[kj] Back pain 101

[Brendan]

Okay, this is my 2c worth, other people have their own theories but most
generally agree with these basics I believe. At the end of the day, keep
an open mind, and use whatever works.

One of the main factors affecting not only lower back pain but also
potentially a whole host of lower body musculoskeletal pathology
(particularly knee problems), is anterior rotation of the hips, or forward
roll of the hips. You know when you look at someone wearing a belt from
side-on, and the belt isnt level on the horizontal plane, its pointing
down towards the floor to the front? This is forward rotation of the hips,
in some people it's very pronounced. The optimal condition for the hips is
relatively level.

Forward hip rotation is, amongst other things, a result of a too much
sitting down and not enough exercise, it's extremely common in western
culture today because a lot of us tend to sit down most of the day at
work, then come home to sit down in front of the telly or PC. Many
athletes who do a lot of hip flexion (runners, cyclists etc) and not
enough stretching, have the same issue. Gym junkies often get it too,
people doing an imbalance of quad to hamstring work in the gym, which
would have to be most people in the gym in my opinion.

Anyway, sitting down for too long results in the hip flexor muslces
adapting to being in a shortened position by remaining tight and shortened
even when not sitting down. (This can happen to any muscles that are in a
prolonged shortened / contracted state...which is why stretching the right
muscles often reduces pain immediately). The hip flexor muscles run along
the front and side of the hips basically, they are the ones that flex the
hip...when you bring the upper legs up to our trunk you're performing hip
flexion. They are very strong muscles, and if they are too tight and short
they are strong enough to pull the front of the hips down, affecting your
posture in a negative way. This throws out the natural curve of the lower
back, increasing it, which can also throw out the natural curve of the
upper back and neck. It also potentially affects the nerve signals running
down through the spinal column to the lower body (and back up), causing
'ghost pain' and reducing strength in the muscles due to interference with
signals to muscles to contract, and can lead to back pain.

Fix one for this problem is to stretch the hip flexors. Because they are
so strong, they require a fair bit of stretching. Use whatever stretch
works for you, personally I use a combination of two stretches, one of
which stretches the quads at the same time, which results in a heightened
stretch of the hip flexors. I'll see if I can find some pics and or a
description of them online rather than describing it myself...

I generally do at least 5-10 mins all up, holding the stretch for up to a
minute at a time, because its hard to achieve a deep level of stretch in
these muscles, moving around between stretches too much results in a
shallow stretch. if this stretch is beneficial for you you'll probably
notice that shortly after finishing the stretch your whole hip area feels
and moves a bit more freely...

Another very useful remedy is to massage the hip flexor muscles.
Stretching primarily works on lengthening tissues (obviously), and has a
secondary effect of reducing tension. Massage primarily works on reducing
tension in tissues, and has a secondary effect of increasing length. A
good daily stretching routine, some specific rehab exercises for joint
control / strength (such as postural ab work), and deep tissue massage can
work wonders for compromised joints. The general idea is to loosen and
lengthen tissues that are too tight, and tighten and shorten tissues that
are too loose and weak. Knowing what to do to which is the key. Yoga and
Pilates generally address these issues, one-on-one sessions with decent
instructors are very helpful, and a good physio *should* be able to help,
although it can be hard to find a good physio in my experience.

Another result of sitting down too much is that the postural abdominal
muscles, especiall the TVA and the lower abs, are not worked to an
adequate degree, because they have very little to do while you're sitting.
If you look at yourself in the mirror side on, and suck your stomach in,
you'll notice that your hips probably roll back. This is one of the
functions of the lower abs and TVA, they posteriorially rotate the hips.
Strengthening the abs is something you should do in conjunction with
stretching the hip flexors, if you have forward rotation of the hips. I
can describe some exercises if you want, one in particular called Thin
Tummy, which is the cornerstone of my ab work, something I've incorporated
from Pilates.

Another thing to consider is strengthening the glutes. If you stand
side-on to the mirror again, and clench your butt muscles, you'll probably
notice that the hips rotate backwards. A lot of people have weak glutes
due to poor posture (external rotation of the feet, which should be
pointing dead ahead), or sitting down too much.

Stretching the lower back is also beneficial for lower back pain, when
done correctly, but always check with a doctor to make sure stretching
your back is okay with your condition, whatever it might be.

The above is basically specific to the problem of forward hip rotation as
it affects lower back pain. The below are other factors to consider, I can
go into some of them later if you want:

Posture - sitting, sleeping, standing

Gait - how you walk

Assymetrical activities - e.g. always walking with one hand in your pocket
or carrying a bag, or always carrying a bag over one shoulder.

Stress - the body doesn't heal as effectively when under too much stress,
of whatever sort...all stress is cumulative, this is an important point.
Stress often also causes the back muscles in particular to tighten as
well, because the body often perceives stress as a physical threat, and
when the body doesn't know the direction of the physical threat the upper
back tends to hunch and tighten. This results in a build up of contraction
waste products in the back, which is why so many stressed people benefit
from a shoulder (trapezius) and neck / upper back massage.

Diet - adequate protein for repair, micronutrients for general health and
repair, hydration, enough healthy fats, reducing refined sugar (which some
say can actually cause joint pain)

Injury history

Work environment





> Pass it on brother. I'm all up for reading a bit.

>

> At 09:38 PM 7/16/2008, Brendan wrote:

>>A lot of ppl are after tha 'best' ab exercise...I do a range of 10-15 or

>>so different exercises (most done on the floor with bodyweight or perhaps

>>a medicine ball for external resistance) over the course of a 3-month or

>>so program, also modifying the volume, intensity, prioritisation, and

>>tempo, along a continuum going from light, isolated, slow movements at

>> the

>>beginning, to harder, quicker, more compound movements towards the end of

>>the program. A single exercise and single set / rep scheme is

>> sub-optimal,

>>and will in fact lead to muslce imbalances over time.

>>

>>The exercise you mention is an absolute killer, but it's a compromise. It

>>works the upper abs and hip flexors simultaneously, the nervous system is

>>also taxed initially because it has to learn a relatively complex

>> movement

>>involving balancing the body while performing two different joint

>> flexions

>>patterns...you're flexing the trunk and also flexing at the hip. But

>>because you're doing two joint movements simultaneously, there are some

>>advantages and some disadvantages. Mixed training = mixed results, as

>> they

>>say. There is very little rotation, side flexion, and no real postural

>>recruitment. No exercise provides all that. Yoga and Pilates do however,

>>as performed undre a good teacher.

>>

>>I just wrote a big spiel on ab training and back pain, lost it when I

>> went

>>to put on some music on this PC, will re-do it sometime if anyone is

>>interested. Basically though, go to Pilates or Yoga because they are

>>great, I've done both and both have helped with back pain and more :) But

>>ab training is probably at most 25% of lower back injury prevention /

>>rehab...you also need to consider stretching, massage, posture, nutrition

>>/ hydration, assymetrical activities, mindset / stress, etc...

>>

>> >   What are those situps called where you do a crunch while pulling

>> your

>> > knees up

>> > to your stomach? Supposed to be the best thing ever...

>> >

>> >

>> > ... ... ... ... ... ...

>> > (looking at the current state of things)

>> >

>> > 'Save me..

>> >  save me from Tomorrow..

>> >  I don't want to sail in this Ship Of Fools...!'

>> >

>> > --- On Wed, 7/16/08, folk devil <folkdevil_23 at hotmail.com> wrote:

>> >

>> > From: folk devil <folkdevil_23 at hotmail.com>

>> > Subject: Re: [kj] Thread attempt one: ex's back

>> > To: "A list about all things Killing Joke (the band!)"

>> > <gathering at misera.net>

>> > Date: Wednesday, July 16, 2008, 8:14 AM

>> >

>> >

>> >

>> >

>> > #yiv537169317 .hmmessage P

>> > {

>> > margin:0px;padding:0px;}

>> > #yiv537169317 {

>> > FONT-SIZE:10pt;FONT-FAMILY:Tahoma;}

>> >

>> > strengthen your abs first, otherwise your back is always going to give

>> you

>> > grief..

>> >

>> >

>> >

>> >

>> >

>> > Date: Wed, 16 Jul 2008 01:56:50 -0400

>> > From: killingjoke at theimmortalfool.com

>> > To: gathering at misera.net

>> > Subject: Re: [kj] Thread attempt one: Poll

>> >

>> > Had back issues for a long long time. I did cut down on my biking

>> since I

>> > started handball.

>> > Only did 20 miles today earlier (Had time off in the afternoon). Then

>> > handball at night for 1 hour.

>> >

>> >

>> >

>> >

>> > With Windows Live for mobile, your contacts travel with you. Connect

>> on

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