Suffer from low back pain?
Have poor posture?
There are a few common ways that low back injuries occur. One of the typical presentations is that one day, you try to lift a very heavy box, and suddenly you hear a pop and immediately feel pain in your lower back. And so, as a result, you attribute the injury to “that one time I tried to lift a box that was way too heavy.” You might be tempted to think, “If only I wouldn’t have lifted that box that day, I would have completely avoided this whole situation to begin with.” That may be true, but most likely it isn’t. The “lifting of the box” was not the start of your low back injury, your low back injury most likely started long before that incident. There are many factors that are often involved in injuries such as this, and that are present for quite a long time prior to the actual “incident” that ultimately led to your back “giving out.” What are these factors and what can be done to avoid them?
Sometimes though, back pain can come “out of nowhere.” You may be frustrated because you didn’t “do” anything that would make your back start hurting. You didn’t lift anything heavy and you didn’t hurt it exercising. But one day, it just began to hurt and you are not sure why. So, what happened then? Why is the pain there and where did it come from?
Or maybe you have low back pain from another cause, one that wasn’t mentioned above. Maybe you know why you have low back pain, but your problem is that you can’t get it to go away. Nothing seems to help it or make it better. You try to constantly shift in your seat or change positions frequently so that your pain doesn’t increase. You try to use a hot pack or rub ointments on your lower back to try and make the pain go away, but nothing seems to work. So what should you do?
Understanding the answers to these questions plays a crucial role in preventing low back injuries from occurring as well as treating them once they have occurred. The first, and most important step you can take towards achieving this goal, is having a clear and very detailed understanding of the different factors that place an individual at an increase risk for low back injuries. If these factors have contributed to your lower back injury, your back will not be able to fully heal unless these issues are addressed.
One of these factors is called the Lower Crossed Syndrome. Lets discuss what this is and how it plays a significant role in low back pain. When a muscle group in the body becomes under developed, or weak, other muscle groups in the surrounding area (that also perform the same function) take over and attempt to perform the same function. It’s your body’s way of being efficient and using what is available in order to still get the job done. This isn’t necessarily a good thing, because the longer this goes on, the more problems it can cause. What happens is, the muscle group that has to “take over” is having to perform a function that it wasn’t really intended to perform, along with the function that it was intended to perform, basically it has to work overtime. When a muscle is overworked, it becomes tight. The muscle group that is weak and isn’t being used, continues to get even weaker because the body is relying on other muscles to perform its function. This creates a negative, self-perpetuating cycle. Here is one very common compensatory pattern that is a present factor in the majority of people who have issues with their lower back. Their core muscles are weak and under developed, as a result, their hip flexors try to take over and compensate. As the hip flexors become more dominant, the abdominal/core muscles become progressively get weaker. As this cycle continues to worsen, it begins to affect the lumbar spine in a few other ways.
The core stabilizes the spine and acts like a corset in order to protect the spine, but because the core muscles are weak and not being used, the spine becomes increasingly unstable and is more susceptible to injury. Also, when the hip flexors become tight, they can easily pull the pelvis out of alignment and into an improper position – which leads us to the second step in this destructive sequence.
This improper positioning of the pelvis (anterior pelvic tilt) then causes the same thing to happen on the opposite side of your body. It elongates your Gluteus muscles and makes it more difficult for them to be fully utilized, leading to decreased use and ultimately, muscle weakness. The lumbar paraspinals attempt to compensate for this weakness and eventually become overworked. This leads to muscle tightness in the muscles surrounding your lumbar spine and ultimately, more pain in the lower back. This is illustrated in the diagram below, and you can see why this is called the Lower Crossed Syndrome. The Lower Crossed Syndrome can also be attributed to a phenomenon know as reflex inhibition. Here’s what happens: When your hip flexors become tight (the muscles become shortened) your brain automatically sends inhibition signals to shut down the muscle group on the other side or your body (one that performs the opposite action). This is illustrated in the diagram below, where one muscle group is weak, the opposing muscle group is tight.
In order to protect your lower back, or make progress in your current condition, this compensatory muscle pattern must be appropriately addressed. The difficulty for most people is that the biomechanics involved are a little complicated and can be confusing if you aren’t familiar with the anatomy as well as the appropriate interventions to address these specific deficits.
If you are looking for a way to address your low back pain that is not a temporary fix and that will produce long term results, or you are interested in learning specific ways to prevent a lower back injury from occurring, click the link below. We provide “On Demand” PT services with individualized training and prescribed home stretching and strengthening exercises from your own personal Physical Therapist. Click the link to find out more!