Yoga and Stretching Can Help Relieve Bad Backs

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Chanting "om" might help ease your aching back, but only if it comes at the end of yoga practice. A new study finds that the physical act of doing yoga — but not its meditative aspect — may help reduce symptoms of chronic back pain.

Based on smaller previous studies, researchers thought it was some combination of yoga's stretching and mental elements — deep breathing and relaxation — that improved back sufferers' function. But the current study found that yoga worked no better than intensive stretching alone, suggesting that it's the physical exercise, not the mindfulness component, that matters.

Whether doing yoga or stretching, however, it takes effort: participants in the study attended weekly 75-minute yoga or stretching classes for 12 weeks, and did additional 20-minute at-home practices with the help of instructional CDs or DVDs at least three days a week.

MORE: Aching Back? Try Massage for Chronic Pain

The trial, published on Monday in the Archives of Internal Medicine, is the largest to date on yoga and chronic back pain, a condition that affects millions of adults and often doesn't have an easy solution. People spend billions of dollars a year seeking relief from pills, doctors, physical therapists and chiropractors. Although there's no shortage of available treatments for low back pain, including exercise, it's not entirely clear how they stack up against one another in terms of effectiveness.

For the new study, researchers recruited 228 adults in the Seattle area, all of whom had moderate chronic back pain but were fairly active despite their conditions. The participants were randomly assigned to do either yoga or intensive stretching or, as the control group, to use "self care."

The yoga group did viniyoga, a style of hatha yoga that focuses on postures that stretch and strengthen back and leg muscles, and include breathing exercises and guided deep relaxation. The intensive stretching class was similarly devoted to exercises that stretch and strengthen trunk and leg muscles, except without the guided breathing and relaxation. And finally, the self-care group was given a book to read, The Back Pain Helpbook, which offers advice on exercise and lifestyle changes for back pain.

Over time, all study participants saw improvements in function, but those doing yoga and stretching did significantly better than the self-care group. By the end of their three-month classes, more than half of those in each exercise group reported at least 50% improvement in measures of day-to-day disability, compared with less than a quarter of the controls.

MORE: Can Yoga Treat a Common Heart Rhythm Disorder?

At each follow-up interview — conducted at 6, 12 and 26 weeks after the start of the interventions — yoga and stretch class participants were also significantly more likely to rate their back pain as better, much better or completely gone, compared with the self-care group. "More participants in the yoga and stretching groups were very satisfied with their overall care for back pain," the authors wrote.

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HEALTH MANAGEMENT. Head count: running backs take hits hardest, linemen take the most

Researchers gathered data on the frequency, direction, and magnitude of head impacts from players who wore sensor-equipped helmets during three football seasons at Brown University, Dartmouth College, and Virginia Tech. The data amount to a measure of players' exposure to head impacts, which can ultimately help physicians and scientists understand how concussions occur.
Thousands of college football players began competing around the nation this week, but with the thrill of the new season comes new data on the risks of taking the field. A new study reports that running backs and quarterbacks suffer the hardest hits to the head, while linemen and linebackers are hit on the head most often. The researchers measured head blows during games and practices over three seasons at Brown University, Dartmouth College, and Virginia Tech.
The study, led by Joseph J. Crisco, professor of orthopaedics in the Warren Alpert Medical School of Brown University and director of the bioengineering laboratory at Rhode Island Hospital, documented 286,636 head blows among 314 players in the 2007-09 seasons. Crisco said the new data on the magnitude, frequency, and location of head blows amounts to a measure of each player's head impact exposure. Ultimately it can help doctors understand the biomechanics of how blows to the head result in injury.
"This allows us to quantify what the exposure is," Crisco said. "It is the exposure that we need to build upon, so that we can then start understanding what the relationships are with acute and chronic head injury."
The study appears online in advance in the Journal of Biomechanics.
Concussions and other head injuries have become a source of elevated concern in football and other sports in recent years, with various leagues revising policies to protect players better. In part based on seeing this new data, said Robin Harris, Ivy League executive director, league officials announced earlier this year that full-contact practices would be limited to two a week.
Hits by position
The new study documents the nature of head blows by player position. Players on the three teams wore helmets equipped with wireless sensors that measured acceleration in various directions. That data allowed the team of researchers from Brown, Dartmouth, Virginia Tech, and sensor-maker Simbex to discern how hard the hit was, how often each player was hit, and where on the helmet they were hit.
Crisco devised the algorithm that Simbex's Head Impact Telemetry System uses to measure head impacts. The system's development and this study were funded by the National Institute of Child Health and Human Development and the National Operating Committee on Standards for Athletic Equipment.
The data on head acceleration and hit direction are used to calculate a composite score of exposure called HITsp that researchers believe might be a good predictor of concussion. On average, running backs had the highest HITsp, 36.1, followed by quarterbacks with 34.5 and linebackers at 32.6. Offensive and defensive linemen had the lowest HITsp numbers, with 29.0 and 28.9 respectively, but along with linebackers, they were hit on the head most often. Doctors worry not only about hit severity, but also hit frequency, because repeated head impacts may cause "subconcussive" neurological damage over time.
By analyzing head impacts by position, Crisco said, researchers can help football league officials and equipment designers begin to think about ways to make players safer.
"It will allow us to begin to understand how to control the exposures," Crisco said. Controlling head impact exposure is critical, he added, because there are currently no treatments for acute or chronic brain injuries, and helmets cannot prevent injuries for all players in all situations.
One possibility could include rule changes. Another could include designing helmets for specific positions.
Crisco and his colleagues are now analyzing data about concussions during the three seasons to determine how and whether head impact exposure is associated with injury. He recently co-authored another paper about male and female collegiate hockey players, which reported that although women were diagnosed with more concussions, they sustained fewer and less severe head impacts.
Although Crisco's analysis is still underway, his insights into head impact exposure led him and co-author Richard Greenwald, a Dartmouth engineer, to write a commentary earlier this year in Current Sports Medicine Reports, in which they argued that intentional use of the head in sports must be curbed.
"We propose the adoption of rules - or in some sports, we champion the enforcement of existing rules - that eliminate intentional head contact in helmeted sports," they wrote. "When coupled with education that leads to modified tackling, blocking, or checking techniques, these rules will reduce head impact exposure and have the potential to reduce the incidence and severity of brain injury."
Crisco, a former college football and lacrosse player, said he is passionate about contact sports and believes they have many benefits.
"Hitting is an essential component," he said. "But intentional hitting with your head was never part of any sport and is poor technique."

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