Episode 7 - Damned Lies and Statistics

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Recently on the social media platform LinkedIn I saw a post put up by someone who I believe was an orthopedic surgeon. He had on his post  an image of a patient’s spine after they had had spinal fusion surgery. This is where rods and screws - and usually bone grafts - are implanted around two or more bones of the spine to reinforce that structure. It’s a risky procedure, despite many brilliant advances in the technology, and requires quite a significant rehab phase. The cervical and lumbar sections of the spine are common surgical sites, as these parts of the back are more vulnerable to injury - the lumbar spine being the main load-bearing structure of the back, and the cervical spine being the most mobile and least supported structure of that spinal column. Outcomes for this surgery are usually pretty good. More often than not patients will see reductions in pain, if at the sake of mobility. However, spinal fusion can increase the risk of pain from future osteoarthritis in the spine. The lack of mobility at the fused site can increase the stress put on other parts of the spine, thus accelerating osteoarthritis. And the site of the surgery itself can also degenerate over time, increasing the risk of further structural degeneration. Spinal fusion should always be thought of as a last resort - when pain becomes intolerable, and other options have been exhausted. So, the image was attached to a comment by the surgeon. To paraphrase, he stated that kettlebell exercises and weightlifting were BAD for the spine, and he advised any and all people he encountered to ONLY ENGAGE IN AEROBIC EXERCISE. He noted that the image shown in his post was from an older man who was swinging kettlebells for health and fitness, who had gone on to have a serious injury, thus requiring a major spinal fusion. Again. Weightlifting bad. Cardio good. End of story.

Further reading: 

Fragala, M., et al. (2019) Resistance training for older adults: Position statement from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research 33(8):p 2019-2052, August. DOI: 10.1519/JSC.0000000000003230

Izquierdo, M., Merchant, R.A., Morley, J.E. et al. (2021) International exercise recommendations in older adults (ICFSR): Expert consensus guidelines. J Nutr Health Aging 25, 824–853. https://doi.org/10.1007/s12603-021-1665-8

Rodrigues, F., Domingos, C., Monteiro, D., & Morouço, P. (2022). A review on aging, sarcopenia, falls, and resistance training in community-dwelling older adults. International Journal of Environmental Research and Public Health, 19(2), 874. https://doi.org/10.3390/ijerph19020874