LOWER BACK PAIN
“The back hurts but it’s the butts fault”!
I recently read an article in The Daily Mail that suspects nearly half of the adult population in the UK are living with chronic pain – lower back pain is one of the biggest causes.
Anyone who has been to visit us in the clinic with lower back pain may have heard us use the expression ‘the back hurts, but it’s the butts fault’. Simply put, your back may well not be the cause of your pain, even though it is the site.
As soon as people experience pain in the lower back, we are quick to thinkthat it is the ‘black spot’, ‘something serious’, ‘in for life’, or one we hear often,‘something that should be expected with age’.
In our clinical experience, we see the majority of cases being solved easily with correction of muscular imbalances, muscle flexibility or posture. Often yielding very quick results.
So why is the butt often at fault when assessing back pain?
The gluteal muscles are the biggest and most powerful muscles in the body. They wrap around the hip to extend and externally rotate the joint. However, they also attach into the lower back, playing an important stabilising role for a joint in the lower back called the Sacroiliac Joint (SIJ). The SIJ is where the spine attaches to the pelvis – held in position by the gluteal muscles. If these muscles become tight they will tilt the pelvis backwards instantly applying excessive pressure into the area, as well as potentially tightening the SIJ.
The gluteal muscles commonly become weak or ‘underactive’ as a result of living in a ‘flexion-addicted society’. What do we mean by this? Next time you are on a train take a look around… we guarantee that nearly every person will be displaying flexion at most of their joints. As they sit and read a newspaper/tablet/phone with their neck bent forwards, lower back hunched forwards and the hip joint flexed, all of the muscles that create this flexion are becoming short and tight. So the opposing muscles that create extension, like the gluteal muscles do for the hip, are not being used, resulting in them weakening over time.
So what do we do to combat this poor posture on the train or in the car? We go to work where most of us will sit for 8 or 9 hours – further adding to the problem!And of course then our train or car journey home at the end of our day.
Finally, after a long day of adopting poor posture what do most of us do? We sit on the sofa and watch television. It’s clear to see why there is an increasing problem!
If we consider our purpose and design, early man was the caveman/hunter-gatherer. Picture the caveman and consider their posture, it will be upright,standing tall demonstrating equal usage of the flexor and extensor muscles.
What is most important is looking through the body as a whole rather than fixating upon the site of pain. We often find simple causes such as tightness through the hips, lack of flexibility in the hamstrings and poor feet biomechanics (watch out for our future blog on this) as a common flaw and creator of back pain.
But this doesn’t affect me because I exercise.
I’m sure a lot of you are thinking ‘I know this’, ‘this is not news to me’, but please bear with me because we are often then confronted with another layer to the problem.
People are definitely much more aware of the health implications of a flexion-addicted society, and the media try to publicise it with campaigns such as ‘sitting is the new smoking’.
The inevitable result is that we try combat this with exercise. During evenings and weekends we are trying to beat the negative effects of work by hitting the gym, going for a run or playing sport – and this is great! But while we of courseencourage everyone to do so, we need to remember that these muscles that we now require for exercise, have been left in a weakened state by our daily routine. They therefore have far increased chances of damage, which couldresult in loss of flexibility and tightening of the structures.
I’m sure lots of you have returned to exercises after a period of not doing any and suffered back pain, or have increased the intensity of your training and suffered back pain as a result. This is all simply a result of trying to use muscles that are not suited for the demands we are placing on them.
So what is the solution?
What can you do to help and reduce lower back pain?
- Avoid sitting for extended periods of time. Try taking telephone calls at work standing up, interrupt your day every hour to stand up, get a drink or talk to a colleague.
- Use the extensor muscles whenever possible – try walking to work instead of using the tube. Take the stairs instead of the lift where you can. Park the car further from work to allow a walk (and perhaps cheaper parking fees!!).
- Before starting exercise have a full muscle check from a specialist. Find out about your muscle flexibility/strength and correct the problems before they occur. These are available from us at Jon W Sports Injury.
- Stretch!! This is so important and especially following exercise. Many times we hear people say ‘I’m just not flexible’. There is only one reason for this and that is a lack of stretching in everyday life.
- Do not ignore any pain. Small pains can be very easily corrected before they become serious. Back pain is typically a chronic rather than acute injury meaning doing something wrong over an extended period of time. So catch it early!
We hope this has been of some help and interest to you. This blog is written from our experience in the clinic and is our opinion. If you have any questions or would like to discuss further, please do just ask.
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