The Truth About Back Pain

In my clinic I see clients for back pain all the time. People want immediate relief but if it is chronic there might not be an easy answer. Friends sometimes approach me with back pain to see if I have a quick fix. They probably imagine that I would just "crack" their back like a chiropractor and it will go away. As a massage therapist I would probably rub their back, or sink my knuckles and elbows into them, but I now know that this would be a temporary fix. What I see now is a person's whole posture and how they carry themselves to be responsible for their back pain, and this will need attention to many places besides the back in order to achieve relief. As a Rolfer, I think holistically, and I could simply charge someone to work on their back over and over again, but my training encourages me to find the root of the problem, and the the root of the problems is usually the whole person. Everything exists in relationship, and our physical problems are typically caused by disorder among the parts. When this is realized, one will understand there can be no quick fix.

Our backs can receive a lot of strain in our daily lives. We think this is because the spine is holding us up, like the central pole of a circus tent. Because of this belief we think it is just a matter of time before we develop problems with our spine, with age comes wear and tear, but this belief is not just misleading, it is wrong. We are self repairing, self correcting organisms. We were able to handle strain and injuries through out our lives, why does it become a problem at a certain point? When we were young we might wake up with a back ache and it would go away in a day or two. Now it might last for years. Is it just getting older that causes our bodies to stop re-establishing balance, or is that by the time we have gotten older we have had more time to accumulate more baggage, more strain? The body may deal with one strain pattern and shake it off just fine, like it did when we were younger, but what happen when we have one strain pattern interfering with another strain pattern that is interfering with yet another? This is how a problem perpetuates its self and lasts for long periods of time. These are the patterns that Rolfers address.

When we have lower back pain we often have hip restriction

The Hips Don't Lie

When it comes to back pain, especially lower back pain, the hips are the first suspect. You may have arthritis, you may have a bulging disk, but one thing is for sure, excess stain in the back with further aggravate it and hip restriction will put strain on the lower back. Many people have issues like arthritis or bulging disks but have no pain at all, but if you add extra drag from the hips when walking, or extra strain when standing the pain can be greatly multiplied. Touching in on the hips right away is usually a good rule for many problems, but for lower back pain it will usually be the first thing I try.

Lateral Hip Rotators

The lateral hip Rotators are the 6 muscles that help you to rotate your leg outwards, laterally. Known as the Deep 6, this fan-like group of muscles can cause all sorts of problems from restricting the hips, putting strain on the lower back, to pinching the sciatic nerve against the bone. Sometimes just a little bit of myofascial work here can release restrictions in the back. Also if someone is having lower back pain, it may be helpful to stretch these lateral hip Rotators out. For some people, even a few minutes can make a big difference. You can also lay on a tennis ball or even a golf ball on this area, careful not to impinge the sciatic nerve, if you feel nerve pain shooting down your leg, just move it over a little. When I was hitchhiking around Europe for the first time and sleeping in a tent, I used to use a little shiatsu knob, like a wooden thumb with a base to hold it up. After carrying around a heavy backpack all day even a few minutes made a big difference.

Pelvic Tilt

Ida Rolf was noted to say that the Rolfing Series, typically 10 sessions, was all about horizontalizing the pelvis. This might seem like an odd statement as we have sessions that focus on the feet or the head, but just as it has been said tha All Roads Lead to Rome, so do All Roads Lead to the Pelvis. The legs affect the pelvis and if there is not differentiation between the legs and the pelvis, every step takes the hips on a ride before allowing a full follow through with each step. The pelvis should be in a position to support the upper body. If it is tilted too far forward, the belly hangs off it, if you have a belly, and there is excessive strain in the lower back. This can cause or further aggravate a bulging disk or vertebral arthritis. Having an exaggerated anterior pelvic tilt causes too much curve in the lower back, an exaggerated lordosis. This will likely cause the individual to have to counter balance with holding their shoulders farther back than they need to, resulting in the posture of a banana.

"Gravity is the Therapist"- Ida Rolf

Holding your shoulders back can give you a banana posture.

A posterior pelvic tilt will take the curve out of the lower back, likewise putting strain on a preexisting problem or opening the door to new problems, like bulging disks and arthritis. When when curve is taken out of the lower back, the upper back collapses forward resulting in and excess curve in the upper back, and exaggerated kyphosis. This will usually take the head and the shoulders with it, giving you that slumped forward posture that is most recognized for "bad" posture. Just realize, you cannot correct this type of posture issue by simply holding the shoulders or the head back, you need to correct the lack of curve in the lower back, to take the excess curve out of the upper back, and to do this you need to address the legs and the hips that are pulling the pelvis back. Are you starting to see the holistic view I am trying to paint here?

Shoulders and Neck

As previously mentioned, the tilt of your pelvis can determine the velocity of the curves in your back, and this can determine where your shoulders are and where your head and neck sit. If your shoulder posture does not look good, take a look at the curves in your back. Many people are self conscious about their shoulders being slumped forward, and so they try to hold them back. This will take up a lot of energy and will be difficult to maintain, but with a lot of effort one can make a habit of holding their shoulder back to the point of it starting to feel natural. If the shoulders are held too far back this can product strain throughout the back, it is primarily the larger exterior muscles of the back that will be enlisted to do this. These are not muscles of posture, they are muscles of action, and should be at rest when not working. The opposite is true if the shoulders are slumped forward, the muscles of the upper back will be in an overly lengthened position, likely to cause fatigue and pain, and stretching these muscles is likely to make things worse.

Although he is expressing an attitude, his posture shows the forward slumped shoulder that causes an excess kyphosis in the upper back.

Prevertibral Support

Back pain is ultimately addressed by getting support up the front of the body, not the back. This is because almost all of our weight is on the front of the spine, not the back. Even bulging disks are more often on the front of the vertebra, not the back. With more prevertibral, front of the spine, support we will have less strain on our spine and our back. Rubbing someone's back when it is sore might help some, but if we want more permanent solutions we need to develop support for the back so the body is better able to maintain a balance and sort out problems. With this support comes better posture, and we are more aligned with gravity, as nature intended. Then the body's natural ability to heal itself is invoked. This is why Ida Rolf often said that "Gravity is the Therapist".

Its All Connected

Fixing someone's back problems, or any problems really, is like fixing a roof, it may be impossible to find out where the leak is actually coming from. Some roofers will do patchwork, but in reality the best thing to do is replace the whole roof. Doing spot work as a Rolfer can be helpful, but at the end of the day we would rather take a systematic approach and do a full Rolfing Series. It is likely that back issues may be the result of not having enough support from the hips and pelvis. The hips and pelvis may be off because of strain in the thighs, and the thighs may have strain because of the legs, ankles and arches. Back strain can also occur because of its relationship to the shoulders, neck and head, so getting the shoulders in a supportive position, and following with the neck and head can allow the back and spine to be in a more neutral alignment throughout the day. Many disciplines take some of these elements into account, but only Rolfers will insist that ankle restriction may be causing your neck issues, or that your forearms may be locking up your neck. Every part of the body exists in relationship, and they are all important, that is why Rolfing is one of the few western holistic disciplines existing today.

#backpain #rolfing #posture