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

In my practice as a physiotherapist in Toronto, I often come into contact with people who end up at the clinic seeking relief from their low back pain.

While many of their stories are unique, there are always certain similarities.

This holds true for not only back pain, but also shoulder pain, hip pain, knee pain or any other pain that you can imagine.

One of the most common questions I’m asked at the clinic is:

“How long will my low back pain last?”

And that, my friends, is a great question.

In some cases, my clients had low back issues resolved within days while others have taken months or longer.

But really, that just means I don’t know.

I wish I had a simple answer but since the actual mechanisms of low back pain are so varied and distinct for each sufferer, I wouldn’t honestly be able to answer that question with a blanket timeframe.

It just doesn’t exist.

There is no magic bullet, cure-all pill or results-guaranteed surgery. There is no exercise panacea.

Unfortunately.

However, in cases of mechanical low back pain, if you remove the root causes of the pain, the body has the incredible ability to heal itself.

While that task may appear simple, it’s not necessarily easy.

Fixing a bad back will take time and effort on your behalf. You will have to be consistent in working on improving your situation.

You’ll have to be willing to acquire the knowledge to learn what’s causing your pain or keeping you there.

You’ll have to be willing to break old habits, be aware of your postures and alter your positions.

You’ll have to be willing to do the work.

Basically,  you’ll have to give your body a chance to heal.

And that begs the question that has become the title of this blog post:

“How long will you let yourself suffer with lower back pain?”

What would you do to stop it?

What steps would you take?

What information would you need?

What price are you willing to pay?

What would you be willing to sacrifice?

These sound like hard questions to ask yourself, but they are absolutely necessary.

I’m looking forward to hearing your comments.

To your low back pain relief.

Dev Chengkalath

As the name implies, this isn’t for those people who are in the midst of an acute low back pain attack.

In fact, I would say this isn’t a physiotherapy core exercise for most people who are in any form of pain…

…Unless they can get out of the pain through abdominal bracing and using a neutral spine position. And they can hold that position without much difficulty.

That being said, in my Toronto physiotherapy practice, I use this exercise often when my client has progressed from the basic core re-training program to add a little variety to the exercise and rehabilitation program.

In this dynamic variation of the plank exericse, the key is to keep your body in that set “plank” position, without allowing your hips or your low back to sag or peak, while you raise and lower your body from your forearms to your hands.

This follows the idea of avoiding excessive flexion or extension based (forward or backward bending) positions through the low back (as discussed in the 3 Worst Core Exercises For People With Low Back Pain).

Yours in planking (dynamically or otherwise!)

Dev Chengkalath

Just wanted to mix things up a bit and try out a new method (at least for me!) of getting the information out there.

I put together this short clip discussing the major causes of lower back pain.

Let me know what you think!

Yours in 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