There are plenty of questions that come up when first learning about inversion therapy and this page is here to help make sense of it all. These are the most common questions regarding inversion therapy for spinal decompression and back pain. As always, you should consult your health care professionals before making the decision to invert.
Inversion therapy can be helpful in many cases of back pain, sciatica, and neck pain, but if you have knee, ankle, or hip problems then inversion therapy may not be for you. If you aren’t sure if inversion therapy is something you should try, you should seek professional advice.
1. How long should I invert?
The most commonly asked question about inversion is ‘how long should I be inverted?’. There is no specific answer that works for everyone because each person is different. For the most part, we recommend beginners to start very slowly: invert for just a minute or two during the first week until you become comfortable, and then work up to longer periods of time inverted, if you feel it’s necessary. The angle of inversion also affects the length of inversion time. The shallower the angle, the longer the inversion time. Most people will invert for 5 – 15 minutes once or twice each day. There is no real time limit — but it’s important to listen to your body. If you’re uncomfortable, return to the upright position.
Virtually all issues of discomfort that occur with new invertees are due to going too far or too fast. Amazingly, you are designed to be upside down, but if you are like most people you are not used to it. Just listen to your body, increase your length of time spent inverted only as you feel comfortable with it.
2. To what degree should I invert?
Again, the answer is unique to the individual. Beginners should start at approximately 20-30 degrees beyond horizontal for the first couple weeks until they become comfortable with the operation of the table and are able to completely relax while being inverted.
20 – 30 degrees
At this angle, your body begins to experience mild stretching of your muscles and joints, while benefiting from stimulated circulation, improved oxygen flow to the head, and repositioning of internal organs.
60 degrees (parallel with the rear legs of the table)
This is the angle at which the average person experiences virtually all the benefits of inversion. Your spine receives the amount of traction it needs to completely decompress (once you’ve relaxed). Most people don’t really need to go beyond this angle.
90 degrees (full inversion)
When fully inverted, your body hangs freely and can perform inverted exercises and stretches. You don’t really need to go to full inversion if you are not comfortable with it. Of course, if you’re using the EZ-Up Inversion System or Inversion Bar you will only be able to be fully inverted. You may need to switch between inverting and resting with your hands on the foam grips until you are used to the feeling of prolonged inversion. You might also want to hang for brief periods of time to start with until you become more comfortable.
Athletes are one group that may enjoy the extra traction and go fully inverted. Strong muscles and ligaments need heavier loads to decompress. Intermittent traction / Oscillation Intermittent traction (alternating 20-30 seconds inversion with returning upright) or oscillation (rhythmic rocking back and forth) are actually the “preferred” methods of inversion, recommended by many doctors, for stimulating circulation and waste removal in and around injured discs.
3. Does inversion cause strokes / popped blood vessels?
A medical study published in 1983 by Dr. Goldman and colleagues showed that inverted patients experienced an increase in blood pressure and internal eye pressure. The media widely reported the study, warning that stroke was a potential result of inversion.
Two years after the original inversion study, Dr. Goldman switched his original position, saying, “New research shows that you are at no more of a stroke risk hanging upside down than if you are exercising right side up.” More in-depth research found that the body actually has mechanisms that prevent damage from hanging upside down. In fact, while oscillating (inverting with movement), some of the patients’ blood pressure actually dropped a few points. (*Note: these studies were based on patients in generally good health. Make sure you review contraindications prior to inverting.)
Dr. Goldman stated that the warnings to the public about the dangers of inversion were “grossly inflated” and that “in the 15 years these devices have been in use, there has not been one single stroke case reported, or any serious injuries.” (This statement, to the best of our knowledge, is as true today as when Dr. Goldman made it 17 years ago).
Other universities, including Marquette, Iowa, and Portland studied inversion during this time, with results that also helped to vindicate inversion as a healthy physical activity.
4. Why do I feel so much pressure in my head? is it normal to turn red?
This is very normal and actually is good for you, indicating increased blood flow to the brain, eyes, skin and hair. One preliminary study showed that the brain runs 7% faster and 14% more accurate while inverted! The feeling of pressure usually lessens over time as you become accustomed to inverting.
If you are a beginner and are uncomfortable with this feeling, it is OK to come up and rest a while. This is referred to as “intermittent” traction (alternating inversion with being upright) and is a good way to help get used to the inverted world. You can also try “oscillation” which is a rhythmic rocking back and forth.
5. How do I focus on the lower back / upper back / neck region?
Inversion is a natural form of gravity-assisted traction. This means that the amount of traction applied to various locations of the body is exactly the right amount! Every vertebra and related disc is just the right size to support the weight above it. The large discs in the lower back are the right size to support the 60% body weight that is above them. The small discs in the neck are just the right size to support the weight of the head. When inverted, the weight normally supported is just the right weight to apply traction.
Gentle stretching and exercise is beneficial to help decompress and mobilize the spine:
Lower back
You may perform gentle stretching exercises to help move the muscles and connective tissues in the lower back area. In partial inversion, try rotating gently from side-to-side, or slowly rocking your pelvis forward and backward.
If you have worked up to full inversion, abdominal exercises (sit-ups, crunches) can be beneficial to the lower back, since strong abdominal muscles are key for proper posture. On the inversion tables, you can try a gentle back extension by placing your hands behind your head on the bed frame and pushing your body in an arch away from the table.
Upper back
Many people experience upper back pain as a result of stress and muscle tension. The key to relieving this pain is to totally relax while inverting. Try deep breathing exercises. Also, partner work can be beneficial. Nothing is more relaxing than an inverted back and shoulder massage!
Movement is also very beneficial. Try rounding your shoulders forward and pushing them back. Also, stretch one arm at a time across your torso to extend those upper back muscles.
Neck
Again, movement can be beneficial. Try rotating your head from one side to the other. Partner massages to the base of the head and back of the neck are very relaxing (do not apply pressure to the front of the neck). You can also add gentle inverted traction to your neck by resting your arms behind your head at the base of your skull (don’t pull, just add the weight of your arms).
6. What exercises do you recommend while inverted?
Partial inversion
Gentle stretching can be performed while partially inverted by crossing one arm over your body, gripping the opposite side of the table frame, and rotating up on one shoulder for a stretch. You can also arch the torso from side to side to loosen muscles and to help the mid- and lower spine to stretch.
Similarly, stress in the neck can be relieved by gently rotating the head to either side, plus lifting the head (do not sit up, only lift the head) or pushing back against the nylon cover while lifting the shoulders off the cover for a stretch in extension.
Full inversion
Only perform these exercises when you are comfortable with being fully inverted. Do not overdue it-as with any exercise to which your body is unaccustomed, you may experience sore muscles if you do too much too fast.
Inverted crunches
Place your hands on your chest or behind your head and lift your torso half way to your knees.
Full sit-ups
This is the only way to perform a full sit-up that is safe for your back. Your spine is in line with gravity, so the full sit-up does not place a harmful load on the back. Place your hands behind your head or on your chest. Sit up all the way to your knees. You may need to place your hands behind your knees to help pull yourself up to a full sit up. Some people claim that 1 full inverted sit-up is as difficult as 10 regular sit-ups (without the strain on your back!)
Inverted squats
On the tables and racks, you are able to exercise your legs as well! You may want to steady yourself by placing each hand on the rear legs of the A-frame. Bend your knees and lift your entire body toward the sky. This action is similar to a standing squat, except that you are utilizing your leg muscles to pull your body weight up instead of resisting your body weight.
Rotational stretching
You can use the A-frame, support structure or doorframes to aid with stretching. Reach with one arm to the opposite side of the structure and pull, rotating your torso to one side. Do the same with the opposite arm.
Back extensions
For the inversion table, reach your hands over each shoulder and grab onto the bed frame. Push your body out away from the bed, arching your back. (Do not use the rear legs of the A-frame for extensions, as that may place your body weight outside the safe support area of the A-frame).
Added traction
On the inversion table, reach your hands forward and grab onto the crossbar of the A-frame. Pull gently to feel added traction to your lower back.
THE MOST IMPORTANT THING TO REMEMBER IS NOT TO OVERDO IT. INVERSION IS NOT A “NO PAIN, NO GAIN” SITUATION. AS SOON AS YOU FEEL LIKE YOU HAVE HAD ENOUGH, STOP!
7. I’m feeling some aching in my back when I return upright from inverting. Is this normal?
There could be several causes for this.
You did too much too soon: If you are new to inversion, your body is not used to being inverted (chances are you haven’t hung upside down since 2nd grade!) By inverting too much too soon, you are probably going to be a little sore. You can liken inversion to beginning any new exercise program. If you overdo it on the first day, you will probably pay for it later!
You returned upright too fast: When inverted, your vertebrae have a chance to separate and the discs can decompress. This action reduces pressure on the nerves that run through your spinal column. When you ascend (return upright) on the inversion table, your spine “re-compresses”–the vertebrae return to their normal position and the pressure on the discs increases again. If you come up from inversion too fast, you might place sudden pressure on the nerves that run through the spine, which can cause some pain. Instead, you should invert to a mild angle (30-40 degrees) for just a few minutes. Come back up only to the horizontal position (lying flat). Remain horizontal for several minutes to allow your spine to slowly re-compress. Then slowly come up the rest of the way.
Always keep in mind that if you experience extreme pain, or if you always experience pain while inverting, you should discontinue inversion until you have had a chance to talk with your doctor.
8. Is the inverting detrimental if you have heart disease or high blood pressure?
It is true that people should not invert if they have uncontrolled high blood pressure. However, inversion can cause a state of relaxation that results in a drop in heart rate and BP (sometimes even lower than at a resting state). Some doctors have used inversion as a treatment for high BP. If you have concerns, you should check with your doctor before inverting.
9. Will inversion therapy help with a bulged disc?
When inverted, the natural pull of gravity allows a separation of your vertebrae, which lessens the pressure on the discs in between each vertebra. The action of increasing the space margins between the vertebrae can actually create a mild suction in the disc, which may help encourage the bulged disc to return to its proper place.
The main benefits are realized by increased circulation and waste elimination to injured discs. In the opinion of many medical professionals, several sessions of intermittent traction are the best way to help the body dissolve a bulged disc.
The length of healing time will vary with different people. However, it has been our experience that you should hang three or more times every day for short sessions at an angle most comfortable for you. Do not overdo it… this is not a “no pain, no gain” situation.
10. Will inversion help with headaches or migraines?
Some people have found that inverting on a regular basis can actually help reduce the frequency of migraines. However, we do not have any medical studies to specifically support this claim. I would advise not to invert while experiencing a migraine, as it could potentially worsen the headache.
11. Will inversion therapy help with draining blood from the lower limbs?
When inverted, you are helping your heart move venous blood from your legs and torso to the heart and liver to be purified. Inversion also helps to move fresh, oxygen rich blood from your heart and lungs to your upper body and brain.
When a muscle contracts, this squeezes capillaries and slows removal of wastes from the muscle. Sustained muscle contraction due to stress or cramping causes wastes to accumulate in the tissue and this produces pain. What inversion does for muscles is two-fold: first, it stretches and relaxes them; second, gravity helps the lymph system to clear out the pain-producing toxins trapped in the tensed muscles.
By stimulating circulation, inversion has been known to relieve varicose veins. Varicose veins are caused when blood pools in the veins due to weakened one-way valves. The downward pull of gravity causes blood to slip back, and over time the vein will distend and become painful. When inverting, the pressure is relieved and the heart is able to clear the blood from the lower body.
12. Is it save to invert if I have a fused vertebra?
There are many types of fusion surgeries. Some post fusion patients are helped by inversion. Any fusion patient should consult with a licensed physician before inverting.
13. Can inversion help children with scoliosis? Does age matter?
Our medical advisor prefers to get patients involved with inversion as early as possible. Using inversion to help slow or reverse the effects of scoliosis is helpful at any age, but especially before the bones fully harden between the ages of 12-14. The size of the equipment may be an issue… so younger children will need an attendant.
There are many causes of scoliosis. Some causes may be problematic for inversion (bone infection, cancer, compression fracture). Most scoliosis found in children is related to bone anomalies or calcification disorders, both of which do well with inversion. Of course, if you have any doubt, you should always consult with a licensed physician.