I am no stranger to back pain. Having lived with chronic back pain for years I know exactly how crappy it can be for the sufferer. I know how crappy it can be for you.
I won’t mention any names but one of my dear patients put it best recently…….
Back pain is a sh*t craic
Currently in a position where I am pain free (most of the time) and having been fortunate enough to help hundreds of others to become pain free too, I know that there is light at the end of the tunnel.
Back pain is something I see every day in clinic. Each and every patient an individual but united in their struggles with their back pain. Despite your uniqueness, patterns do exist.
Nearly all of the back pain I treat is caused by a tissue in the back…..a joint, ligament, muscle, disc etc.
I am sure you could have told me that. Knowing the source of the pain is the obvious thing. Let’s face it there are only a number of things which can cause the back pain and that thing is normally located at the end of your pointed finger.
Knowing what is hurting is one thing, figuring out why it is hurting however, is a completely different matter.
VILLIANS & VICTIMS
I like to look at the painful area of the back as the victim. The tissue that is over worked, over burdened and over strained.
There are other areas however, which lead to this situation. These are the areas which are not sharing the load but instead increasing the burdon on nearby tissues. These areas are usually silent and painfree but when not functioning well, can wreak havoc on your back. I like to refer to these areas as the villains.
For today I am going to talk about one of the serial villains – “the psoas muscle“.
WHAT IS THE PSOAS MUSCLE?
The psoas muscle is a powerful hip flexor muscle which attaches on the anterior (front) part of your lower back (discs, verterbral bodies and transverse processes), passes through the pelvis and attaches onto the inside of your thigh.
Despite it’s lack of visability this muscle is big, very big. I am talking calf big. Therefore this muscle is powerful, very powerful.
With great power comes great responsibility but unfornately, at least for today example psoas will not save a dog from a burning building.
The psoas muscle essentially pulls your knee to your chest and is shortened in the sitting position. Muscles like being shortened, its comfortable for them, and certainly more appealing than being stretched.
The longer a muscle spends in a shortened position the tighter it will become. For that reason if you spend significant periods of time sitting throughout the day, psoas is probably going to be tight, very tight.
Having a “tight” psosas within itself is not really a problem. If the psosas is shortened but functional enough to stretch and faciliate full hip extension then you stand in good stead.
If however, the psoas is shortened to a point where hip extension is no longer possible, or where even getting your hip into neutral alignment is difficult then we may start to run into some issues.
LET ME TELL YOU A LITTLE STORY ….
Since my late teens I always suffered with lower back pain. Fit, healthy, exercising regularly, stretching as much as I can, sleeping well but no let off on my pain. I bounced around from GP, to physio to osteopath back to the GP and so on for years. The only professional that seemed to be able to help at all was my osteopath but relief from treatment was short lived.
I am talking 2 days……MAX
I was fustrated and as a student osteopath at the time, a little down on my chosen profession.
One morning, just like many previous mornings and after a hard nights training the night before, I hobbled into my technique class and slumped myself onto the plinth.
I was in AGONY!
Back pain really was a sh*t craic.
I literally couldn’t move an inch without being in excrutiating back pain. As I lied there on the plinth, momentarily hating life, one of my tutors walked over and said, “How long have you had a hip problem?”
Hip problem? Can’t you see it’s my back that is hurting, I thought to myself. So I asked,“What do you mean hip problem? My hip dosen’t hurt, it’s my back!”
And the education began…….
It turns out that, my back was compensating for the lack of movement in my left hip. Being unable to produce certain movements with my hip left my lower back in a very vulnerable position. I was therefore over extending and over rotating through my lower back, which was irrating the joints at the base of my spine.
In this instance psoas was heavily involved. Treating psoas alone and restoring hip extension basically relieved my back pain fully.
Unfortunately the hip progressively became very painful and therefore I did not live happily ever after until I had hip surgery for a developmental hip problem called Femoroacetabular Impingement (FAI). I will talk about this another day.
I do occasionally still have lower back ache. The reason I say ache is because the symptoms I have in my back now are not comparable to what I experienced in the past. When I do have back ache now I can act fast and do the things I need to do to relieve the ache before it becomes a pain.
When does my back pain get worse? When I spend long periods of time sitting.
What do I do to fix it? Stretch psoas! and a few other exercises.
This stretch is amazing to restore hip extension in a pain free and timely manner. The best part is….no fancy equipment needed.
LESSON OF THE DAY
Psoas tightness can lead to decreased hip extension which can lead to increased extension demand on your lower back which can lead to back pain.
If you suffer with back pain and are having little relief from your current management it is about time you started to look elsewhere.