Can you bend forward with a herniated disc? (physio explanation)

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Se lean forward when suffering from a herniated disc is a common question among my patients. You may have read or heard that slouching or hunching forward is bad for your back, and that keeping your spine straight could prevent or avoid a herniated disc. But is that really the case? In this article, we’ll separate fact from fiction and provide you with actionable tips for understanding when and how to bend safely.

Pressure on intervertebral discs: what the science says

Several studies have shown that certain positions put more pressure on the intervertebral discs, thus increasing the risk of pain. On a graph of disc pressure, we see that the pressure is lowest when you are lying on your back, but increases when you are standing, and even more when you bend forward, especially if you are sitting. Sitting combined with forward bending (such as bending over while sitting) is where the pressure is highest.

However, it is important to qualify these observations. While excessive and prolonged pressure can contribute to a herniated disc, this does not mean that bending over is always bad. The human body has a incredible adaptability, and with the right amount of stress, the intervertebral discs can become stronger instead of weaker.

Back bending: dangerous or beneficial?

Let's take an example of a study on regular runners. Contrary to expectations, runners who regularly experience compressive forces on their spine (such as when running) have discs more hydrated, thicker and healthier than non-runners. This repeated and progressive pressure allows strengthen the discs, proving that the body can adapt to the forces exerted on it, including during lumbar flexion.

In summary, lean forward can be sure and even beneficial, provided that it is done in a gradual and measured manner.

Patient Story: Avoiding Bending Is Not the Answer

Now I would like to share with you the story of one of my patients, whom we will call Mr. X. Mr. X suffered from a herniated L5-S1 disc and believed that avoiding bending altogether would help him heal. For over a year, he avoided all activities that involved lumbar flexion, whether it was sitting, tying his shoes, or even lying down.

Result? Not only did his condition not improve, it got worse. Mr. X developed a joint ankylosis, meaning his hip and pelvic joints were so stiff that he could no longer bend over even slightly. Worse still, he had developed a kinesiophobia (fear of movement), which affected his confidence in himself and his physical abilities.

This shows that avoid bending over long term is not the solution and may even lead to additional complications.

Looking short term: what you need to know

So does this mean you can bend over right away if you have a herniated disc? Not quite.

During the acute phase of a herniated disc, when the inflammation is significant, it is best to avoid bending excessively so as not to aggravate the symptoms. You can even wear a lumbar belt to stabilize your back and prevent sudden movements. Some physical therapists also use kinesiotaping tapes to remind you to limit bending during this time.

However, these strategies are temporary. Once the pain is under control, it becomes important to reintroduce flexion in safe and progressive exercises.

Looking long term: the key is gradualism

When the pain has subsided, lumbar flexion should be gradually reintegrated. Specific exercises, such as the Jefferson Curl, help strengthen the posterior chain and improve hamstring flexibility while protecting the back. These controlled movements help reintroduce flexion in a progressive manner, thereby strengthening the intervertebral discs and back muscles.

Le key message is that in the long term, bending over is not dangerous, provided it is done carefully, under the supervision of a health professional.

Danish study on bending and back pain

An interesting study conducted in Denmark followed 682 workers over a one-year period to determine whether prolonged lumbar flexion led to back pain. The researchers compared workers who spent more time in a bent position with those who spent less time in that position. The result? The differences between the two groups were minimalThe study concluded that there was no significant link between bending over and the development of long-term back pain.

This study confirms that there is no reason to systematically avoid flexion, especially in the long term.

Conclusion: Flexion is not the enemy

To summarize, Yes, it is possible to bend over even if you have a herniated disc, but the key is to do it at the right time and in a progressive manner. During the acute phase, avoid excessive bending, but reintroduce it gradually when the pain subsides. The most important thing is to stay active while listening to your body.

If you want to go further and benefit from an exercise program adapted to your condition, I offer my 21 day program against back pain, 100% free.

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