Jeff Langmaid argues that telling patients to keep their back straight can reinforce fear and harmful beliefs. Fear-driven stiffness and over-bracing increase spinal compressive forces and fatigue, making patients more vulnerable over time.
Another clinical insight that I gleamed from this was telling patients to quote unquote keep their back straight may reinforce harmful beliefs. The occupational lifters in this study had sky high fear scores and most of that was probably due to their training around neutral spine and don't bend. Now I'm not saying to be flippant about how you encourage people to lift safely, but you have to frame things in context because they don't have your patients, by definition 99.9% of them don't have the education that you have. So just choosing the words, your context and framing for how you go about rehab, for how you educate your patients is really important to how they translate that into their life. And the clinical insight number four that I took away was really that fear driven stiffness increases spinal load. So over bracing actually can increase the compressive forces and fatigue. So trying to use these protection mechanisms they might be making themselves more vulnerable over time.
