MedHum Mondays Presents: OUCH part 2, a series on pain

DailyDose_PosterWelcome back to MedHum Mondays on the Daily Dose! A few weeks ago, we featured orthopedic massage therapist Joseph Watts on body communication and chronic pain. Today, we wanted to follow up that article with OUCH part two: chronic low back pain. It afflicts many–and “cures” abound–but what does low back pain really mean? And what does it tell us about how (and if) our body is communicating to us? The answer, it seems, is right under our noses. Well. Under us, anyway… Welcome, Joseph!

Low Back Pain:
It Might Just Be Your…..Butt.
Joseph H. Watts LMT

Low back pain is the scourge of the developed world, especially in the United States. It accounts for billions of dollars in lost work hours, millions in healthcare costs, and quite frankly (if you have ever had low back pain), it just plain sucks! There is a constant barrage of products shamelessly promoted to help you with this problem. For a price, they will give you the next supposed “cure all.” However, low back pain still exists in our culture at an ever increasing rate. What gives? I wish I could give you the quick and easy cure, but if I could, I’d be writing this from a far away beach somewhere… and I am not. Take heart: the answer *is* simple, but putting these things in practice is rarely as easy as the quick fix television salesmen would have you believe!

Wellcome Library: Anatomical illustration showing muscles of the back; Brown, 1681
Wellcome Library: Anatomical illustration showing muscles of the back; Brown, 1681

So…..what is this all about? Good question! I am glad you asked. Our low back pain is generally caused by a weakness of our core muscles, which are the transverse abdominals, the multifidi of the spine, the pelvic floor muscles, and the diaphragm. Alas, I am sorry to report thatthe elusive “six pack” is not part of your core. (Wait for another post for that explanation!) If you want to strengthen these you can ask a personal trainer, Pilates Instructor, or Yoga Instructor for help; even the internet will give some suggestions. But remember, simpler is better. However, if they tell you to focus on crunches then they do not know what your core is. It’s not about your stomach—it’s about a crucial and over-looked missing link: Your butt!! The Gluteus Maximus to be precise.

All day long, many of us sit. We sit at work, sit in our cars, sit in front of the TV or computer at home, sit, sit, sit, sit, sit. When we are in the seated position we keep our Glut Max in a constant stretch, while at the same time shortening our hip flexors. This creates chronically shortened, tight hip flexors, and the brain then neurologically shuts of the Glut Max.   Now, when we walk, these Glut Max muscles, which should be powerful hip extenders, don’t fire. So the Hamstrings fire, then the low back takes up the slack. This is not the job of the low back. Now the low back muscles are working overtime. That alone is enough to make them hurt, but add the shortening of the hip flexors and a forward tilt to the pelvis and you add in potential compression and pinching of the spinal discs, as well as irritation of the nerve trunks coming from the spine. This is a pain soup in the making.

Very few programs even have Glut Max on the radar to relieve back pain. So, if you have back pain, exercising the Glut Max might be a great idea. This is where the work of an experienced orthopedic massage therapist can help. Someone trained in muscle spindle activation can help re-awaken the Gluts max. And of course, you will always want to consult your doctor to make sure there is no serious spinal condition before you do any new forms of exercise.

So, remember, get off your butt. It might be the pain in your back!

To Your Health

Joseph H. Watts, LMT, has logged more than 1000 hours of massage training. He has a passion for exploring the deep mystery that is the human form. He is a father, husband, brother, and friend who loves working with people, particularly aiding those suffering from chronic and intermittent pain. When he is not working as an orthopedic massage therapist, he spends his time in nature or his garden. (Also, he is a huge dork for Lord of the Rings–but who isn’t?)

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