While there seem to be many plausible arguments in favor of some lumbar flexion, there are many effective arguments against it’s use in your program design.  As I presented many arguments used to support it’s use, I’ll give you the refutations from the anti-flexion camp.

1.  “Flexion hydrates disks and brings nutrition.”

While this is true, there are many ways to change interdiskal pressures without putting the spine at risk.  We should understand that proper breathing cycles alter interdiskal pressures effectively enough to allow efficient transfer of nutrition to avascular disks.  Additionally, we know that the anterior fibers of the psoas insert on all lumbar disks saving L5-S1, and facilitated contraction of the psoas leads to compression of the lumbar spine and anterior shear providing the same benefit as flexion exercise.  Bogduk also shows that contraction of the psoas produces flexion in the inferior disks and extension in the upper disks as well.

2.  “Stress without distress is useful in stronger, healthier disks”

I can agree that this is true, but at the same time, do we have better options to achieve the same result than programmed lumbar flexion?

3.  “Combined motion into flexion and rotation is most deleterious to disk health”

There is no argument here, but does that make flexion a safe option?  Not necessarily.  They still use repetitive flexion and extension in the lab to rupture intervertebral disks, and I have a hard time believing that simply because it is not combined with additional rotation that it is a safe option.  Likewise, if an athlete has hypertonic or short psoas on one side, you run the risk of piling flexion onto rotation making the situation that much more harmful.  A smart assessment may help prevent this risk, but it is still a risk.

4.  “Well I’ve done sit ups for years and never had a problem”

While this may be the case, your population is N=1.  It only takes one client to change your opinion, however.  This argument shows the limitation of research.  While it is very good at telling you what will happen to a group of 100 people, it cannot tell you which people of the 100 will experience disk problems.  If you work with enough people and train flexion, you will ultimately create problems.

5.  “Sport happens in flexed positions”

In the words of Mike Boyle, if a football player is on his back, he’s not very good at the sport.  That said, even in sports like wrestling and MMA where more work on the floor occurs, it still doesn’t make sense to use flexion based exercise.  Do sit ups really translate to increased punch power in supine?  Additionally, as Sahrmann notes in her book, the assumption that participation sporting activity results in healthy and highly functional athletes is somewhat fault.  My good friend and physical therapist, Chris Nentarz, sees sports as a double edged sword.  Yes, they are “healthy” but at the same time they develop and contribute to relatively predictable levels of dysfunction that training should alter not reinforce.

Whether or not you choose to program in flexion based exercise is definitely your choice, however, I do not go out of my way to do so in a traditional manner because I feel that the benefits of flexion can be achieved in better, more functional environments.  I believe that the total restriction of flexion to be a bit extreme, but I also believe that flexion occurs enough residually in some of our exercise selections that I need not incorporate focused flexion training.

As with anything, if you do, be sure you can defend it.

Best regards,

Carson Boddicker