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

In keeping with the theme of relieving your low back pain and getting you back to the things you love doing, I’m going to be talking about mobility.

What does mobility mean?

Mobility in this context is your body’s ability to move a joint and create range of motion. Some people equate mobility with flexibility. The only problem with that is when dealing with flexibility, we typically don’t take into consideration any of the neurological implications.

Too much mobility is NOT a good thing.

So how does mobility relate to low back pain?

As with everything in life, either too much or too little mobility can cause problems. However, with mobility issues, it depends on which joints are mobile and which ones are immobile.

In the case of low back pain, many sufferers will find they have hypermobile lumbar spines and hypomobile hips. Basically this means your low back moves way too much, more than likely as a compensation because your hips don’t move enough.

Remember, your body doesn’t know muscles. It knows movements.

If your hips don’t move enough and you can’t produce extension there, your body will find a way to recreate that desired movement by forcing extra movement elsewhere. Usually through your spine.

Combine the above with poor posture, weak core and a few adaptively changed tissues and you’ve got yourself a recipe for low back disaster.

With all these problems, your body’s biomechanical movement pattern will be severely altered. And you’ll keep inflaming and irritating the tissue in that area.

Irritated tissue= source of your pain.

Cause and source.

Remove the source, you get temporary relief. The band-aid solution. I’ll bet that’s not what you’re looking for.

Remove the cause and the source can heal.

Permanent solution.

So how do you get from having this problem to implementing the solution?

This is where I recommend Magnificent Mobility.

This amazing product is geared towards maximizing your hip mobility while maintaining your spinal stability. This DVD has everything you need to improve performance and maximize your potential. 

In only 10 minutes.

Flexibility, Performance & Health

And for most of you reading this, I am sure you can find that 10 minutes to dramatically improve your health. Even if it’s during commercials when you’re watching TV. 

Yours in mobility.

Dev Chengaklath

So now that you’ve had a few hours to work on those glute squeezes, how’d they go? 

Were you able to get the muscles to contract when you wanted them to? Were you able to get them to contract to a sufficient level? Were you able to squeeze them hard enough?

Although this may seem like a wasted exercise, I assure you, this is probably the easiest motor control movement you can do to get you on the path to a pain free low back.

It requires no equipment, it’s portable and best of all, it take very little time. 

In this post, I just want to go a little bit more in depth on why the glutes are so important for your back health. 

First off, this group of muscles is one of the largest and strongest in the body (or so it should be!). It’s also one of the major constituents of your core.

That’s right.

In contrast to popular belief, the core is not just made up of the muscles that form your six-pack abs or allow you to rip out all those sit-ups. It’s actually an interconnected network of muscles, joints and tissues that work to transfer energy, create stability and resist various forces such as rotation through the trunk.

As the glutes are one of the largest groups of muscles attached to the pelvis, they play a significant role in creating stability, transferring energy and creating optimal movement in that body region.

Functionally, the glutes’ major role is to extend through the hip and allow your leg to move behind your body.

This becomes important because if you’ve turned off your glutes from all that sitting or those hours and hours of repeated poor postures, your hip won’t be able to extend as far back.

Inhibited muscle=less movement. 

The problem is that your body doesn’t understand this.

It doesn’t know muscles. It only knows movements. 

If your brain says extend the hip, your body will find a way to get that hip extension. Unfortunately, this usually happens through painful or undesirable compensations in the low back and spine. 

So if you’re walking uphill, going for a jog, or doing that all familiar sit-to-stand, and you have inhibited glutes, there’s a good chance that you’re actually compensating with excessive extension through your low back in order to get that full hip extension. 

Over time, or for those unlucky few, instantly, this will cause low back pain. 

Now get back to working on your squat and get those glutes firing!

To your low back pain prevention and relief!

Dev Chengkalath

P.S. If you didn’t catch the squat video, you can check it out here!

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

…To remove the cause of the pain.

I’m not just talking about quick fixes or dealing with symptoms. I’m not talking about looking for the source of the pain. I’m not talking about figuring out what tissues hurt. I’m talking about finding what’s truly causing you the pain.

That, however, is one of the hardest things to do, if you don’t know what you’re looking for.

In most cases of low back pain, there is no one defining incident, there is no one injury, or no one single devastating event that can be pinpointed as the root of that shooting back pain, those tight knotted back muscles and those crippling back spasms.

In fact, your low back pain is usually the end result of years of neglect and abuse of your poor spine!

Now if you do know what you’re looking for, things get a little less complicated (although, nothing related to low back pain ever gets easy!).

Low Back Pain or Fire on the Spine?

As a high performance physical therapist in Toronto, Canada, I see quite a few bad backs. I see low back pain of every type and description. I see low back pain that’s been around for 30 years. I see low back pain that’s been around for a few days. I see that low-grade, nagging type of low back pain that comes and goes. I also have people limp, crawl and stumble in to the clinic in incredible pain, unable to function or perform their most simple daily tasks.

These backs are typically attached to a few different types of people, from executives to stay at home moms, to athletes to weekend warriors.

No one is immune.

According the the research, approximately 4 out of 5 people in North American will suffer from low back pain at some point in their life. Of that 4, many will have recurring episodes. Many more believe they have to live with the pain, suffering and dysfunction.

It doesn’t have to be that way.

The following is my list of the top 5 causes of low back pain. These aren’t based on scientific findings or research papers, but on observations from my physical therapy practice and my own personal clinical experiences.

These are the ones that you can fix. Simple, yes. Easy, no.

1. Poor Posture
2. Muscle Related Issues
3. Mobility Issues
4. Bad Movement Patterns
5. Deconditioning

For now, I’m going to give you some homework.  I want you to see if you can come up with your own thoughts as to what could be the problems, in each area, that could lead to low back pain.

Yours in freedom from low back pain.