Low Back Pain

MY BACKKK This week I threw my back out when I decided to show a patient what they were doing wrong in an exercise. As I continued to increase my back extension, mid-move I knew I had F****ED up. There it was, sharp spasms down both sides of my lower back. Sleeping that night was eventful and so was coming into work the next day. I blame my bad back from years of ego deadlifting, 14 hour watch rotations sitting in front of a computer, and sleeping in a 6'x6' rack; Hooyahh Navy days! Low back pain is nothing new to me, however since doing PRI the amount of time I spend experiencing the pain has significantly decreased to the point I had forgotten what right Sacroiliac (SI) pain even felt like. So thank you posture gods for reminding me what a nuisance it can be.  Thankfully, I now know how to treat It. This email will encompass HOW I rehabbed my back that was in full spasms in less than 48 hours along with the anatomical components of WHY back pain even occurs. (Of very important note, I will be linking videos of these workouts to this email. If you see anything in light blue it is hyperlinked and will send you to the information being discussed. Smash the link!) Why does back pain occur:  Low back pain can be caused by many things all mostly involving compression of the lumbar spine. An anterior pelvic tilt of the pelvis is the main component of the compression. This excessive anterior tilt is caused by weak and over-lengthened abs and hamstrings in comparison to over active back extensors and hip flexors. My quad dominant people... hows your back feel? Sacro-iliac (SI) pain is another form of low back pain. You know those dimples some people have on their lower back right above their belt line? Yupp those are the SI joints! This area becomes a spot for constant pain for some which is caused by the gapping of the joint. In a typical human the left hemi-pelvis is flexed, abducted, and externally rotated (FABER). Some compensate further into this pattern and further increase the FABER position of the left hemi-pelvis which causes the right SI joint to gap as seen in the photo below. This opening causes the right sided pain you feel. though its rather ideal since right sided pain is easier to treat! You just turn on the muscle thats going to close the gap... which is listed in the How section below ;)  HOWEVER, Once this pain moves to the left SI, thats where we have larger problems. When the left side begins hurting it becomes more chronic and takes longer to treat because now either 1. the right hemi-pelvis is in a FABER position along with the left, or 2. the continued compression on the left SI is causing pain. The protocol of treatment is roughly the same, this patient will just have to be more patient in regards to progress since we are working on getting out of a more compensated, chronic pattern.  How to eliminate back pain:  1. Decompress the spine! ~ 90/90 Hip Lift and/or Foam Roll Out - As read above, low back pain mostly derives from compression of the lumbar spine. Therefore, the first step of treatment will be to decompress the space by taking the pelvis into a posterior pelvic tilt. The 90/90 Hip Lift can achieve this by allowing your back and glutes to relax as your hamstrings and abs engage to roll your pelvis back. Wanting more burn from your hamstrings? The Foam roll out (minute 4:30) is just a nasty hamstring burner I learned from a PRI guru, Conor Harris, Check it out! Tips: If you can not engage hamstrings with feet on the wall in 90/90, drape them over a chair or ottoman and dig heels down into the surface. 2. Close the gap! Right Glute Maxxx to the rescue ~ Left sidelying Clamshell - The right glute is attached to the femur, iliac crest and sacrum, meaning when the right glute is engaged it pulls these attachment  sites together and closes that pesky SI gap that is causing so much pain. This is achieved beautifully in the clamshell exercise.  Tips: Theres many, but a few most individuals need are: keep heels on wall, keep left abs engaged, keep right hip down toward heels to avoid any right side hip hiking.  3. Rotate that spine back to neutral ~ Left sidelying figure 4 - This Is a GOLDEN exercise because their is nothing quite like it. Those of you who love getting manipulated by a chiropractor or PT will love the almost instant relief this one can provide. During this exercise you are able to target and manipulate your L4 and L5 by using a muscle synergy technique to rotate the lumbar spine back to neutral by co-contracting specific muscles listed in the video. Tons of tips with this one, I uploaded a video of myself performing it with written tips and cues, Enjoy! ** Some perform this first, if you can activate your right glute in it go for it! If you have trouble sensing a right glute I would follow this current order. ** Protocol of exercises: 4 breaths = 1 set, 4 sets total morning and night.  As you can see, most of these exercises are side specific meaning you will only perform them on one side to counteract our bodies inherent asymmetries. One of the things I love most about PRI is how functional it can be. Yes these exercises are complex, but they are teaching you how to find neutral in your own body. They achieve this by getting you out of a sympathetically driven nervous system that is over extended and ready to fight by teaching you how to relax, digest, flex, breathe etc. So, get rounded! Childs pose, cat, bear crawl, burpees. We are living in over extended states, FLEXXX. If you have any questions please don't hesitate to ask. Best, Taylor Boryca Freely Moving CEO