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

So I’m sitting here at the Pearson International Airport in Toronto, Canada just preparing myself for one of the most physically challenging events that I undertake about a dozen times a year or so.

Flying.

My travel schedule is typically full of courses and seminars but this time I’m off to sunny Alberta, Canada for a family visits and a wedding.

Five days of Rocky mountains, prairies and family fun time.

The problem is Alberta is a significant distance from Toronto. It’s true. Canada is an expansive piece of landmass.

Which is why I fly.

Therein lies my issue (some of my friends may say that this is just one many that afflict me!)

I hate flying. I really do.

My thoughts exactly

If you’ve been following anything on my blog, you’ll realize that I’m not a big fan of sitting. And flying, especially long distances, typically entails hours upon hours of just that (the same could be said of trains and automobiles as well!).

In fact, I would say that the simple act of sitting is, or has been, one of the fundamental reasons why people have consulted me for physical therapy to relieve their varying and incessant aches and pains, most notably low back pain.

I could go on all the other issues that arise, but I’ll save that for another time.

Let me guess…at this point you’re probably rolling your eyes in disdain at me with my sitting equals doom and gloom decrees.

Well, let me clarify this a bit.

Sitting isn’t so bad in itself.

The problem is that we tend to sit for LONG periods of time.

Without moving. In set positions like the famous slouch. Especially in airplanes with their cramped seats and long delays.

And that, my friends, is the reason I hate flying.

Think of it this way.

How often do you really get a chance to stand up and move around on an airplane? Do you really stretch your legs? How comfortable can you really get? And those tiny bathrooms…don’t even get me started on those.

I’ll be the first to admit…I’m a chronic fidgeter.

And it’s pretty damn hard to fidget when you’re strapped to what could essentially be considered a flying “profit-maximizing” seat.

Now imagine taking a flight that lasts 8-10 hours (thankfully, most of my flights are 5 hours or less). Now imagine doing that 5 or 6 days a week.

What kind of chronic stress and trauma do you think is placed on your body? On your bones, joints, tendons, ligaments and muscles? Or even on your mental state?

For those of you out there who work in offices, sit at desks or drive for long periods…this is what you do to your body. Everyday.

You take that daily airplane ride, without the airplane.

Think about that for a few minutes and ask yourself about the power of your posture.

Yours in fidgeting.

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

Around this time of year, there’s a spike in flat screen TV sales.

With this incredible TV buying frenzy there is also the potential rise in low back pain. 

How are the two related?

Usually, when people watch TV, they lounge on their cushy couches.

That’s where they break all the posture rules. Add an ALL DAY LONG major sporting event like the Superbowl and you have people sitting for longer periods of time than usual. Immobile. Stressed. Tense.

Heck, everyone even sticks around to check out the million dollar commercials.

People stop moving. 

I mean, I’ve seen my buddies resist the urge to go to the bathroom, lest they miss something too important during their pee break.

Time stands still. 

Unfortunately, these habits are the perfect breeding ground for your next episode of low back pain and a visit to your local physical therapist.

So for the sake of your poor back, during the game, get up and move! Or at the very least, watch the commercials while standing!

Dev Chengkalath

Now that I’ve lightly touched upon postural issues, it’s time to move on to muscular ones.

In the last post, I alluded to the fact that repeated poor postures cause certain muscles to change from their ideal through adaptive changes. I also talked about the pelvis and its relationship to low back pain.

Today and over the next couple days, I’m going to link the two.

At this point, I think it would be wise to take a moment and welcome the brothers glute: Maximus, Medius and Minimus.

Rock Crushing Glutes: Not Dysfunctional

Collectively and colloquially they are known as the “buttocks”. And we’ve all got ‘em.

So how does this tie into relieving your low back pain?

This powerhouse muscle group is almost always dysfunctional in the posteriors of all the non-traumatic, chronic bad backs that I’ve had the pleasure of working on.

Think about this for a moment. People with low back pain have weak butts.

Let’s dig a little bit deeper, shall we?

For most of you out there, what’s the most challenging movement you’ll do in your day?

I’m sure there are a few of your out there who will do some pretty incredible feats in the gym or whatever your training field may be. You may be crazy acrobats or gymnasts or super-athletes.

However, for most of you, as is the case with the majority of the clients I see at the clinic, it will be…drum roll please…

Sitting and Standing (aka The Sit-to-Stand).

You do this when you wake up in the morning and roll out of bed. You do this when you use the toilet. If you eat breakfast, which you should be doing, there’s a good chance you sit then stand from the kitchen table. If you drive or ride the bus or train to work, you more than likely sit then stand. At your desk, sure enough, you sit and stand. Repeatedly. And so on and so forth.

Now if you are a low back pain sufferer, I can almost guarantee that you do this incorrectly.

Yup. You do.

I know. It hurts. Sitting then standing seems like such a simple skill! I mean, after all these years, you should be a pro right?

Unfortunately, somewhere along the line, you picked up some pretty bad habits and developed a beneficial relationship with gravity. It’s called the “plop”. This means you “plop” into you chair without any control. 

When’s the last time you thought about how you sit? Or how you stand from sitting?

If you spend a good part of your day sitting, you will end up inhibiting the glutes. When these muscles are turned off like that, it changes how your pelvis functions. It changes how your hips work. Which then changes how your spine functions.

All these alterations in function then affect all the tissues up and down what we call the kinetic chain.

Think dominoes. 

Now if your glutes don’t work properly, your low back has to pick up the slack. Little muscles start doing the work of big muscles. Big muscles start doing the work of little muscles. And some muscles just stop working. 

In the following clip, a couple squat variations for you to try out are shown.

Before I get any of my clients squatting like in the video, I get them to actually turn their butt muscles back on. Since there isn’t a switch to flip, this does require some effort. 

First exercise: The Glute Squeeze. 

If you’re sitting, sit up tall and sit on your hands. Now squeeze your butt cheeks. You should feel the muscles tighten on your hands and it should feel like you’re lifting your body up. Do this for 10 reps every chance you get and every time you find yourself sitting. 

So that’s your homework for today. Nice and simple. Squeeze your butt. Lots.

Tomorrow, we’ll talk more about those glutes of yours. 

Yours in search of buns of steel,

Dev Chengkalath

Before I write about how you can fix or improve your posture as it relates to low back pain, I would be remiss if I didn’t discuss the following…

It is common sense, but I feel it does need to be addressed.

This information is just that. Information. It’s not medical advice and shouldn’t be thought of as such.

The words on my blog, or the information you may find on the internet will definitely help educate you, but it does not replace the care of a trained health professional who can fully assess your individual situation.

If you or your clients have any concerns, seek medical attention!

Now that that’s out of the way, on to posture and how it’s related to low back pain.

How many of you spend hours in front of a computer? How many of you spend hours driving a car, sitting in rush hour traffic? How about watching TV while relaxing on the couch?

Think about it.

In one day, count the hours that that you spend sitting. Eight? Ten? Sixteen? More?

When you sit, you don’t move a whole lot. At least that’s my experience with watching people sit (yes, this is what I do on the weekends). But even if you’re not moving much, you still end up using certain body tissues. Especially those in the low back. And you use them over and over again or you use them incorrectly.

When you’re positioned a certain way, for example, in that typical slouch position on the couch, you use specific muscles constantly and turn other ones off.

Unfortunately, this causes your body to rely on the passive system. The passive system includes the bones, joints, ligaments and other soft tissue structures that don’t have contractile properties. In this case, they’re usually the ones that weren’t designed to absorb gravity’s constant force on your body in that manner.

Over time, these passive structures adaptively change.

Sometimes, like when trying to build muscle by lifting weights over time, adaptive change is a good thing.

In the case of your low back pain, it’s not!

Poor seated posture

Some muscles and ligaments get stretched out. Much like a rubber band that’s been pulled apart and won’t go back to its original shape. Some tissues just get turned off or stop working the way they should. Kinda like that use it or lose it thing.

So if you were slouching away all day at work in front of the computer, then slouched in the car all the way on your drive home, then crashed in front of the couch in that same fetal-like position, you’ve just spent the better part of your day compressing your discs while stretching out your spinal ligaments.

Doesn’t sound so comfortable when you look at it like that, does it?

Now repeat that day-in and day-out, for weeks or months or years on end.

See where I’m going?

It all comes back to movement. Do what your body is meant to do. Move. Change posture. As so eloquently put by Dr. Stuart McGill, spine researcher extraordinaire, the best posture is the one that keeps changing.

Where do you start to relieve your low back pain? How do you go about getting rid of the pain?

Why not start with what your mamma told you to do!

Sit up tall.

Ideal seated posture

This is going to be one of the hardest physical challenges you will face today. Since you started school when you were about five years old, you’ve been teaching your body some very nasty habits. You need to unlearn them.

Let’s start with the spine.

Imagine a string is tied to the crown of your head and is pulling upwards. This will keep you extended through your spine and will also keep your chin tucked in and horizontal. This position keep your spine in proper alignment and helps to maintain the normal curves required to reduce the crushing effects of gravity.

This is the way your body posture should be. Easy. Efficient. Effortless.

Next, try to get and keep your shoulders back in their normal position.

After years of abuse and repetitive postures, you may find you sit with your shoulders rounded forward. Trust me, you’re not the only one!

In fact, the next time you get a chance, look at the person in the car beside you at a red light, or look at your cubicle neighbour as they diligently type away at the computer or talk on the phone. Look at how their shoulders are positioned. I tell ya, it’s everywhere!

Trying to change this will be tough for some of you. But it’s all part of the plan to get you pain free. You need to be diligent. You need to put the effort in. You need to be consistent. For now, try working on those two posture items and let me know how it goes. It’s not going to be easy, but nothing worth doing usually is. 

Don’t slouch. Defy gravity.

Dev Chengkalath