Our back makes it possible for us to walk upright. It supports the head and the entire body, while being flexible and rigid at the same time.

Believe it or not, running a marathon or going on a kilometre-long hike is much better for the back than a lack of movement.

In this programme, we’ll learn all about the back and how to keep it healthy.

Session 1 : Back to the basics

Back to the basics

Section 1 : Structure

The anatomy and function of the back

What does the back do and how is it structured? In this session, we’ll learn everything we need to know about the different parts of the back.

The spine

The back is a combination of bones, muscles, ligaments, and nerves. The most important and sensitive part of the back is the spine.

At the top end, we find the cervical vertebrae, which are responsible for supporting the head.

Somewhere in the middle, the costal arches (or lower edge of the rib cage) is connected to the spine and at the very bottom, we have the tailbone.

Knowing about the spine gives a whole new meaning to having a good head on our shoulders!

Structure of the spine

In total, the spine has 7 cervical, 12 thoracic, and 5 lumbar vertebrae, plus the sacrum and coccyx (aka tailbone). The vertebrae in each area have a different structure related to their function.

The cervical vertebrae must allow for great mobility, but don’t carry a lot of weight, while the lumbar vertebrae carry the entire trunk of the body and the head.

For this reason, the lumbar vertebrae are larger in size.

Individual vertebrae are connected to each other by intervertebral discs, which act as shock absorbers and allow the spine to move in different ways.

The ligaments, tendons, and muscles all contribute to stabilising the body.

Intervertebral discs absorb the shock from the impact of our movements.

Functions of the spine

• Stabilising the trunk
• Ensuring upright body posture
• Protecting the spinal cord and spinal nerves
• Absorbing shock with the intervertebral discs and joints
• Allowing for movement in many directions

From the side, the spine has an S-shape, formed by 3 natural curves that cushion impact to the body and protect our spine from injury. These also allow us to walk upright.

The spine is the movable pillar of the body

Section 2 : Intervertebral discs

There are 24 vertebrae in the moving part of the spine. In between them are 23 intervertebral discs, each with a fibre ring and gelatinous core that are surrounded by ligaments.

The intervertebral discs are made of cartilage tissue.

The core of the intervertebral discs is soft and yields when the spine bends. There’s no blood supply to the intervertebral discs, since they’re supplied by a loading and unloading process:

When there’s pressure on the intervertebral discs, they release fluid into their environment and absorb fluid when the pressure is lifted – this allows them to get their job done.

Without shock absorption, there’d be major wear and tear on all our joints.

The intervertebral discs ensure that when the spine is unevenly loaded (like when we lift or carry on just one side of the body), the pressure is distributed more evenly. By doing this, they protect the vertebrae against uneven wear.

When sitting for long periods, the intervertebral discs are mostly under pressure and this doesn’t allow for a good exchange of nutrients and oxygen. This results in brittleness and possible tearing (oh no!).

When this happens, we may experience a herniated disc, or what’s also known as a bulging or slipped disk.

Intervertebral discs are able to regenerate themselves to a certain extent, which can be observed daily:

In the morning, discs are higher and filled with more fluid. In the evening, they’ve lost this fluid because of everyday movements like standing, sitting, lifting, or bending.

Herniated disc

When parts of the discs’ gelatinous core shift or leak out, we have ourselves a herniated disc.

In this situation, the intervertebral disc puts pressure on the nerves that run in the area of ​​the spine or in the spinal cord. This causes back pain and muscle tension. It can also cause numbness.

Symptoms of a herniated disc can include tingling in the arms or legs.

A herniated disc can have several causes:

• Age (more common in those aged 30-50)
• Incorrect strain
• Chronic overloading (or lifting of heavy objects)
• Obesity

In about 20% of cases, a herniated disc may go unnoticed because there are no nerves affected.

Luckily, these ‘silent’ herniated discs don’t need treatment.

Section 3: The muscles

Our back and stomach muscles play a key role in our bodies being able to keep an upright posture.

In order to work properly, these muscles need to be elastic, flexible, and strong. Training our core muscles is important for a healthy back.

The deep muscles (or autochthonous back muscles) are particularly important, since they lie directly on the spine and are crucial for the back’s stability.

The back has both deep and superficial muscles.

Important properties of the deep muscles:

• They stabilise the spine
• They can’t be tensed voluntarily
• Their movement is purely reflexive (meaning they act in response to something else)

The back muscles react to all incoming stimuli in order to protect the spine.

Exercises on unstable surfaces such as wobble boards are good for training the deep back muscles. They force the body to react in response to the instability.

On top of the deep muscles, we find another layer of muscles called the superficial back muscles, which we’ll get to next.

Exercises on a balance beam also help train the deep muscles.

Superficial back muscles

By supporting the functions of the deep back muscles, the superficial muscles also play an important role in stabilising the spine.

Properties of the superficial back muscles:

• They make shoulder, shoulder blade, and arm movements possible
  They support breathing

The consequences of bad posture

Sitting for long periods in the wrong position can strain our muscles in a bad way.

We see this in people who tend to have their shoulders pulled up, which creates tension. At the same time, the muscles responsible for pulling the shoulders down are neglected.

Important: The more muscle strength we use to maintain a healthy posture, the less pressure we put on our joint system.

Spinal deformities

When experiencing tension or pain in the back, shoulders, or hip area, this may be a sign of a crooked spine.

Be sure to consult a specialist who is able to diagnose important changes, which could be the result of:

• scoliosis (the spine is curved sideways)
• hyperkyphosis (rounded back)
• hyperlordosis (spine rounded to the front)