My Perspective on the MedX Core Stabilisation System
By Richard Newton (Founder of Pindara Physiotherapy Clinic)
As a Physiotherapist with a special interest in back pain (especially chronic or long term back pain) and with a desire to achieve good, long term results for my clients in a short period of time, the MedX Core Spinal System is interesting for a number of reasons.
For me to be comfortable with any approach, it has to tick a number of boxes.
Is it evidence based?
These days the medical profession demands evidence based practice, i.e. well conducted research showing true benefits to our patients. There are thousands of supposed "cures" for back pain, but at the top of the tree in the evidence-based approaches is "supervised exercise programmes".
The Australian Physiotherapy Associations "Position Statement" on management of chronic low back pain states, "Supervised exercise programs are strongly recommended in the treatment of low back pain." The MedX system is exactly this. a supervised exercise programme, and as such, fits in perfectly with these evidence-based guidelines.
There are many studies published in respected peer review journals such as "Spine" showing the benefits of exercising on the MedX Spinal Stability System, so you can be assured that the MedX Core Spinal System will deliver what we say it will.
How does it "feel"?
I like to feel things for myself. If I am going to recommend something for my patients, I have to have a good "feel" for what it is like and be able to match this "feel" to different demands of different clients. The demands of an 80-year-old patient with an arthritic spine are quite different to that of a 25-year-old athlete with chronic back pain. Because of the design of the MedX machines, we are able to exercise both the high end and the low end of the scale with equal effectiveness.
I have looked at a range of back strengthening systems and exercises over many years. One of the major determinants of successful rehab is good lower back strength. Here is my take on all of those:
Swiss or Exercise Ball - Now don't get me wrong, I love the ball and still teach a class of this every week and for some "extra" work at home for those who are keen it is great, but. my older clients can't get on and off the floor easily and even the five basic positions are too much for many of my weaker clients - no such problems with MedX - easy access to all the machines and because of our low starting weight and lower coefficient of friction, it is very easy to do.
For the athletes and active workers, MedX works the all important posterior chain like no other. 15-20 minutes on the ball still doesn't target the lumbar extensors as well as the MedX lumbar extension machine. The extensors simply work harder on the MedX and part of this is because of the restraint system taking the legs out of the picture.
You can certainly try this for yourself. Please come and do a whole Swiss ball class and then try the MedX lumbar extension machine. There is no comparison and feel, with a much higher level of targeting with the MedX.
The next aspect is rotational movement. In cases of lumbar instability, the current thinking is that it is the rotational component that is the "unstable" component. We need this to be controlled by a good rotator muscle function. Rotational movements on the ball just don't load the rotators to anywhere near the same. It is just too low key and quite difficult from a balance perspective.
Most people injure their backs flexing (bending forward) with a small rotational component. The classic statement is "I just bent down to .. and felt it go!" We have also tried to set up rotational strengthening work with rubber tubing attached to poles etc, but still it is nothing like the MedX core rotation.
What about Pilates? - Isn't that about "core strength"? Well yes and like the ball it is and does work well in some cases. But again, getting isolated loads to strengthen the core is difficult as all the exercises involve arms and legs to a degree, so we question if the "core strength" is happening or just increased arm and leg strength.
Certainly from a flexibility viewpoint Pilates is great, but again needs to be properly targeted by a Physiotherapist skilled in back pain management, not just skilled in Pilates. Again, for some of our older clients, Pilates is just difficult to do and for our athletes they just don't feel the loads are high enough to meet the demands of their sport or physical job.
What about more traditional gym work?
There are a number of design differences with the MedX Medical Exercise Machines versus conventional gym machines.
Low start weight: MedX Machines have a very low start weight so we are able to start people with spinal problems earlier in rehabilitation without aggravation. Weight can be increased 2 pounds at a time, simply by inserting a pin.
Safer Movement: Every element of the machine's drive train is designed to achieve vertical weight stack movement of only one foot on a full-range repetition; about half of what other equipment produces, reducing inertia and enhancing safety.
Low-Friction: Eliminating friction-inducing weight stack guide rods, and using high quality ball bearings throughout the machine produces a very low coefficient of friction. This produces a movement that is exceptionally smooth, which is very important for rehabilitation. MedX is simply unmatched in this regard by any other gym equipment I've tested and tried.
Patented Compound Weight Stack: Base plates of 20 pounds each combine with the upper stack of nine 2-pound plates to accommodate both gradual increases and depending on the exercise up to 1,200 pounds of total resistance. What this simply means is that using MedX Medical Exercise Machines we can exercise a 90 year old with arthritis problems who we need to be careful with just as easily as a 25 year old. elite athlete who wants more of a challenge to meet the demands of his work or sport.
Patented Restraint Mechanisms: Most conventional strength work for the all-important posterior chain has a large contribution from the glutes (buttock muscles) and hamstrings. Quite often the result is the glutes and hamstrings get stronger, but the back remains weak. The restraint mechanisms lock out and take out assistance from the legs and hips, so the core muscles are isolated which increases stability and allows specific, intensive and effective strengthening.
As Physiotherapists we have a simple test for measuring back endurance called the Beiring Sorenson Test which tests the endurance capability of this posterior chain and it is interesting that most patients comment that it is often their legs that give out before their back in this endurance test.
Biomechanics: The other thing to consider is biomechanics. In traditional gym work you are lifting the same weight through the entire range and as such, it follows that you can only lift what the weakest part of the range can tolerate.
The designs of the MedX machines are quite unique. They work on a "cam". This "cam" means the weight varies throughout the entire range. It is lighter in the weakest part of the range and heavier in the strongest part of the range. These are called resistance curves and are matched to tested and proven strength profiles.
The Way You Train
All this means the MedX Equipment is incredibly efficient, requiring just one set of 10 - 15 repetitions per exercise. As the muscles are loaded optimally throughout the range of motion, no more than that is required for muscle strength stimulation. Free-weights, on the other hand, are also effective, but require more sets of repetitions per exercise - barbells etc, are simply not as efficient in eliciting strength gains under the same time frame as MedX.
It is not only the machines themselves, but also the specific way you train on the MedX machines that makes the big difference here. For those of you who have done more traditional gym work you will notice the difference in the speed of movement on a MedX training session. It is much, much slower than traditional gym work. It is this "time under tension" which is the critical factor. This builds not only strength, but high levels of endurance also. Research shows that "endurance" may be more important than overall strength when it comes to back pain.
To do 10 slow reps on the MedX equipment, which takes out all the inertia and makes you work slowly through the whole range, may take 4-5 minutes, whereas a number of sets on traditional gym work may take the same time. Simply, it is just not as efficient as the time under tension in reality is very small.
To progress with MedX you simply increase the intensity of the exercises you're doing by lifting a little more weight as you become stronger. This leads to more efficient training and therefore more rapid results.
Speaking of results...
Our Patient Results
We have been assessing the results of the MedX since August 2007 and have put hundreds of people through this system over this time. I must admit I treat most things with a healthy degree of scepticism these days, as I have been disappointed by different treatment aspects in the past, but certainly not this time. Quite simply we have had some sensational results and often with people I didn't think it would actually work with. To put it quite succinctly I've been pleasantly surprised!
Is it going to help everyone? Simply, no technique will ever work with everyone but with a combination of a home flexibility exercise programme designed specifically for you, an additional functional and stabilisation effect provided by the MedX Core Spinal System, we believe this is going to give us the best chance of a good response.
So essentially, MedX really does tick all the boxes for me. It is strongly evidence based and feels better than anything else I have tried over a long time frame, it also has a number of design and programme implementation advantages and the patient results for me are there.
As such, we encourage anyone with some longstanding back pain to go through a full assessment by one of our Physiotherapy team to assess your suitability for the programme and also to establish a working diagnosis and home exercise programme and with the additional core spinal stability provided by the MedX, I strongly believe you will achieve superior results to any other method out there.
Please feel free to have a chat with your Physiotherapist at any time about any particular questions you have with regards to your rehabilitation programme.
APA SPORTS PHYSIOTHERAPIST
PAIN MANAGEMENT CONSULTANT
FOUNDER AND DIRECTOR PINDARA PHYSIOTHERAPY and SPORTS MEDICINE
How long does it take?
We have found, based on both research and our own experience, that it takes 2 sessions per week for 12 weeks to achieve good results. This time frame allows for both specific changes in the muscle (more muscle fibres/ bigger muscle fibres/ lower fatty content in the muscle itself) as well as improved neural outflow (the ability of your nerve system including your brain, spinal cord and peripheral nerves to become more efficient at "firing" the core muscles).
After this time, you may be able to maintain your strength gains on a reduced program or a home program.
A simple test to see if you can still "hit the numbers" achieved at the end of the 8 week program (which can be done any time after the 8 weeks) will tell you whether you need to have a few "top up" sessions to get back on track.
The simple test mentioned above can be done for free for 12 months after the completion of the program.
Don't forget as the program is designed and monitored by your Physiotherapist (and supervised on your Physiotherapist's behalf by our MedX trained staff) you can claim these sessions back on your private health insurance, which makes the program very affordable.
Phone 07 5539 4484 Now to Make Your Appointment