Back pain – Why it doesn’t have to be that complicated

Back pain has been a difficult area to manage long-term for many people. However, it doesn’t have to be that way. Many physical therapists and trainers look at the back when that’s where the pain is, but that isn’t the most comprehensive approach. The thing is, the human body needs every joint to do its job, or else a change within one joint can cause a cascade of compensations down the chain.

Your major joints alternate between mobility and stability purposes so that the stable joints provide stability for the body to move through the more mobile joints. Low back pain will occur because it is trying to be more mobile to make up for lack of mobility through the hips. In the naturally asymmetrical body, our left pelvis is forwardly rotated and the right pelvis is backwardly rotated. As a result, our femurs (thigh bones) compensate and cannot express full, healthy ranges of motion. If they cannot do that, then the back begins to be more mobile than it should be, causing you pain.

This picture illustrates the position we are stuck in with the aforementioned natural pelvic orientation. So what should we do? A significant amount of back pain cases I see are resolved through training the hamstrings and obliques through proper breathing, particularly on the left side to pull our left pelvis back. If we can get a more neutral pelvis AND breathe well, then we are addressing the root of the problem. Proper breathing is essential because it will help facilitate activation of the obliques and reinforce good ribcage mechanics. In addition, our body will understand that if it can breathe through a new position, the position isn’t a threat and we can maintain that position long-term.

​And that is EXACTLY what we do at Sandhills Sports Performance. We treat the body as an entire functioning unit, not as separate parts. This is our approach in both our physical therapy practice and wellness program.

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Why you SHOULDN’T stretch your hamstrings

How many times have you spoken, thought, or heard the following sentence?

“Man, my hamstrings are so tight!”​

The next logical idea would be to stretch them out. You might bend over and reach for those toes, or maybe prop your leg up one at a time on a desk and feel that sweet relief.

The problem is, you just made you problem worse. That’s right, worse.

For too long the fitness industry has been a proponent of hamstring stretching to relieve tightness in your back and legs. However, what they didn’t consider is that the body naturally gravitates to a state of anterior pelvic tilt and lumbar extension. In layman’s terms, we live our lives with our backs arched and our ribs flared up. It’s comfortable, it’s familiar.

Anterior-Pelvic-Tilt.jpg

Take a look at the image above. If you have any back pain, hamstring tightness, or dysfunction in general, changes are you are stuck in this anteriorly tilted position. Look at the hamstrings – they attach on the back of your pelvis and knees.

So here’s the question: If we live in a state of constant anterior tilt and our hamstrings are lengthened, WHY are we stretching them?!

Imagine a rope that has two people on each end. If both people are pulling on each end, of course that rope is going to be very tight. Your hamstrings are that rope and they aren’t tight because they’re short and overactive, they’re tight because they over-lengthened and being pulled on all the time from both directions!

Here’s an even more interesting thought: The way to fix your hamstring tightness is to turn on your hamstrings. We need to restore them to a more optimal resting length so they can relax and your pelvis can get out of an overly-rotated state.

We are very fortunate to be able to implement Postural Restoration Institute methodology at our clinic, where we specialize in recognizing the patterns the human body falls into, just like this one. Every day we get to work with individuals who have this anterior tilt and we help them get out of it!

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Why your core training is WRONG, and how to fix it

“Toning up the core” is a common concept within practices in the Health & Fitness community. Hundreds of sit-ups, planks for minutes, and extension-driven ab wheel rollouts are a few examples of exercises personal trainers or online resources will likely prescribe to you.

The problem is, you aren’t training your core effectively with those exercises. You’re either targeting one muscle group in the core (the Rectus Abdominis) or training a pattern of extension that you’re already stuck in, making your pain worse.

If I gave you a TRUE core exercise that involved correct respiration, you would be shaking and begging for mercy within 15 seconds. The “core” is not designed to just do sit-ups. Its function is to help you breathe and stabilize your body throughout the day.

Take a look at the following diagram of the core musculature:

Muscles_of_the_Abdominal_Wall.jpg

That’s a lot more than just your Rectus Abdominis, or your “six pack” abs. And you know what muscle works with all of these abdominal muscles for breathing? Your diaphragm, which is HEAVILY involved in core functioning.

19072.jpg

Your diaphragm is supposed to ascend and descend during breathing, and if our Obliques and Transverse Abs are not securing our ribcage down, we are setting ourselves up for dysfunctional breathing and pain since our diaphragm can’t do its job if the ribs are stuck flared up. Flared up ribs means less room for the diaphragm to move.

True core training involves breathing. Any good core exercise forces you to own a position and not compensate by extending your back or moving out of alignment. It’s transverse abs and obliques, all while keeping those ribs down so we assist the diaphragm in getting in a proper position.

This is what we do at Sandhills Sports Performance. You will never see anyone do a sit-up here!

So next time you do a core exercise, keep those ribs down. Get a full inhale through your nose and exhale ALL that air out through your mouth. Own the position, or else you aren’t owning your core.

​See the video below for a great core exercise that hits your obliques hard. Keep your pelvis posteriorly rotated, keep those ribs down, and breathe!!

https://www.youtube.com/watch?v=8gu5U580aM8

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