Last week I wrote about the solution to about 75% of the low back pain cases that come into my office and this week I am going to address the other, roughly, 25%. In this case, the low back muscles are extremely tight, the trunk may or may not reflect this and the person is either of dense musculature or a combination of muscular with a belly. This is a case of the back supporting not only the weight of the trunk but also the muscular “pull” of the trunk as it contracts (or is in constant contraction).
In a person with dense musculature, this can be a very powerful force that literally crushes the discs in place by compression from not only gravity but the muscular contraction. Since the spine is elegantly constructed and curved to minimize the effects of gravity, it is this muscular contraction that is the cause…at first inspection. However, there is often another culprit…shortened abdominal muscles.
So often we have been told (by our well meaning doctors no less) that the “cure” for low back pain is to simply strengthen the abdominal muscles and so, many have come to believe that shortened abs are a good thing. For one they give us the “six pack” look that the muscle mags all showcase as being the goal to shoot for. In reality though, comfort in the low back is all about tensional balance of the muscles of the trunk RELATIVE to one another (theres that word again…RELATIVE).
So the key here is to release the tension in the FRONT of the body in order to release the tension in the BACK of the body. That’s right, I said lengthen the abs to lengthen the low back. This is because, you see, the back is often a counter tension to the front of the body and in this case, because the abs are such a powerful contractor of the front they exert a special leverage on the back (think of the space between the lower front ribs and the pelvis as the open end of a lever while the spine is closer to the point of leverage.
As always I encourage your participation in the conversation with comments, experiences, questions, etc.