I have your back. Do you?

Sunday, March 17, 2013, Posted by Prema

You probably are eager to emerge from cabin fever and engage in a warm and colorful spring. This change in physical activity has to be supported with a strong back to provide the greatest chance for a healthy, long life.

First things first! If you have numbness, weakness, tingling, burning or sharp pain radiating down one or both of your legs, this indicates you should have a medical evaluation. Pain can refer proximally (towards your head) as well. If there is constant pain between your lower ribs, waistline or between your spine and lateral torso, this is an urgent indication of a medical assessment. Loss or change in bladder, bowel or sexual function could also be a cause to report to your health care provider.

Much of our musculoskeletal tissue, soft and osseous tissue can be protected with proper posture, biomechanics, physical and psychological conditioning [1]. Nutrition, appropriate weight to skeletal ratio, injuries and genetic background, have a significant influence on the body. Back posture involves the muscles of the spine that provide stabilization against gravity and others that allow movement. To get a better understanding of posture and biomechanics, let’s explore the anatomy.

Basic Low Back Anatomy
The spinal vertebral column is sub-grouped into seven cervical, twelve thoracic, five lumbar, five sacral vertebrae (fused into one) and one coccyx bone. The lumber vertebrae are larger than others and provide a larger mass for the attachment of large muscles. The erector spinae consists of three muscles on each side of the spine [2]. This group assists in stabilization, extension, lateral flexion, ipsilateral rotation, pelvic anterior tilt, and contralateral tilt of the pelvic region. This is just one group of the superficial muscle groups! There are deeper muscles which support many of the same movements and postural stability.

There are a few more muscles that are helpful to know for bio-mechanical understanding. Quadratus lumborum, gluteus maximus and the psoas are significant core muscles that stabilize the torso [3]. Psoas muscle attaches to the anterior side of the lumbar spinal column and bilaterally attaches to another muscle on the inferior sides of our hips. This muscle is a significant player in providing lower torso strength, mobility and flexibility.

Psoas Muscles and It's Role in Low Back Pain
When the psoas contracts, it can allow flexion of the spine or hips depending on the physical position. The analogy of two, liked-sized children balancing on a teeter totter creates a dynamics stabilization can be applied to the bio-mechanics of soft tissue function. This relationship of leverage can be applied to the primary muscles, the erector spinae or gluteus maximus muscles and the antagonist muscle groups, abdominal muscles and the psoas major.

Due to the modern occupational life styles, many of us have contracted tight muscles and over stretched muscles in the wrong locations. Sitting in front of computers, driving cars, et cetera for prolonged periods of time can contribute to weakened back muscles. Posture is best addressed by contracting and relaxing both the primary and antagonist muscles groups. Because of prolonged sitting and leaning forward, the upper abdominals are contracted. Lengthening the upper abdominal muscle elevates the rib cage for increased respiratory ability and space for the thoracic and lumbar region. Contracting the lower abdominals elicits a reciprocal response to the lower erector spinae group.

Just the simplest execution of transferring oneself from lying to sitting or sitting to standing can either reinforce strength or weakness our backs. Instead of rotating the torso and depending on the appendages (the arms) for transferring a position, contract the quadriceps and the psoas for efficient power muscle loading.

Mindful awareness protects the smaller deeper muscles of the spine from improper usage potentially causing repeated, micro-muscle scaring. We have all heard and maybe said,” I just bent down to tie my shoelace and could not move”. As an infant develops, muscular strength increases to hold its head on top of the spine, a normal curvature develops in the cervical, thoracic and lumbar aspects. Being bipedal in our structure provides muscles to stabilize the column-like posture.

Exercise and Stretches for Lower Back Pain
Consider this concept-- if we have strong torso muscles, we do not need to depend on the ‘appendage muscles’, the arms and legs, to keep our bodies upright. When the head is positioned forward (our ears are anterior to our shoulders instead of above our shoulders) the curvatures in the spine are altered. If the curvatures of vertebrae are misaligned, the muscles, over time, cannot function and they change their configuration. Imagine a string attached to the base of your spine; the top of the string is realigning each vertebra, one on top of the other, right up to the base of your skull. Your musculature actively stabilizes your skeleton. The orchestration of movement seems so elementary, mostly because we do not stop to make the mind body connection. Yet, 80 % of Americans report lower back pain some time in their lives; it is the second most frequent cause of loss of time away from employment. It is not uncommon to jeopardize a long, healthy life, to suffer from back pain, degenerative disc disease, arthritis, osteoporosis, disc herniation and facet joint dysfunction.

Are your moves mindful?
Psychological states of mind can affect the circulatory, endocrine and nervous systems. The psoas is referred to as “the fear muscle” ; it clutches to protect vital organs. Many of the mind /body therapies have beneficial impacts on how we conduct our lives. Pain and /or discomfort have an understated effect on our mental capability and emotional composure [4]. Avoiding or mitigating chronic pain requires awareness and a multifaceted approach.

For additional information, visit the following site:

Stretch for Lower Back Pain

More Information about Low Back Pain and When to Seek Medical Attention:

Alternative Therapies

[1] Barker, MD, Victor. Posture Makes Perfect. Third ed. Waiwera International Limited, 2005. pages 12-14.
[2] Granger, Jocelyn. Neuromuscular Therapy Manual. 1 Pap/Psc ed. Baltimore, MD: Lippincott Williams & Wilkins, 2011. pages 233-240.
[3] Gray, Henry. Gray’s Anatomy, The Anatomy of the Human Body. 29th ed. Ed. Charles Mayo Goss. US: Lea & Febiger, 1973. pages 488-9.
[4] Koch, Liz. The Psoas Book. Third ed. Felton, CA: Guinea Pig Publications, 1997. pages 37-42.

Disclaimer: This blog provides recipients with the opportunity to learn about the benefits of massage therapy. Inner Balance Therapy is not a medical organization and the contents of this blog should not be construed as medical advice or diagnosis, nor should it be interpreted as a substitute for physician consultation, evaluation or treatment.