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

In the last blog post, mobility, stability and flexibility were defined in the context that I will be using them.

This is important to keep in mind as they have very different applications when it comes to relieving low back pain issues.

Quick Recap:

Mobility refers to the available motion at a joint, generally taking into consideration the amount of control exerted through that range.

Stability is on the same continuum as mobility but refers more specifically to the ability to resist excess motion and maintain joint integrity under neuromuscular control.

Flexibility (which falls under the broad expanse that is mobility) for our purpose will refer to the total range of motion available at a joint, whether or not it is under neuromuscular control

Mobility, stability and flexibility on low back pain:

As stated before, most people with mechanical low back pain have decreased mobility (are hypomobile) at their hips (think of the hours you spend sitting in a flexed hip position!) and have excessive movement through their lumbar spines (hypermobile or flexible lumbar spines; think of those poor, slouched postures you sit or stand in for long periods of time!).

This becomes a problem because the body will do what it needs to do to create the movements you want it to create.

In many of these low back pain cases, this means that the hips won’t extend far back enough. The body just can’t get enough movement through the hips.

The  body’s solution: find the next best place to achieve that extension in order to execute the desired movement pattern.

Unfortunately, this almost always means excessive movement through the flexible (hypermobile) lumbar spine.

Hypermobile Lumbar Spine

What does this mean for you?

Well, if you now have too much movement going through an area that is supposed to be stable, various tissues will get irritated and injured.

For most people, this won’t happen right away.

In fact, for most people, this happens over a longer period of time because they repeat those same injury-causing faulty movements over and over again, day in-day out, week after week, month after month, year after year.

Remember repeated flexion and extension through the lumbar spine is the primary stimulus for the creation of bulging or herniated discs.

Now imagine what happens to those poor lumbar discs if you repeatedly flex then extend through the lumbar spine to make up for your loss of hip mobility…Not a very pretty picture at all!

One day, the last straw is placed on the camel’s back, and it breaks.

So how do you save the camel’s back?

Well my friends, in the next post, I’ll go over some specific strategies that you can put in place to stabilize your spine and mobilize your hips.

Just remember this equation and many of your back troubles will disappear:

Stable Spine + Mobile Hips = Healthy Back

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