Distribution of tissue loads in the low back during a variety of daily and rehabilitation tasks.

Successful rehabilitation programs arise from the balance of wisdom obtained through scientific laboratory experiment, and the "art" developed from clinical experience. Specifically, choosing the best exercises is enhanced by knowledge of the resultant tissue loads to reduce the risk of injury exacerbation and to strengthen healthy supporting tissues. The following report attempts to briefly describe a technique to obtain tissue load distribution, together with examples of tissue loads during the performance of some selected tasks. For example, it appears that those persons with shear injury to the vertebral joint (including facet, neural arch damage, or spondylolisthesis) or posterior ligament damage should avoid fully flexed postures given the resultant tissue loading. Specific data are provided to guide selection of various abdominal and low back exercises. Finally, some hypotheses and opinions are offered for possible improvements in clinical success.