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Book Review ....
The techniques and exercises described in these books may well be helpful to those whose muscle tone is poor and back pain is mild to moderately severe. The exercises would help a healthy person who wants to prevent back problems from ever developing. Anyone trying some of these exercises without expert guidance might do more harm than good, if they were doing them incorrectly. Some of the exercises might be unsuitable for their specific condition. Everyone should seek expert professional medical advice before starting a new exercise regime. The Australian-born author trained as a physiotherapist and was later influenced by reading fellow Australian G. D. Maitland's book "Vertebral Manipulation. She then learned the first essentials of spinal manipulation from Alec Sinclair at King's College Hospital in London. After working in London hospitals, Sarah eventually opened her own clinic near Harley Street, though she is now working again in Australia. Her non-invasive technique of spinal joint manipulation combined with a regime of gentle stretch exercises, challenges collective conventional thinking on back treatment. Key's book "New Back in Action", looks at why back pain is so common and what goes wrong with backs. She feels that 21st century sedentary lifestyles, sitting in soft sofas, hunched over computers and driving long hours without allowing our bodies to open out into a full stretch will all lead to inflexibility of joints. When these under-exercised joints are suddenly subjected to a burst of activity they eventually complain. Her theory is that spinal joints are designed to move flexibly, and this movement feeds the discs and joints with lubricating fluid. She maintains that back pain is rarely caused by disc problems, but simply by joint stiffness, which leads to muscle imbalance. As soon as these spinal joints are deprived of reviving fluid they begin to dry out and seize up. Muscle action is then distorted to compensate for lack of flexibility - leading eventually to flare-ups and to back pain. The pros and cons of various treatments for many common back problems are described. Advice is given on coping with other factors which can contribute to back pain such as depression, tension, excess weight, lifting, pushing, housework, travelling and sexual activity. Lengthy periods of sitting and standing compress the discs and the author recommends stretches to counteract this. There is advice on the design of chairs and seating positions. A section of the book also deals with bed and mattress design. The author believes that although sports have a healthy image, many of them can be very bad for joints even though they may be good for lung and heart health. Sports which do not decree monotonous repetitive movements are kinder to joints. Sports which are likely to aggravate joint problems are golf, running on hard surfaces, rugby, tennis and some swimming strokes. Ballet dancers often suffer badly from back problems. Safer sports she believes are yoga, table tennis and walking. The constant theme throughout the book is the importance of relieving spinal stiffness, combined with strengthening and balancing the muscles. For Key's method to succeed, the patient has to play his or her part with a programme of daily exercises. She advocates the use of a "Back Block" and a "Ma Roller", followed always by a "knee bounce" exercise, and finishing with a gentle curling up and down "sit up" exercise with anchored feet. Some of the yoga-based exercises suggested are fairly extreme and may not be recommended or suitable for all conditions. Improving stomach muscle tone by sucking in the tummy muscles before manoeuvres, to protect the back is stressed. Clear warning is given that the exercises should be done very gently and the number of repetitions increased very gradually. The main mistake that most people make is trying to do the exercises too vigorously and for too long. The author's aim is to show that once the spinal segments are "reflated" with fluid, becoming fully flexible and more "stretchable", the pressure lifts then from the spine and the pain starts to recede. Key claims that spinal mobilisation by a qualified practitioner, combined with dedication from the patient by continuing with a progressive exercise programme, will eventually succeed in most cases. She points out that her technique will not be suitable in all cases particularly those with rheumatoid arthritis, osteoporosis, bone cancer or for pregnant women. The book has a foreword by HRH The Prince of Wales, BackCare's Patron, who, being a back pain sufferer himself, is apparently an advocate of the Key's method of treatment. The book which is written in a question and answer format, uses technical terminology, but it is written in an easily understandable style for the lay-person. The simple black and white line diagrams are fairly clear, though a labelled colour diagram of the complex muscle structure around the trunk might help the non-medically trained reader. Another useful addition would have been a video to accompany the book, to demonstrate the exercises properly. The Sarah Keys website indicates that a video of exercises will soon be available. This is welcome news as this format will be able to show much more clearly than a book, the pace and movements of the exercises. This book would make a suitable addition to a BackCare Branch library to give members a chance to find out more about this particular form of treatment and compare it to other techniques. From a personal viewpoint, as a long-time sufferer from stiff and aching lower back joints, I found the theory put forward by Key as sensible and worth trying, especially if one could find a local physiotherapist with spinal mobilisation training to treat and monitor the exercises. The Key's website has many examples of appreciative readers who have apparently made dramatic recoveries after only a few weeks on the Key's exercise programme. These opinions should however be weighed against some of the critics of her method, to get a balanced view.
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