We aimed to determine whether beneficial effects on the IVD of exercise can be seen in humans and what loading patterns this might entail. However, directly applying loading thresholds and protocols from animal models to humans is problematic 12 and there is no evidence yet 9 of a beneficial effect of exercise on the IVD in humans.
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Quadrupedal treadmill running exercise in rodents 10, 11 can have a positive impact on the rodent IVD. Given human data on intra-discal pressures in different activities 8, this could 9 be extrapolated to suggest that walking or running exercise is likely anabolic for the IVD. These models suggest 7 that a “likely anabolic loading window” for the IVD exists: dynamic loading of 0.2–0.8 MPa, generating intra-discal pressures of approximately 0.3–1.2 MPa, at 0.1 to 1 Hz for approximately eight hours a day. Furthermore, data 6 on turnover rates in the IVD, lead to the assumption that positive adaptation in the mature IVD is unlikely to occur during the normal human lifespan.Ĭurrently we rely on data from animal, IVD cell and IVD tissue models to suggest what kind of loading might be beneficial for the human lumbar IVD. Whilst this information can inform what activities people should avoid to preserve IVD integrity, it does not inform us on exercise or habitual physical activity to “strengthen” the IVD.
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We have good knowledge of loading types that are more likely to damage lumbar IVD tissue in humans, such as flexion of the spine with compression 3, torsion 4 or to damage to the vertebral end-plate via axial compression 3 with subsequent IVD degeneration 5. For the intervertebral disc (IVD), little is known about what loading protocols are beneficial for IVD tissue and cause anabolism in humans. In the intervening years, evidence 2 has been obtained as to which loading protocols are beneficial (osteogenic) for bone. Wolff 1 described the theory of bone adaptation to loading. We expect that tissues will adapt to loads placed upon them. We anticipate that our findings will be a starting point to better define exercise protocols and physical activity profiles for IVD anabolism in humans. These findings represent the first evidence in humans that exercise can be beneficial for the IVD and provide support for the notion that specific exercise protocols may improve IVD material properties in the spine. Via quantitative assessment of physical activity we further find that accelerations at fast walking and slow running (2 m/s), but not high-impact tasks, lower intensity walking or static positions, correlated to positive IVD characteristics. Here we show that chronic running exercise in men and women is associated with better IVD composition (hydration and proteoglycan content) and with IVD hypertrophy. Some authors have argued that IVD metabolism in humans is too slow to respond anabolically to exercise within the human lifespan. There is currently no evidence that the intervertebral discs (IVDs) can respond positively to exercise in humans.