Lower back pain; only a mystery if you ignore the blindingly obvious! 6 steps to make your back better.


    So many runners and indeed people generally come to me with lower back pain. They tell me they’ve seen their GP or another health professional and they don’t know what causes it or they’ve just had it described as ‘wear and tear’ or ‘old age’. Incredibly they are prescribed powerful pain killers or told to ice it and the like.

Well I have no medical training whatsoever, but I spend a lot of time in my job looking at the way people stand and move and it’s incredibly easy to spot those people who are likely to be suffering from this and those who are not. Therefore, I don’t really get why they can’t see this – I suppose they just are not trained to look at the whole body, either in standing posture or movement, but just seem to be obsessed with the site of the pain and fixing symptoms short term and cannot see the blindingly obvious whole picture.

In virtually every case it’s clear how the client will present even if you know nothing about them and have never even see them before.

In standing posture they will tend to have one or both feet pointed out significantly, usually combined with at least one knee tracking inside the foot (i.e.. poorly aligned). Usually the pelvis will be tilted forward, causing a rounding of the lumbar spine. One hip is often hiked up higher than the other and the pelvis will drop and rotate as they move.

They will not be able to touch their toes and will struggle to squat or lunge properly. Usually one or both glutes will not be firing (pretty much inevitable if the foot is turned out). Hamstrings and adductors will be tight and hip rotators not functioning much. Usually they will have very limited ankle dorsiflexion, preventing proper shock absorption all he way up the kinetic chain. Hip flexors will also be tight.

If asked to run, they will run with a very upright stance, a slow cadence and tend to heel strike out in front of their body with extended knee – again no proper dissipation of ground reaction forces. Some will actually lean backwards as they run, effectively slamming on the brakes with every stride and sending shockwaves all the way up to the lower back and beyond.

This set up also makes them much more prone to knee and hip pain, as well as calf pain and Achilles tendinopathy etc. They will be unable to either extend or flex their spine much.

So what’s the answer? Well it’s certainly not stronger painkillers! Nor is it pilates or yoga by themselves I’m afraid (although these are useful add-ons sometimes). These problems have come about usually over a long period of time. Much is down to Western lifestyle – sitting too much, wearing built up ‘protective’ shoes, occupational factors, working at desks on laptops, devices, no education on how to stand or move (because, of course, you just need to ‘move more’, it doesn’t matter how!)

The fix is not as instant as a painkiller but symptoms can be improved considerably very quickly, if not completely resolved. These are some of the measures, depending upon the individual, which yield excellent results, such that many clients have totally forgotten they had back pain after a few weeks!

  1. Teach people how to stand properly – feet forwards, finding a neutral pelvis and shoulders externally rotated, not rolled inwards.
  2. Get them performing simple functional movements properly regularly – toe touching, squatting, lunging, reaching overhead, moving all joints and spine through a full range of motion in all planes of motion, with special attention to pelvis, feet and spine. All done with mostly just bodyweight, nothing heavy at all for now.
  3. Addressing any mobility issues that arise during this with myofascial release, foam rolling, dynamic stretching, banded stretches, compression etc, referring to specialist for anything hands-on that is needed when all of the above cannot get the desired result.
  4. Address walking gait through brisk walking which lubricates joints, fascia etc and conscious awareness of compensations (often due to old injuries etc.)
  5. Address running gait (if a runner) through encouraging less upright style, increased cadence with shorter stride, foot landing underneath a fixed knee etc. for proper shock dissipation.
  6. Implement better lifestyle strategies for improved posture and movement, including minimising sitting, a variety of movement, barefoot when safe and possible, proper nutrition (this plays a significant role in all physiological aspects), good sleeping positions etc. etc.

Or you could just carry on believing that it’s just ‘wear and tear’ or ‘old age’ or ‘overuse’ and there’s nothing you can do – just take some ever stronger painkillers or have a massage and get some short term relief.

One thing is for sure – unless you address most of these other issues, it will only get worse and the more you sit immobile, the faster this will happen.

I have no pretensions to be medically qualified – I’m just telling you what I see every day. The people who just accept what they’re told and end up on a cocktail of more and more pills don’t ever get better – they just resign themselves to doing nothing. I’m afraid that we all have to take responsibility for our own well-being and stop relying on a system that promotes painless ill health and longevity, at the expense of life.

I’m happy to take a look and see how you can be helped by posture and movement practice.

Contact David at Roads to Freedom on 07504439555.



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