Wednesday, October 24, 2018

Back to Basics: Decreasing Low Back Stress

A big problem that we see in our patient populations and in the community are
misconceptions about proper rib, pelvic, and back positioning during functional
movements and prolonged postures. A common complaint we often get from
patients at Soul Physical Therapy is pain localized to the center of their low back
or on the sides. Often but not always, the culprit is over arching in our low back
(lumbar extension) without proper rib and pelvic position. Correct rib and pelvic
position is achieved with activation of the transverse abdominus, a muscle that lies beneath our “6 pack abs”. If unable to activate this muscle appropriately, we
can get too much compression in our spine, which can result in muscle tightness
and pain.

These extension or “arching” positions do not need to be avoided or feared, but we
do need to be mindful of what positions we are in for too long. These more extreme
positions into extension (arching) put more compressive forces through our spine
compared to a neutral or “straighter” spine and are more likely to lead to pain over
time if they are sustained or if they are loaded with strength training/lifting. Cortisone
shots, heat, electric stimulation, etc. can make this pain feel better temporarily, but in
order to rid this pain long term we must clean up our movement patterns to clear up
the source of the problem.

In this post, we will focus on how to achieve this position and what the differences in
these postures look like.

In this video, the subject shows how to achieve that ribs down, neutral spine/pelvis
position. If we look at his ribs, we can see how they are pulled down when he
activates his transverse abdominus as opposed to the initial rib flare position where
his back is more arched and pelvis is rotated forward. This muscle acts to give
stability through the spine to help accept the forces that on our body while we are
sitting, standing, and moving.

This picture shows the subject in a position where his ribs are flared out, his pelvis
rotated forward, and is putting more compression through his low back.

This picture shows the subject with his ribs down, pelvis in a neutral position with
less compression through his lower back.

Stay tuned for future blog posts on using these principles in the gym and exercises
on how to strengthen these postures!

If you're having back pain or have questions about these concepts / exercises.
Set up a free screening at Soul PT - 978.524.0333 or

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