much more commonly worsens in people when they are standing, walking, or trying to bend backward.  Another way you bend backward is coming up from a seated position into standing. The spine is actually moving backward or extending so I always clarify with patients if their pain is while sitting or while standing up from sitting.  In the 20+ years, I have been using SCS to treat patients, the majority of back pain has been from the front of the spine.  It is quite common to have problems on the front and back of the spine so I always like to teach people both treatments.

Using a stretch rather than poking

I prefer to use the Restriction Indicators (RI) or tender points associated with abnormal alignment of the spine.  The RI helps you to know which joint is restricted from normal movement and then helps you find the most precise treatment position to release the restricted joint.  I do not typically teach people how to look for the RIs when there is a problem on the back of the spine because it is too hard to contort your body to look for your own RIs on the back.  For most people, doing the backward stretch is adequate to unlock the extended backbones and ribs that are extended.  Ribs that are extended cause pain when breathing out.  This stretch is a good stretch to do two times a day to both sides.  I like to do it just to keep my back from becoming stuck in extension.

 

Remember to use a pre-test before doing this stretch.  For example, see how the back feels in sitting or lying down with knees bent.  Then perform this backward stretch to one side.  Follow this by doing the post-test of sitting or lying down with knees bent whichever you did as your pre-test.  Make sure that your pre-test and post-test are exactly the same.  For example, if you are holding still in a position as a pre-test and you feel pain, don't do a post-test during movement.  Repeat this backward stretch to the other side and repeat the post-test.  Perform it 2 times a day or any time the pain during sitting or bending forward increases.

 

Handout:  RJR Backward stretch lying down

 

Another way to do the backward stretch is in standing.  It is difficult to do, but if you do not have a bed to lie on then standing can work well.  Just make sure your balance is good enough or you have someone standing by you to make sure you do not fall.

 

Handout:  RJR backward stretch standing

 

Inner Core

Make sure to hold your inner core as you move into and out of this position.  The inner core is critical to maintaining improved alignment of the skeleton after you have performed the movement combinations or treatment positions.  The most important thing you should learn from me is to learn to fire the inner core and make that muscle strong.  When the inner core is strong the pelvic floor muscle keeps the two halves of the pelvis together and is less likely going to allow them to slide apart again.

 

Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT