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

It seems to me that people like lists.

They’re short. Concise. And should be to the point.

And if created correctly, they’re pretty easy for most people to remember.

So here goes…

This is my list of the five worst things you’ve done to you low back today:

1. You’ve flexed through your lumbar spine on fully hydrated intervertebral discs (yup, these are the same discs involved in those famous disc herniations or “slipped discs”). In fact, this was probably the first thing you did this morning upon awakening from your more than likely short and insufficient sleep.

• Sitting bent forward on the edge of your bed in that sleep induced haze right after you wake up.
• Sitting in that same bent forward and flexed position on the toilet.
• Brushing your teeth, washing your face, and maybe even standing slouched in the shower.
• Hunched over the breakfast table (you SHOULD be eating breakfast!).

2. You’ve spent more than 30 minutes (this being a fairly conservative guess) in a static and continuous slouched posture.

• Collapsed on yourself with your ribs resting on your pelvis during your commute to work (this includes planes, trains and various forms of automobiles).
• In your standard computer posture in front of that technological wonder that was designed to make your life easier and more manageable. This position likely has you with your head protruding and your shoulders rounded forward for extended periods of time.
• On the couch watching your favourite television programming (typically for a few hours) after a long, grueling and tiring day at the office.

Slouched Sitting Postures: Over time can lead to injury.

3. You sit. And sit. And sit. Enough said. Follow the link if you need more info on the dangers of sitting.

4. You wear high heels. This one is mostly for the women out there, although, who am I to judge? This piece of fashion will confer the wearer with an instant and noticeable alteration of lower limb appearance. But at what cost?

• Centre of gravity shifts with resultant changes in weight bearing
• Increase in lumbar spine curvature (increased lordosis, possibly excessive)
• Altered muscle recruitment patterns, biomechanics and gait patterns

5. You decided that you were too tired to exercise today. This follows along with number 2. And number 3. I think everyone is aware that exercise is good for you so there’s no need to belabor that point. It’s just a matter of prioritizing it to get it done.

Yours in movement.

Dev Chengkalath

In yesterday’s post, I discussed the subtle loss of stability in the lumbar spine when most people complete the sitting action.

Today, I’ll be giving you some quick physiotherapy tips on how you can fix your sitting. In the next post, I’ll give you tips on how to improve your standing from a sit.

As always, I’ll be using my trusted three part approach for relieving low back pain:

1. Knowledge

2. Motor Control

3. De-Conditioning

First, recognize that you are doing something to yourself multiple times a day (repeated sitting with loss of control) that is causing trauma to your tissues and that you must remove these injurious forces in order for healing to take place. If these forces aren’t removed or resolved, things just won’t get better.

You have take action to fix it.

This is the knowledge component.

Second, improve your motor control.

Recognize that motor control encompasses four major components including posture, movement patterns, mobility, and muscle balance. Each of these areas will have to be addressed for a long term solution.

This is the action phase where you apply your knowledge.

Start by fixing your posture as described previously (just click the link to be taken directly to the posture post).

Next, learn proper sitting mechanics. Sure, you’ve known how to sit since you were an infant, but when’s the last time you checked to see if you were doing it right? Are you sure you haven’t picked up any bad habits along the way?

You can work on mobility (loosening the hips and stabilizing the spine) and muscle balance (think about resolving any imbalances you may have because of compensations or specific movement habits) concurrently using simple drills such as the quadruped hip rocking movement in the following video clip.

Finally, and just as important as the other two areas, is fixing your fitness level. If you’re de-conditioned, you’ll let gravity do more work than it should, especially on the sit (remember the plop?).

Putting it all together…The sit breakdown:

From a standing position, control yourself down towards your seat while keeping your lower spine in neutral position (between rounded and arched). As your buttock descends towards the seat, push your hips backwards, making sure you keep your spine in that optimal, stable alignment.

Toronto Physiotherapist Demos Neutral Spine Sit To Stand

Some common errors include standing with your feet too close together, rounding your back as you sit down and of course, not controlling yourself down. Another often seen compensation is the use of the arms to lower yourself down.

Toronto Physiotherapist Demos Bad Sit: Posterior Pelvic Tilt and Rounded Spine

As your buttock touches down on the seating surface, this is where you need to be aware of the potential for loss of control through the lower back and pelvis. The plop tends to allow the lower back to round and the pelvis to fall into a posterior pelvic tilt (tailbone tucked under position).

For a proper sit, don’t allow the lower back to deviate from the neutral position throughout the WHOLE movement. Maintain that position right from the standing to the descent into the seat.

And that, my friends, is how you should be sitting. With control and purpose.

How many of you can honestly say that you pay attention to how you sit down every day?

If you’re experiencing low back pain, it’s probably time you started.

In the next post, I’ll work through the standing component to keep your back healthy and safe.

Yours in movement.

Dev Chengkalath

Doesn’t exist.

Because everybody is different and every body will respond differently to different treatment approaches.

But using the basic principles outlined in my post on the 3 most important steps to relieve low back pain will definitely give you a head start in solving your low back problems. 

Those principles are designed to take into consideration the root causes of your low back pain and not just mask the symptoms. 

Today, I just want to touch on an activity we do all the time yet take for granted. 

Sitting and Standing.

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 at work, sure enough, you sit and stand. Repeatedly.

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

Yes. You do.

I know…It hurts.

Sitting then standing seems like such a simple skill! I mean, after all these years of doing it, you should be a pro right?

Unfortunately, somewhere along the line, there’s a good change you picked up some pretty bad habits and developed a seemingly beneficial relationship with gravity.

I like to call this relationship the “plop”.  

Basically, this means you “plop” into you chair without any control; you let gravity do all the work and pull you into the chair. 

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 your buttocks, guaranteed.

When the glutes are turned off like that, it impacts how your pelvis functions, it impacts how your hips function and in the end, all of these changes will impact how your spine functions.

All these alterations in function affect the tissues up and down what we call the kinetic chain. This basically allows for a dysfunction in one part of the body to cause, through various compensations, dysfunction in another part of the body.

Think dominoes. You push one over and one by one, they all fall over in a chain reaction.

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 altogether. 

Over the next few days I’ll be outlining some exercises you can add in to your daily routine to get your butt back in gear. 

As always, yours in movement.

Dev Chengkalath