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  • Robert Brovarnik

Lower Back Pain

Updated: Jan 4, 2019

What you need to know

Chronic back pain is one of the most common ailments in our society with up to 80% of our population experiencing back pain at some point in their lives (Rubin 2007).

Why is this happening at such a high rate? And what is happening in the body to create such discomfort? In this article, I will discuss how it happens, why it happens, and strategies to improve symptoms. 

Pain in general is a complex issue that is commonly misunderstood. It is important in signaling something is off with the body. However it can be deceiving, for instance, pain felt in limbs that have been amputated called phantom limb syndrome is more problematic than useful.


In understanding strategies to alleviate back pain, there are things we can do to help reduce symptoms. Posture is the first thing we can assess... What is the one activity humans do most often? SITTING

Chronic sitting at your desk, in your car, during dinner, watching tv, drinking coffee, etc. can wreaks havoc on your back. Think back on your day or week, and try to add up the hours spent sitting. I can guarantee for most people it's more than they would like to admit.

Ok Robby, sitting is bad for me, but what specifically is causing my body to produce pain signals?


Lower Cross Syndrome

When you sit for extended periods of time certain muscles become shortened and overactive, while others become lengthened and under-active. This image above shows opposing musculature with opposite lines of pull. On the right we have the erectors and the iliopsoas which are shortened and over active, putting your hips and spine in a compromised position. On the left you have the opposing, under-active musculature, the glutes and the abdominals. These muscles oppose the iliopsoas and erectors to keep your hips and spine in a balanced alignment.


When your iliopsoas (hip flexors) and erectors (back extensors) are shortened and over active, they pull your hips into a state of excessive anterior pelvic tilt (hips tilted forward). This causes the lumbar spine (lower back) to be in a position of excess lumber extension as shown in the picture.




When your lumbar spine is in constant extension the facet joints of the vertebrae are pressed against one another. This may put strain on the facet joints which can cause inflammation of the joint capsule. A narrowing of the nerve canals can also occur, putting additional stress on the nerves exiting your spinal chord.


The combination of these factors creates chronic pain symptoms. If left unattended it can create more serious issues such as spondylolysis or spondylolisthesis which is the fracturing or complete break of part of your vertabrae that press against one another during excessive lumbar extension. Keeping your spine in constant extension during physical activity increases you odds of one of these conditions.




Lower Cross Fix

In order to to reduce the imbalance of lower cross syndrome, you must strengthen the weak musculature. No matter how much you stretch the tight musculature, if your core and glutes are still weak, the opposing muscles will constantly pull you back into an anteriorly tilted position. Pairing strengthening and stretching exercises will be optimal


LEARN Learn how to control your hips by moving from an anterior tilt to a posterior tilt. Tuck your tailbone under by engaging your glutes and core, pressing your lower back against the ground. Another way to think about doing this is doing a hip thrusting motion. Hold for 30 seconds






STRETCH 1) Hip Flexors: To stretch your hip flexors, get into a lunge position with both knees at a 90 degrees. Now posteriorly tilt your hips by tucking your tailbone and squeezing your glutes. Elevate your back foot to intensify the stretch and target a different key hip flexor muscle. Hold for up to 3 sets of 45 seconds







2) QL/Lat Stretch: To stretch your lat and QL (side and lower back muscle), hold on to a pole or a doorway with both hands overhead, and with the outside foot step to the inside as shown in the photo. Now relax and lean away from the doorway, or whatever you're holding onto, and feel a deep stretch down your whole side.









STRENGTHEN

1) Deadbug: While maintain your lower back pressed against the ground and a posterior pelvic tilt, opposite arm and leg before returning to start. Alternate 10 reps on each side. To regress exercises hold arms nad legs in the air for 30s while pressing your lower back into the ground. Perform 3 sets



2) RKC Plank: While holding a plank position, posteriorly tilt your hips and actively squeeze your glutes and core. Perform 3 sets of 30s





3) Banded Glute Bridge With a band around your knees (above the knee), start with your feet about shoulder width apart and posteriorly tilt your hips. Then bring your hips up into the air and squeeze your glutes. Perform 3 sets of 10 reps

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