Relieve Low Back Pain | Reduce Low Back Pain | Canada's Leading Authority in Human Movement | Dev Chengkalath

As always, in the realm of physical therapy and injury rehabilitation, there are often more questions than hard answers.

One of the most often debated areas relates to the notions of mobility, stability, flexibility and how these impact low back pain.

Because the language used can change from person to person or physical therapist to physical therapist, I want to start off by defining some terms in the context I’ll be using them.

That way, we’re all on the same page. Or at least on different pages of the same book.

Mobility: Ability of a joint to go through a specific range of motion under neuromuscular motor control. To confuse things even more, mobility can be further categorized as hypomobility (not enough movement) or hypermobility (too much movement). So as you can see, mobility can encompass components of both stability and flexibility).

Stability: This term falls under the continuum of mobility, but for our purposes will be used to denote the ability to of a joint to resist excess motion and maintain joint integrity under neuromuscular control.

Flexibility: The total range through which a joint can move through without necessarily taking into consideration the level of neuromuscular control that is exercised (e.g. when you’re lying on your back and someone is pushing your leg into a hamstring stretch).

One of the most common statements I hear  in my physical therapy practice from my low back pain clients is that they believe they need more flexibility in their lumbar spines or in their hamstrings, that these areas just don’t move enough.

In most cases, this couldn’t be further from the truth.

As I’ve stated previously, what is needed is more hip mobility and increased lumbar spine stability.

In the next post, I’ll dig a little deeper into the impact of mobility, stability and flexibility on low back pain and how mobilizing your hips and stabilizing your low back could spare your spine and save you pain.

Yours in movement.

Dev Chengkalath

“As a physiotherapist, if I could boil down all the information that’s available to help people find low back pain relief and put them into 5 simple points, what would they be?”

1. The first step is always to figure out what’s the cause of your low back pain. And by cause, I don’t mean the irritations, the bulging discs, the inflamed tissues or any other item that may be considered the source of the pain (click here to read my post differentiating cause versus source). By cause, I mean truly find out what it is that you do everyday (e.g. repeated movements or prolonged postures) that puts your body at risk for injury or keeps it there.

2. Once you’ve figured out the first step. The second step is to remove or reduce that cause. Unfortunately, these are usually well-entrenched, well-engrained habits that you’ve probably been doing for years. For example, think of your daily postures.  Removing the cause of your low back pain will often require you to change your postures often (the best posture being the one you’re not currently in!) or necessitate that you decrease certain, repetitive motions (e.g. repeated forward and backward bending). Fighting to change these long-term habits is no easy task!

3. The third step is to re-train and re-educate your body. This is the motor control side of things. After the first two steps which fall into the realm of knowledge (the acts of learning and understanding what gets you into pain) the next few are designed to keep you out of it. Motor control encompasses postures, movement patterns, mobility concerns and muscle imbalances. By addressing each of these areas, you can work towards removing painful postures, correcting faulty movement patterns, improving mobility where needed (e.g. hips), increasing stability where required (e.g. lumbar spine) and creating an environment for optimal muscle balance and function.

Stable Spine + Mobile Hips = Healthy Spine

4. The fourth step is based on removing any ill effects from de-conditioning. When you’re de-conditioned, your body can’t tolerate the stresses placed upon it in the same manner as if you were in top form. Think of it this way, if you’ve been working yourself into the ground, putting in lots of overtime at work, eating poorly, sleeping just a few hours a night, your body more than likely feels drained and exhausted. You’re more prone to colds and other illnesses. In the same manner, if your body system is out of shape from lack of quality exercise, it won’t be able to deal with the various stresses that it faces everyday, from your morning commute to your prolonged postures. Eventually, something in that system will fail and lead to low back injury and pain.

Just move.

5. While I’ve listed this as the 5th step, it could just as easily have been placed as step 1. You don’t need to live with the pain. If you suffer from mechanical low back pain, there are solutions out there. Many of them are simple. None of them are easy. But there are options. Hopefully my blog gives you an idea of some of them.

Yours in movement.

Dev Chengkalath

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