Lower Back Pain/Injury

Lower Back Limitations: This is by far the most common upset taking hold of people’s work out routines and rendering them useless at the gym and at home. Read below for understanding, Scroll to bottom for a list of exercises and doing.

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It is debilitating to have to take aspirin daily and to feel your lower back all day long. It is nice to feel sore muscles once in a while from a good work out, but you should not, I mean under no circumstance feel the aches of your lower back every day.

As you guessed it, not everyone has pain in the lower back for the same reasons. Flexibility is the first step to a healthy spine and pain free lower back, but too much mobility in these painful areas is most likely what has caused the pain in the first place. It is typically the tightness of larger muscle groups that consistently pulls on the tiny muscles of the lower back. Overtime this pulling goes beyond the healthy realm  and can misalign spinal facet joints and discs.

One common cause for lower back pain is hip flexor tightness, this can come from one of two strangely named muscles: Illiacus or Psoas or both. This predicament takes a lot of dedication to overcome, not just because these are stubborn muscles, but because your desk at work, couch at home, and general postures of relaxation are all contributors maintaining this tightness. So in an effort to improve this situation, you are acquiring new habits, learning how to stretch this strange and foreign muscle somewhere deep in your belly attached both to the front of your hip and your lower back, but also you have to change all the old habits you don’t even yet know about. In most cases, these muscles are the perfect and terrible combination of tight and weak. You need to strengthen them but they are so weak that it’s nearly impossible to not exacerbate the pain. 

People with lower back issues are often talked into surgery, or have a pain management doctor that is either doing Cortisone injections or ripping nerves out as if that will cure everything. I realize that it is rather easy, with considerably good health insurance anyway, to get X-rays and/or an MRI and shortly thereafter, even trust a doctor. But, what these surgeons do not tell you is that literally thousands of people have spinal dysfunctions without an ounce of pain. The dysfunction I speak of includes things like, dislocation, herniation, compression, bulging discs, and yes the dreaded degenerative disc disease, which we all have, if not now, will surely acquire at some point in our future. I AM NOT LYING NOR AM I EXAGGERATING.

  1. How do we get over this hump? First let’s discuss the anatomy of the pelvis. The lower back is so connected to the muscles and anatomical structure of the hips that it is really hard to not put them in the same category. The pelvis is actually two pieces connected in the center. This is surely over simplified, but the very detailed specifics are unnecessarily confusing and will not help you to make the changes to start feeling better. I want you reading as little as possible so you can do what you need to for optimal health and pain pain relief.
  • The pelvis can tilt forwards and this is called an Anterior Tilt.

When and if you see someone with a butt that sticks out, particularly when they walk, this could be the result of an anterior tilt. I will refer to this as a “Sexy Butt.”

To be sure that one has a Sexy Butt, you can test to see if the front of their hip bones (iliac crest) are lower than the tops of the same hip bones on their backside. One of the most displeasing aspects of an anterior tilt is that it takes a lifetime to correct, like even after you correct it, you can never forget to pull the belly in and activate the pelvic floor. Perhaps a bubble but is your structure. It is perfectly normal for you to have shortened lower back muscles as your massive glutes continue to pull on them, but the awareness you develop will make a world of difference in terms of pain and exercises you do.

  • The pelvis can tilt backwards and this is called an Posterior Tilt.

A posterior tilt is a tilt towards the backside of the body. I call it “Old Man Butt.”      A posterior tilt can be tested by checking to see if the hips in the front of the body are higher than the tops of the hips in the backside. You can have a friend check your pelvis with a tape measure, but if you glance at yourself in the mirror with a side eye and you’re honest, you will see where your pelvis naturally sits.

There are many abnormalities or non-neutral positions for the pelvis, but I will only discuss one more, and that is something called a hip obliquity. A Hip Obliquity is an uneven connection in the pelvis. Hip obliquity requires a bit more anatomical explanation, as there are many muscles and bones that are interconnected to the pelvis. As a whole, and any one of them can be uneven to form a Hip Obliquity, whether it is from left to right or front to back. It can take place in the pubic symphisis, the socket of where your leg bone joins the joint, at the sacrum, or SITS bones. The Hip Obliquity is usually diagnosed after much frustration, as it is not an obvious or even common answer to pain in this region. However, it’s a good marker that you suffer from a hip obliquity when there is a leg discrepancy, as in one leg is longer than the other, and also mild to excruciating pain in the in any one of those junctions I have explained that several doctors just can’t seem to get to the bottom of. It is an issue of alignment rather than muscular tendency, although it can be both. A physiatrist or osteopath is the best person to see if and when you suspect you may have a hip obliquity, and expect to do a lot of your own research as it is not common.

 

        2. What to do? Beyond stretching and creating space in the area, which most likely has existing compression, if you are over thirty, is strengthen your core. You can do this with tons of different exercises. TONS! PLEASE NOTE: The abdominal muscles support the spine, keeping it upright, and when and if these are weak, the smaller and less capable muscles of the lower back are called in to do so, resulting in pain.

Exercises to stabilize the lumbar spine> Supine toe taps, Tabletop toe and arm taps, Table top, reach in.

Exercises that create new patterns of movement in the lumbar spine> Hip circles on ball, Wall Kisses, side squat walking with resistance bands

Yoga postures> Cat cow, Sphynx, Prone Quad stretch, Pigeon, Seated Bent knee Forward Fold, chair with block between legs.

Exercises that create mobility in the thoracic spine and pelvis> -Side lying Shoulder abduction, Y’s, locust arms only, locust arms and legs,

Stretches to take some tension out of the hamstrings>

Quads> supine quad stretch, bended knee wall stretch

and hip flexors> bended knee Thomas stretch using wall or foam roller.

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