There was a brief period, after my surgery, when I flirted with the elliptical machine. It started when I showed up to physical therapy (which was an hour’s walk away), and the therapist stuck me on an elliptical for fifteen minutes. Hey, this must be good for me, I figured.
I started using the elliptical at the gym as well, thinking it would be a nice break from walking. Although the elliptical was boring, it was a different kind of boring from walking, which counted for something.
Unfortunately, my sciatic nerve did not accept the substitution, and my sciatica got worse. There were some major freak outs before I made the connection. Once I stopped using the elliptical, my pain level went down again.
But although I knew the elliptical made my sciatica worse, I didn’t know why. How exactly was it different from walking? Why did walking improve my pain, while the elliptical made it worse?
A Studied Answer
I’m a fan of Dr. Stuart McGill, and it turns out that he and a colleague, Dr. Janice Moreside, already looked into the issue. In 2012, they published the results of a study conducted on 40 healthy males, in which they evaluated the effects of using an elliptical on the low back.
Judging by the introduction, I was not the only one to have a problem with the elliptical:
“Anecdotally, there are mixed reviews as to the effect of the elliptical trainer on the lumbar spine. While some people use it regularly with no ill effects, others claim that it provokes low back pain.” (Moreside and McGill 2012)
The study subjects were measured and evaluated while walking, and then again on an elliptical. Since people use an elliptical in different ways, the researchers evaluated the effects of speed, stride length, and hand position.
Subjects were asked to find a comfortable speed on the elliptical, which was considered a normal speed. “Fast” meant 30% faster. The elliptical model they used allowed for stride lengths of 46–66 cm (18–26 in), and both extremes were tested.
In addition to the moving hand grips, this elliptical also came with two stationary, vertical bars at the front which participants could grab onto. Subjects were also encouraged to let go of all handholds from time to time so their freehand movements could be assessed.
Why Use an Elliptical at All?
Before we consider how using an elliptical compares to walking, it’s worth asking why anyone would prefer an elliptical in the first place. After all, walking is free, and requires no equipment. What’s the advantage of an elliptical?
If you’re recovering from an injury or illness, or otherwise have trouble walking unassisted, an elliptical might be a sensible choice. Because the hand grips are connected to the foot supports, people can use their upper body strength to help compensate for weakness in the calves and ankles.
If you follow the instructions, your foot will never leave the support pad, which can lessen the impact (and therefore, pain) for people with certain foot problems. It can also minimize the chance of falling.
Healthy people who are more interested in a good workout than in physical therapy often choose the elliptical because it’s more challenging for the butt and thighs.
How You Use It
Walking vs. elliptical training is decision number one. But once you get on the elliptical, you can move in different ways. You can hold on to the hand grips, grasp the bar in front of you, or let go of everything and let your hands go free.
You can go faster or slower, or keep alternating your pace. Some of the differences are constraints of the machine, which have different designs, and may offer adjustable stride lengths.
Your own body proportions matter as well. The same stride length may feel long or short depending on the length of your legs, and the position of the hand grips and horizontal bar require a different posture and positioning of limbs depending on your height and arm length.
Leaning Forward Hurts
Ellipticals are supposed to mimic gait, at least to an extent that’s helpful for training and rehabilitation. But the parallels obviously aren’t perfect.
When using an elliptical, you raise your knee higher with each step, and your back leg never sticks out as far behind you. You rely on your butt and thigh muscles more, and on your calf and ankle muscles less.
But for those with back problems, the most meaningful difference is the position of the pelvis and spine. On an elliptical, the pelvis tilts forward more, and people tend to lean their trunk forward more as well.
In the study, the men leaned forward at an angle of 5.4° when walking. While using an elliptical machine, this angle ranged from 8.8° to 12.3° depending on speed and hand position. Moving faster, or holding onto the front bar, increased forward lean.
This posture puts more pressure on the intervertebral discs, and can contribute to disc damage, as well as exacerbate pain in patients with an existing disc herniation.
Movement with a Twist
To make matters worse, each step on an elliptical requires a bit of a twist in the torso, which can also contribute to disc damage. The angles of rotation in the lumbar region were larger on the elliptical. When walking, participants averaged 14.8° of rotation. When using the elliptical, they averaged from 16.6° to 23.1°.
In general, there was less lumbar rotation when participants walked slowly and held on to the vertical bars in front. There was more lumbar rotation when people sped up, and let go of the bars. When people held the moving hand grips, their lumbar rotation increased even more.
This movement cycle of bending forward and twisting is repeated each time you take a step on the elliptical, and you can easily go through thousands of cycles during the course of a workout. This repetition only makes matters worse for your discs.
Side Bends
There was one area in which walking showed the greatest angles. This was side-to-side bending (think of swaying your hips). The average side-bending angle when walking was 11.5°. Averages on the elliptical ranged from 8.0° to 11.0°.
A person’s build mattered as well. The tall, long-legged men in the study leaned forward significantly more – the flexion angle for the 8 tallest men was 18.4°, compared to 9.4° for the 8 shortest men. However, the tall men also twisted their low back less (22.0° compared to 28.1° for the short men).
How to Use the Elliptical Wisely
If you are inclined to use an elliptical machine anyway (say, because your physical therapist sets you on one), how can you minimize the damage?
If you’re sensitive to flexion, then don’t hold onto the stationary bars, since this encourages you to lean forward more. However, if twisting provokes more pain, then holding onto the front bar might be a good idea, since it minimizes twist.
Holding onto the horizontal bar might also be prudent for those who are extension-intolerant, since it opens up the facet joints. (Although it does still stress the discs.)
Going faster and using longer stride lengths tend to increase forward flexion and twisting, so be judicious about intensity and speed.
Prior Training
Although this study was too small to evaluate other individual factors, the authors noted some interesting differences among participants which may result from sport-specific training.
One powerlifter showed lumbar rotation that was twice the group average, both when walking and using the elliptical. Although he was one of the shorter participants, he leaned forward more than average. He had a particularly small range of motion in the hips, and the authors speculated that this might cause him to adjust his movement patterns.
The authors also noted that men trained to play contact sports (such as football linemen) tend to lean forward when exercising, while runners tend to stand up straight.
Takeaways
The authors succinctly summarized the problem:
“Thus, the elliptical causes the spine to rotate through most of its available range of axial rotation but in an associated position of lumbar flexion, which may be problematic for individuals who are intolerant of repetitive flexion/rotation of the spine, such as those with lumbar discogenic disorders.”
That definitely explains my bad experience with the elliptical, as I’m sensitive to both bending forward and twisting. And I suppose my approach, which was to race like a horse in the Kentucky Derby, didn’t help matters.
So, I will stick to walking. At least it’s free.
You May Also Like:
- 7 Exercises to Avoid If You Have Sciatica
- New Study Asks, “How Well Do Epidural Injections Treat Sciatica?”
- Sitting and Back Pain: What’s the Connection?
References
- Burnfield, Judith M, Yu Shu, Thad Buster, and Adam Taylor. 2010. “Similarity of Joint Kinematics and Muscle Demands Between Elliptical Training and Walking: Implications for Practice.” Physical Therapy & Rehabilitation Journal (American Physical Therapy Association) 90 (2): 289–305. doi:10.2522/ptj.20090033.
- Moreside, Janice M, and Stuart M McGill. 2012. “How do elliptical machines differ from walking: A study of torso motion and muscle activity.” Clinical Biomechanics (Elsevier) 27 (7): 738–743. doi:10.1016/j.clinbiomech.2012.03.009.
