This article will summarize my clinical and personal experiences using the reverse hyper as it pertains to improving function of the lower body and the spine, especially strengthening and improving mobility of the lower back. I first discovered the reverse hyper, like many people, online via Youtube videos, through a Louie Simmons video sent to me by a friend. I was immediately intrigued when I first watched the video because I had never seen anything like it. Many people may not actually know what the reverse hyper is nor have they seen one, let alone tried it. If you haven’t, I recommend that you seek one out and try it out, because there’s really nothing out there that I’ve seen in over 15 years of high level training and work as a therapist that I’ve been able to compare it with.

The reverse hyper was invented by Louie Simmons to help powerlifters combat compression of the lower back during and after performing heavy training. Through trial and error he came up with this device, and developed it to heal himself from a severe lumbar injury that was supposed to require surgery. He never had that surgery and then went on to make a full recovery and eventually to set many powerlifting records, later patenting his design.

The hyper immediately engaged my interest because low back pain is such a frequent and serious problem. This is obviously apparent in the general population as well as specifically in my practice and the athletes that I work with. Recurring, chronic low back pain is a lower-tiered complaint for many people, who report it in a clinical setting even if that’s not their primary issue. The American Chiropractic Association reports that low back pain is the second leading reason for doctor's visits, and as many as 80% of Americans will suffer from it at some time in their lives. (See my last post on low back issues here for more on this.)

When I saw the device I knew that it was probably something that I would use to treat clients but wanted to try it out on myself first. I intentionally joined a gym that had this machine and I went through a steady protocol of dosing it and adapting to it, observing meanwhile how I felt and how I performed in strength and conditioning training.

I noticed after the third week, that doing it had become fairly easy where it had been fairly hard for my low back at first (though not painful). By week three I was also starting to feel a notable positive effect on my posture and on my strength, at the bottom of the squat position for example, and even, surprisingly, a reduction in thoraco-lumbar pain and CT junction stress. As a manual therapist the CT junction and the whole cervical thoracic region is a site of stress for me, and I felt that my posture and strength even there was improving through the use of the hyper.

I conclude that this machine does a few things extremely well. It’s simple but it’s also elegant in how much it can accomplish:

It creates traction of the vertebrae and the discs. This is key because traction on the vertebrae and opening up, tugging those apart essentially reduces the axial compression of the skeleton, and in doing so it draws hydration into each disc. A major part of combating aging and disc degeneration is movement and keeping the discs hydrated so they don’t become compressed and dried out.
It targets the intrinsic musculature of the spine. All of the transversospinalis group and also the ligaments that connect everything in the spine are positively influenced by it. It’s extremely difficult to really target, for example, the multifidus muscle which is a deep, deep muscle and a major postural stabilizer, but this machine seems to really get that for me and also in my patients.
It leads to enhanced glute and hamstring contraction. It seems to automatically produce a really powerful glute contraction, but more than that, more appropriately, I think, an overall extension reflex through the entire superficial back line. This extension reflex; coordinated contraction of the whole posterior chain, is something that I see becoming dulled over time as people go through years of sitting too much, or improper muscle recruitment patterns, or bad posture, or undergo disruptive injury.

I can’t definitively assert this but I hypothesize that putting someone on the reverse hyper and going through this position somewhat simulates when a child is learning how to crawl, and puts the body into that extended spinal position, which I think could be quite healing. It’s just a conjecture but it’s interesting to me to imagine how we can tap into that innate reflex from our developmental years.

Who should use this?

We will see particular benefit from the reverse hyper in several cases.

One is degenerative disc disease, where there is significant desiccation in the discs--there’s not enough space for the spinal segments to move, which will contribute to osteoarthritis of the spine and will create facet joint pain and jam. It will also shut off or de-emphasize the need for some of the stabilizing musculature like the multifidus, rotatores, and interspinous musculature to stay fully engaged. The hyper makes these important muscle groups work and re-engage.

This can also be used generally post training, for maintenance of a healthy spine. If you are squatting or dead lifting or doing anything with a a lot of jumping, things that do create a lot of axial load on the skeleton, using the reverse hyper after training is a good idea to keep your spine strong, even without an acute issue to address.

A lot of people get confused about the differences between a reverse hyper and a glute/hamstring bench or an inversion table. In reality they are completely different tools. The reverse hyper creates pressure into your abdominal cavity which is similar to what your transversus abdominis does.This pressure from the table up into your spine creates a stabilizing effect, and then you’re moving your hips with some spinal movement and that’s the power of it. You’re getting traction and decompression through movement and muscular co-contractions which is different than an inversion table, which merely attempts to lengthen the spine passively through use of gravity. Inversion tables are a different tool and mechanism which seems to produce less dramatic results.

The glute/ham machine can put unhelpful stress on the low back if you use it for back extensions. It does load the hamstrings and the glutes, but the spinal column isn’t stabilized, and this seems to produce more symptoms in many people who have low back problems/pain.

Contraindications for the RH:

Anyone with a rib injury. If you have rib injuries, lying on the table may apply too much pressure for comfort.
People with a pubic symphysis type problem or any groin injury, or a sports hernia, where the table is pushing up into the lower abdomen or the pubic region
Someone with osteoporosis--I wouldn’t necessarily recommend this in this case because of the potential compression on the ribs from the table.
Someone with a really hot low back. Having a flared up or acute disc injury is not a case where you want to get on a reverse hyper table without some supervision or without consulting with an expert beforehand.

How to use it:

A video instructional for the visually inclined!

The beginning phases require a conservative approach of learning the technique, adapting, and building up how much weight you put on. I think the typical progression would be to do 10-15 reps and 2-3 sets of that. You get up to where you can do 3 sets of 15 reps and then steadily increase your weight. I started out with 10 pounds, very, very light, and now I’ve worked up to doing 80-90 pounds, which is about 50-70% of my heaviest front squat. I’m not a heavy lifter but I do encounter a decent amount of spinal compression from running and jumping and plyometrics and I find that this really diminishes my low back symptoms pre- and post-training.

That’s a brief synopsis of the reverse hyper and what you can use it for and I hope you enjoy self-experimenting. Good luck and keep taking care of yourself.