People come to a chiropractor for many reasons, but far and away the most common reason for that first visit is back pain.
That makes sense. When you have digestive trouble, infertility, asthma, or even arthritis pain, “chiropractor” is not usually the first word you think of, but when your back hurts, you call the chiropractor first.
At least, I hope you do.
I recognize that there are plenty of medical and surgical alternatives available to you. In fact, I always appreciate when a new patient comes to see me, because I know that they had to overcome the pervasive cultural mindset of going to see a medical doctor or surgeon for any and all health issues. How many people have I met over the years who got irreversible, permanent back surgery for a condition we might have been able to address with adjustments?
Unrelated Problems Are Related
One of my favorite moments in working with a new patient is that “eureka” moment they have when they discover that seemingly unrelated health conditions that have vexed them for years suddenly have cleared up after we get their spine and nerves aligned.
But that again is part of the reason people associate back pain with the chiropractor, but not other health issues. It’s easy to segment our lives into discrete boxes:
- Body, mind, and spirit
- Diet, exercise, and supplements
- Spine, muscles, organs
If you isolate these areas from each other, you miss the bigger picture.
All of the facets of your life are interwoven. For instance, your body can physically manifest emotional pain through indigestion, headaches, or tension. A deficiency of magnesium in your diet can damage your muscles organs. And overtension in one part of your body can result in pain in another area.
Tension, Balance, and The Low Back
With that in mind, I propose that when you are experiencing lower back pain, your lower back is the victim, not the culprit.
How does this happen?
One of my neighbors recently had some landscaping done, including having several young trees installed in his front yard. The landscaper made sure these scrawny young trees would grow up straight by hooking long wires from each tree to stakes in the ground on three sides. The balanced tension prevented the trees from leaning in any direction as they grew.
Your body is not just a bag of bones. Your body is set up with each bone surrounded by groups of muscles that provide balanced tension to keep the bones aligned properly. It’s an extremely efficient system, but it has its drawbacks. You can throw off the balance by injuring the muscles, over-tensioning the muscles, or under-using them.
For instance, if you have a comfortable sitting posture that you use all day, every day, the result will be that some muscles develop a habit of over-tightening, while other muscles form a habit of staying loose and limp. That imbalance of tensions can pull your bones out of their correct alignment, and that can cause pain, stiffness, and immobility.
The Core Muscles
So, let’s look at your lower back. Your lower back is in the middle of an area we call “The Core.” Your core muscles are the centerpiece of your posture, flexibility, stability, and motor control. The best athletes have simply mastered the movement of their core muscles.
Your spine is in the middle, your ribcage on either side and a hip on either side at the base of your spine. Wrapped around all of these are bundles of muscles – some pulling the bones toward each other and some pulling them away from each other. If the muscles pulling your hips up toward your ribcage are overtightened and the muscles pulling your hips down toward your your legs are undertightened, your posture will be distorted and you will experience pain when you sit down.
Here’s where it gets tricky.
Beyond The Core
These core muscle groups are pretty stable – they don’t move much. Meanwhile, your hamstrings are pulling down on the back of your thigh and your quadriceps are pulling down on the front of your thigh. I see this all the time with weightlifters and runners: their workouts over-tighten either of these muscle groups, which then put imbalanced tension on the glutes (your buttocks) and obliques (wrapped around your sides). I can adjust the lower back all day long, and you won’t feel any better until we address the real problem, which is that your spine and oblique muscles are overcompensating for imbalanced tension in the legs.
This is one of those “eureka” moments for so many of my patients. If you’ve ever come to me with lower back pain and I started with your shoulders or your calves, now you know why.
Treat The Root, Not The Symptoms
There’s a principle of health management here that I really want to impart to you. Like so many areas of health, it’s never enough to address the symptoms – you need to identify and treat the root issue.
In this regard, pain is a mixed blessing. Pain is like the flashing red light on your car’s dashboard that lets you know something is wrong. It’s necessary and good in that it directs your attention to a specific area of your body that needs help. The problem is that our brains don’t always interpret the signals correctly.
Gray Cook is a physical therapist and Olympic weightlifting coach, and I love they way he explained low back pain:
“It’s a symptom and it can come from everything from tight hips to poor lifting mechanics to bone cancer.Oftentimes, it’s a result of compensations the body is making due to dysfunction elsewhere.
“If you’re trying to rehabilitate, stabilize or train a spine and you haven’t looked at all the reasons a spine may have to compensate—lack of hip extension, lack of medial rotation on one hip, poor balance on one leg, poor thoracic spine mobility—you’re not doing a very good job at protecting the spine. You’re trying to add a positive to a situation that would do better if you removed a negative.”
It’s easy to point at the pain and blame what hurts. But unless you identify the real cause of the pain, you will treat the symptoms and never deal with the actual problem. If you suffer from consistent headaches, my first question will likely be about your diet, not your pillow. We’re looking past the symptoms to the root causes. With lower back pain, I am going to make sure your hips and shoulders are aligned and your leg muscles are balanced, so your core muscles aren’t having to overcompensate and end up pulling your posture out of alignment.
The Power of Muscle Memory
I also want to talk this week about habits.
No, I’m not going to get on you for picking your nose or drinking alcohol; I’m talking about muscle memory.
If you’re a golfer (this is also true for tennis players), you probably understand the importance of learning proper technique early on. If you didn’t learn it when you were young, you are likely paying for it now. One of the problems I see with self-taught golfers is that they start with poor technique based on poor posture and rotation, and then they form habits around it that are very difficult to overcome. Why? Because poor posture is easy, while good technique feels unnatural at first.
Proper technique involves rotation of the hips and shoulders, while the lower back stays straight. But unless you were coached properly starting your first day, you probably formed a habit of twisting your lower back instead of rotating your shoulders, hips, and feet.
Muscle memory is a series of habits that your muscles form that allow you to repeat an activity without having to relearn it every time. It’s one of the most powerful faculties of the human mind and it allows us to advance our own intellect, because we don’t have to concentrate our conscious mind on the little activities we repeat many times a day.
Muscle memory can also be the biggest stumbling block to learning a new skill, developing good posture, or improving our health. Some researchers say it takes 21 days of consistent repetition to learn a new skill or rewrite an old one. I think it’s actually longer than that because you are having to retrain small-muscle actions that have been ingrained in the subconscious for weeks, months, years, or decades.
Two Steps to Move Right
If you are suffering from back pain, there are two things we need to do:
- First, we need to identify all the systems related to your back and see where the imbalanced tensions are occurring and realign those.
- Second, we need to identify any muscle movement patterns that are exacerbating the problem and re-program those habits with proper movements. Then, we can rewrite your muscle memory based on proper techniques.
As the trainers at Functional Movement Systems have said,
“The most responsible action in back pain is not to reach for a remedy, but to thoroughly, objectively and consistently attempt to map out the contributing factors before pursuing spine stabilization.”
It reminds me of a favorite trick I use with some patients. If a patient is stiff and unable to relax enough for me to perform an adjustment, I will distract them from what I am doing. For example, if I am trying to do an adjustment on your hip and you won’t relax enough to let the hip muscles release, I will ask you to lift your opposite-side hand, or take a deep breath and let it out. It takes your attention off the area I am working on, so those muscles can relax and I can do what I need to do.
In the end, we want to train your body to automatically use the right technique in all your movements. That will lead to a longer, pain-free life.
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“At the end of your FEELINGS is NOTHING. At the end of your PRINCIPLES is a PROMISE.” — Eric Thomas