Thursday, 24 January 2013

The Flip Side of Inversion Tables


Earlier this week I was at my neighbourhood Globo Gym (reference from the movie Dodgeball), when I saw a personal trainer put what looked like a 65 year old man with a stenotic antalgic posture onto an inversion table.  Now I have to admit I have limited use/knowledge of these tables so my curiosity took over and I was hooked.  The grey haired, over weight man was strapped onto the table and then without hesitation he was flipped 180 degrees to weightless tranquility… right?  Well, probably not.  As I continued to ride nowhere on my stationary bike I watched the man go all the way up and then back to the inverted position every few minutes for multiple reps until he was literally red in the face.  That, my friends, is the reason I asked myself, what happens your body when you are flipped upside down?




I searched the databases for academic research on the effects of inversion therapy on the lumbar spine (low back) and the cardiovascular system.  The first thing I realized was that inversion tables were all the rage in the 1980's as not much research has been done since.

I found one study that took x-rays of the low back while the subjects were standing and a second x-ray while the subjects were inverted.  The study did not use an inversion table, instead the authors made an inversion harness that was suspended from what looked like a chin up bar.  Let me tell you, the inversion table that I saw at the gym looked much more comfortable than this contraption.  Anyways, the authors noted an increase in both anterior and posterior disc spaces, with a 31mm total increase in distance from the L1-S1 vertebrae in patients with disc injury, and a 23mm total increase in the same distance in healthy subjects.  This means that there is an increase in disc space while inverted.  However, when you are lying on your back there is 75% less compression in the low back compared to standing.  So, does being inverted decrease the compressive force in your spine more significantly than simply lying on your back?  A newer study compared MRI images of the supine position (lying on your back) to that of standing.  What they found was when supine the posterior disc spaces open while the anterior disc space lessens.  However, the first study noted increases in both the anterior and posterior disc space, therefore there maybe further benefit using inversion tables compared to simply lying on your back.

The second reason for digging into this topic was to find out the increased stress placed on the body while inverted, and to see if increases are time dependant or not.  The first thing I found was that heart rate does not increase.  However, there are significant increases in systolic blood pressure (ie. The “120” in the 120/80 measure) and the pressure in the eyes.  It is important to know that both of these measures do not increase significantly from 2.5 minutes of inversion to 5 minutes of inversion.  In essence, the increased strain has reached maximum significance by 2.5 minutes.  I did not find a study that looks at the effects beyond 5 minutes.  The other variable that plays no effect on the increase of blood pressure and or eye pressure is the type of inversion used.  Whether you are suspended from your thighs, knees or ankles, they all lead to the increased pressures.  

Now going back to the Globo Gym story, maybe the inversion table was helping the man, as many report personal success stories with this therapy.  My biggest concern was the trainer’s apparent lack of knowledge of the stress placed on the body when flipped immediately upside down.   Although, this is an in-home therapy that any Joe Schmoe can perform, I’m sure somewhere in the instruction manual it says something about progressive inversion to limit the immediate strain on your body, even if you are an inversion veteran. 

So, if you have the chance to try out an inversion table, remember there is no rush to go completely inverted, as slight inversion may yield positive benefit without putting rapid strain on your body!



Until next time, stay healthy my friends.


Dr. Adam

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