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

In my experience as a physical therapist, a majority of my “bad back” clients hobble in the clinic door only when they’re in the midst of a disabling episode of low back pain.

And when I say hobble, I really do mean hobble. In many cases, they’ll be doubled up, limping and staggering with their faces contorted in agony. 

In fact, I’ve seen that pain grimace so many times I take it as their version of a friendly hello.

Friendly Hello!?

Sadly, this is usually a “typical” case of acute low back pain for them. By typical I mean a flare-up of their long-standing back issues. I’ve had clients come in with histories of low back pain spanning almost their whole lifetimes.

Some longer than I’ve been alive! 

Some caused by trauma such as falls or motor vehicle crashes. Others caused by sports or athletic related injuries.

But most often, these poor souls have just been mistreating their poor backs for way too long. 

Could you imagine 15, 20, 30 or more years of intermittent, chronic low back pain? 

What’s your magic number? How many days, weeks, months or years will you let it go on?

Two? Three? Four? Five? Ten? Twenty? More?

Leave a comment and let me know how long you’ve been suffering and what you’ve tried in the past. Let me know what’s worked and what hasn’t. 

Yours in health.

Dev Chengkalath

Now that you’re educated about your problem, it’s time to take control of the situation. 

In the case of solving your low back pain issues, this means getting your motor control back.

Motor control issues encompass a broad spectrum of items that relate to how we move and how we interact with gravity and our environment. These include daily postures, our muscle function, our mobility and our overall movement patterns.

Motor Control at its finest

I like to split motor control issues into four sub-sections and will explore each one separately. Do keep in mind that each of these items interact with each other and should not be considered independent of the others.

Motor Control Issues:

1. Posture
2. Muscle Imbalances
3. Mobility Issues
4. Movement Patterning

In this post, I’ll just briefly highlight each of the above.

Posture: Posture is the combination of all the positions of all the different joints of the body at any given time. Faulty posture may put you into positions of stress while ideal postures may alleviate them.

Muscle Imbalances: This simply means that your muscles aren’t working properly. In most cases this relates to how your muscles deal with forces. If an imbalance exists in muscle function the end results is that they aren’t dealing with either creating or resisting forces properly.

Mobility Issues: Mobility is your body’s ability to move a joint under control. With mobility, three states of being exist: optimal, hypermobility, hypomobility. Optimal mobility means your joints can be controlled through any required range of motion. Hypermobility is when a joint moves too much (too much range of motion) without being under control. Hypomobility then becomes the opposite-when the joint doesn’t move enough to allow the required range of motion.

Movement Patterning: As humans we tend to move through the same patterns every day. If we’ve picked up some bad habits, this can put various tissues at risk of injury. Take for example a sit-to-stand. This movement is probably one of the most frequently performed functional tasks we do each day: think toilets, chairs, cars etc. Now imagine that you have a faulty pattern and you repeat that pattern every time. Day after day. Week after week. Month after month. At some point, there will be a structure in your body that won’t be able to tolerate that stress and it will fail. This is where your back “goes out”.

Now if you can apply the appropriate knowledge and take control of the above four issues using physical therapy, you’ll be well on your way to relieving your low back pain.

In the next post, I’ll cover the final element of the top 3 steps to relieve your low back pain: Get Fit.

Yours in movement.

Dev Chengkalath

LARGE BREASTS.

Warning: May cause severe back pain

“Where the heck is he going with this one?!?”

I am going to assume that’s what you’re thinking.

And rightly so. 

Read on to find out how big breasts are related to back pain… 

While I’ve discussed many learned or habitual causes of back pain, there is an area that I haven’t spent much time talking about. 

Structural causes. 

Now these types of causes are many and can include bone related issues as scoliosis (curvatures of the spine), leg length discrepancies (one leg shorter than the other), or a number of other problems related to the structural make up of various human tissues (bones, joints, tendons, ligaments etc). 

One such structural issue that is fairly common, but not often discussed, is the case of the massive mammaries. 

Being a male physical therapist working under the auspices of the Regulated Health Professions Act, I’ve had to broach this subject with my clients with significant caution.

You can’t just tell someone that their boobs are causing their back pain. Even if that’s really the case.

That being said, this problem is very real for those that suffer from it and must be addressed.

For this problem, there are a few solutions I’d like to suggest:

1. Proper bra fitting: Obviously, not being a bra expert myself, I’ve had to reach into my extended network of colleagues and experts for information (no matter what industry you’re in, you MUST have a network you can access for things you don’t know!-but that’s for another post!) This includes the correct size, style, support and structure. Even a small change such as a wider shoulder strap can make a HUGE difference. So for all you women out there, have your brassieres professionally fitted. 
2. Fix your posture. ‘Nuff said. 
3. Lose excess body weight: This is not only important for back pain issues but also for health issues. My good buddy Rocco has a program that can help you out. You can check it out HERE.
4. Get in shape: If you have a heavy chest that collapses you forward, you need strong, resilient muscles to defy gravity and keep you upright. Get strong. Get fit. 
5. Breast reduction surgery: Sometimes, it’s gotta be done. Your health is probably worth more than having cleavage. 

So there you have it. Big breasts and back pain.

The silence has ended.

Dev Chengkalath

In my physical therapy practice in Toronto, I often get people who have been in fairly chronic low back pain for a good chunk of time, something you might be familiar with. 

So let’s use your situation as an example. 

Because of the length of time you’ve been suffering, there’s a good chance that you’ve been to see at least one, if not multiple, health care practitioners such as physicians, physical therapists or chiropractors. 

One of the most common self or health professional “prescribed” treatments that you’ve probably been given in the past is to statically stretch your low back. 

Sound familiar yet?

In fact, you could even google low back pain relief related terms and you’d probably come across dozens upon dozens of websites all proposing various low back static stretches to get you feeling better.

Unfortunately, for most of you, stretching your low back in this manner doesn’t deal with the root causes of your low back pain.

Sure, it’ll feel good.

Temporarily. Stretching usually does.

But feeling good doesn’t always mean doing good. And in this case, stretching the poor muscles of your lower back is probably not a good idea.

Don’t get me wrong.

There are times when those tissues do need to be stretched out, but it’s not as often as most people think. 

So what’s the solution?

What should you do instead?

What you need to do is stabilize your spine. Unfortunately, here’s where it gets a little more complicated.

Stable doesn’t mean immobile. In this case, stable really means mobile under control. Control being the operative word.   

In the following clip, the Cat & Camel mobility exercise is demonstrated.

This movement is geared towards keeping your spine limber while still keeping control.

It’s NOT about going as far as you can, it’s about going as far as you can, UNDER CONTROL. 

Give it a try and let me know what you think.

Yours in movement.

Dev Chengkalath

If you suffer from low back pain, I’m willing to bet that you’ve been told to “strengthen your core” from someone, somewhere, at some point. Maybe your doctor, maybe your physical therapist, or maybe even from Uncle Johnny or Auntie Suzy. 

While I do believe that having a strong core helps, I don’t believe it will protect you from low back injury or pain. Often, it won’t even help you relieve the pain you already have. And at worst, it could do you harm.

I’ve seen this first hand in my physiotherapy practice in Toronto. I’ve had clients come in who had taken this advice to heart, and for years, they had worked on their abs. This usually involved a whole routine of abdominal curls, crunches and twists, with hundreds or thousands of repetitions a week. Their abs did get strong, but they didn’t relieve their low back pain. Sometimes, they actually made it worse.

They went about it the wrong way.

So what should you do if you shouldn’t strengthen your core with curls, crunches and twists?

Improve your muscular endurance with stability exercises!

Dr. Stuart McGill, one of the world’s foremost spine researchers, discusses this concept in depth in his book Ultimate Back Fitness and Performance. He presents a strongly supported, evidence-based argument for the back-protective nature of improving muscular endurance as opposed to doing the same with muscular strength.

A must read for low back health.

So where does that leave you if you can’t get your daily fix of abdominal work?

Just give the following series of exercises a go to improve your core endurance and spinal stability. 

Yours in movement,

Dev Chengkalath