CHAPTER 70 • MEDICATIONS AND ERGOGENICS 415
Gracovetsky S, Farfan H, Helleur C: The abdominal mechanism.
Spine10:317–324, 1985.
Hodges PW, Richardson CA: Feedforward contraction of trans-
verses abdominus is not influenced by the direction of the arm
movement. Exp Brain Res114:362–370, 1997.
Hodges PW, Butler JE et al: Contraction of the human diaphragm
during rapid postural adjustments. J Physiol505:539–548,
1997.
McGill SM, Norman RW: Reassessment of the role of intra-
abdominal pressure in spinal compression. Ergonomics
30:1565–1588, 1987.
Morris JM, Lucas DM, Bresler B: Role of the trunk in the stabil-
ity of the spine. J Bone Joint Surg (Am) 43:327–351, 1961.
Oddsson L: Control of voluntary trunk movements in man: mech-
anisms for postural equilibrium in standing. Acta Physiol Scan
Suppl140:595, 1990.
Panjabi MM: The stabilizing system of the spine. Part 1.
Function, dysfunction, adaptation, and enhancement. J Spinal
Disord5;383–389, 1991.
Panjabi MM: The stabilizing system of the spine. Part II. Neutral
zone and stability hypothesis. J Spinal Disord5:390–397,
1992.
Richardson C, Jull G, Hodges P, et al: Therapeutic Exercise for
Spinal Segmental Stabilization in Low Back Pain. Edinburgh,
Churchill Livingstone, 1999.
Sapsford RR, Hodges PW, Richardson CA e et al: Co-activation
of the abdominal and pelvic floor muscles during voluntary
exercise. Neurourol Urodyn 20:31–42, 2001.
Solomonow M, Zhou BH et al: The ligamento-muscular stabiliz-
ing system of the spine. Spine23:2552–2562, 1998.
Steffen R, Nolte P, Pingel TH: Importance of back muscles in
rehabilitation of postoperative lumber instability; a biome-
chanical analysis. Rehabil(Stutt) 33;164–170, 1994.
Wilke HJ, Steffen W, Claes LE et al: Stability increase of the
lumbar spine with different muscle groups. A biomechanical in
vitro study. Spine20:192–198, 1995.
BIBLIOGRAPHY
Arokoski JP, Kankaanpaa M, Valta T et al: Back and hip extensor
muscle function during therapeutic exercises. Arch Phys Med
Rehabil 80(7):842–850, 1999.
Hides JA, Richardson CA, Jull GA: Multifidus muscle recovery
is not automatic after resolution of acute, first-episode low
back pain. Spine21(23):2763–2769, 1996.
Hodges P, Richardson C: Insufficient muscular stabilization of
the lumbar spine associated with low back pain: a motor con-
trol evaluation of transversus abdominis. Spine21:2640–2650,
1996.
Hodges PW, Richardson CA: Delayed postural contraction of
transversus abdominus in low back pain associated with move-
ment of the lumber spine. J spinal Disord11(1):46–56, 1998.
Leinonen V, Kankaanpaa M, Airaksinen O et al: Back and hip
extensor activities during trunk flexion/extension; effects of
low back pain and rehabilitation. Arch Phys med Rehabil
81(1):32–37, 2000.
Luoto S, Taimela S, Hurri H et al: Mechanisms explaining the
association between low back trouble and deficits in informa-
tion processing. A controlled follow-up study. Spine21:2621–
2627.
Luoto S, Aalto H, Taimela S et al: One-footed and externally dis-
turbed two-footed postural control in chronic low back pain
patients and healthy controls. A controlled study with follow
up. Spine23:2081–2090, 1998.
Luoto S, Taimela S, Hurri H et al: Mechanisms explaining the
association between low back touble and deficits in informa-
tion processing. A controlled study with follow up. Spine
24(3):255–261, 1999.
Panjabi MM: Lumbar spine instability: a biomechanical chal-
lenge. Curr Orthop8:100–105, 1994.
Taimela S, Harkapaa K: Strength, mobility, their changes and
pain reduction during active functional restoration for chronic
low back disorders. J Spinal Disord9:306–312, 1996.
Taimela S, Kankaanpaa M, Luoto S: The effect of lumbar fatigue
on the ability to sense a change in lumbar position. A con-
trolled study. Spine249(3):1322–1327, 1999.
70 MEDICATIONS AND
ERGOGENICS
Scott B Flinn, MD
OVERVIEW
- Many athletes self medicate without medical supervi-
sion using both traditional medications and ergogenic
aids. Commonly used medications include anti-inflam-
matory medications used to limit pain and inflamma-
tion and presumably speed healing from injury. In
overuse injuries, both oral medications and corticos-
teroid injections are used. Additionally, ergogenic aids
are used in an attempt to develop optimal performance
as well as to prevent and heal injuries.
MEDICATIONS
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
- Nonsteroidal anti-inflammatory drugs(NSAIDs) are
commonly used to treat both acute and chronic
injuries.
•Over 50 million people in the United States take daily
prescription NSAIDs, with over 100 million Americans
using prescription NSAIDs during a year (Simon and
Smith, 1998).