Stop the Assault & Remove the Hammer - best strategies to fix low back pain
Flexion is the number 1 cause of disc injuries...
“If you were to hit your thumb lightly, but repeatedly, with a hammer, it would eventually become very painful, and soon, the slightest touch would cause pain.” - Stuart McGill, Low Back Disorders: Evidence-Based Prevention and Rehabilitation
The number one cause of low back pain is repeated or sustained flexion. If you add in a rotational component, it’s even worse!
Today, it is agreed across professions that flexion is the number one mechanical cause of disc injuries, whether it’s repeated as in bending over to pick up boxes, gardening in the yard, or sustained (sitting in flexion at work) or even if the lumbar spine is over-utilized in sports without adequate stability.
Simply put - flexion is that slouched posture you are probably in right now while reading this sentence. There is nothing inherently wrong with flexion, it’s just that we tend to do a lot of it.
If you have low back pain and it’s a constant problem in your life, then you might want to reconsider traditional core exercises that focus on abdominal flexion movements, such as sit-ups and knees-to-chest, these “often recommended” exercises can actually make the situation worse, especially if the disc is already irritated. Not long ago, sit-ups and flexion exercises were the gold standard treatments prescribed for low back pain sufferers. Today, current research has changed this line of thought.
Injury Prevention and Performance Enhancement
Most injuries are a combination of overuse coupled with bad form over a relative period of time. For example, sitting at a computer for 8 hrs a day in a flexed position, or running with improper mechanics and even the repetition of lifting weights without proper stabilization. Over taxing a certain body part in excess will damage soft tissue structures - muscles become tight, restricted and even weak.
Not good right. I’m a big proponent of soft tissue work (Active Release Techniques), mobility/stability exercises, and joint manipulation when the body breaks down and tissues becomes short and tight. These techniques are able to restore normal soft tissue and joint motion.
To help support these treatments, with proper technique training - 6 principles of injury free running - we can learn to reduce the amount of wear and tear to the body, prevent injuries from re-occurring and even increase performance.
If you play golf, any expert will explain that technique is crucial, well, the same holds true for running. There are certain universal principles that every runner should know…
This article from the “Triathlon Jones” blog has some very helpful hints to improve your running technique and overall form with just a few simple modifications.
He suggests the “Chi Running” and “Pose Method” techniques that each possess three specific alterations that you can easily make to improve your running form. These alterations include
- Leaning slightly forward while running.
- Making sure your entire foot hits the ground at contact - mid-foot strike.
- Increasing the number of times your feet hit the ground during a run.
Each of these tips are said to decrease the amount of pressure on knees and joints, decrease injury, as well as lower your heart rate, which are all common problems associated with runners. He gives some equipment and book suggestions, as well, to help you get started on improving the way you run.
Improving running technique has been a valuable tool when treating running injuries. There are 3 areas that are imperative to address when dealing with overuse/repetitive strain injuries; the first is to restore normal joint and soft-tissue motion, the second is to correct muscular imbalances, and the third is to improve bio-mechanics. To read more about an integrative approach, check out my previous blog, Improve knee Healh.
When these 3 strategies are implemented, we get quick results, happy patients, and long term solutions.
Hope this helps…
Best,
Cole Ellis
Tight Lateral Hip Rotators
Following up from the last blog - foot flare - I want to go into more detail on the importance of preventing your external (lateral) hip rotators from becoming too tight. Hip rotators can easily become tightened, usually as a result of overuse or sitting too much throughout the day.
Lateral Hip Rotators in Order of Importance - Warren Hammer, author of Functional Soft-Tissue Examination and Treatment by Manual Methods.
- Gluteus maximus
- Quadratus femoris
- Oburator internus
- Gluteus medius and minimus (dorsal fibers)
- Iliopsoas
- Obturator externus
- All adductors except pectineus and gracillis
- Piriformis
- Sartorius
These actions will cause your leg to rotate laterally causing the foot to pronate, or roll inward, more than it should at foot contact. Although the external rotation is often small, it is enough to cause a problem during running or even walking. Overuse and asymmetries are the top factors leading up to an injury, there are approximately 1,500 steps in a mile, if there is a mechanical dysfunction, given enough time something is bound to breakdown…
What Causes the Foot to Flop Out to the Side?
Tight external hip rotator muscles deep inside the hip. This pulls on the hip and externally rotates the leg and foot. Results in foot flare, will exaggerate pronation and alter foot mechanics.
Calf and thigh muscles are often tight and restrictive. This will not allow the leg to absorb impact forces gracefully.
Hip Flexor Tightness…this can weaken the glutes, remember the glute muscles are extremely important for the runner and overall health and function. If the glute is weak, other muscles will have to compensate and work harder.
All of the above are examples of muscular imbalances and soft tissue restrictions that are directly related to plantar fasciitis, back and knee pain, IT-Band Syndrome, and other running conditions.
The 6 principles to injury free running are important, although to go full circle - fix the injury, prevent future injuries, and improve performance - the muscular imbalances and soft tissue restrictions need to be addressed as well.
We all (at some point) have that one stubborn injury - or injuries - that won’t disappear. It can impact performance, work, health, and even relationships.
For example, chronic back pain, problematic knees, a bum ankle and shoulder, or a running issue. Often heard, “I have a difficult time staying active because” - fill in the blank - “I used to run, but now I can’t because - fill in the blank.
Most treatments revolve around ice, medication, rest, and stretches. This is a feel good approach, and yes I agree, we all want to feel good, but we will feel much better once the problem is fixed and we get back to doing the things we enjoy and have passion for.
To learn more about cutting edge treatments that will quickly and permanently get you back to doing what you enjoy, click here for The Stay Active Manifesto.
If you have any questions or concerns I would like to hear from you.
All the Best
Cole Ellis D.C., ART
Improve Knee Health
Knee pain is a common injury that sidelines runners and impacts overall health. To resolve knee pain, it is critical to understand that the knee is sort of a biological “fall guy” because it is located between two mobile joints: the ankles and the hips. If there is a lack of mobility within these joints, then greater demand is placed on the knee and problems can arise.
To keep knee pain from becoming a problem or to resolve ongoing knee complaints, here are 5 proven suggestions that will make a difference:
- Improve posterior chain strength
- Fire up the glutes
- Improve your running technique
- Increase mobility of the ankle and hip joint
- Release chronic myofascial tension
Suggestion 1: Improve Posterior Chain Strength!
Combo move targeting core, glutes (glute medius), and the hamstrings.
Force producers-the glutes, hamstrings, hip flexors, and quadriceps-stabilize the knee by working together. Over-dominance in the quads, tight hip flexors, or weakness in the posterior chain can result in knee instability.
Action step: incorporate exercises that improve posterior chain strength, for example bridges to improve hamstring strength.
-
Recommended Professionals
