Less talk, more action! It's time for some management strategies!

In Part 1 of our series, we talked about the concepts of lower back pain and reasoning behind treating lower back pain which honour the concept of regional interdependence. Local pain more often than not is not the source of course of the injury, but rather symptoms which have resulted in long standing dysfunctions or restrictions.

In Part 2, we talked about the myths surrounding lower back pain and the common colloquial sayings in relation to lower back pain. 

This time, in our final post of this series, we talk about management strategies with regards to lower back pain, both what we do in the clinic, as well as exercises that the everyday client can do. 

Firstly, one thing that everyone can do easily, is to remove our shoes and socks as often as we can! Dr Perry Nickelston of Stop Chasing Pain refers to shoes as "foot coffins"! Our feet is one of the greatest area of sensory feedback in the body. When we remove our shoes and socks, we allow our body to feel and sense, and thus relay as much sensory information as we can to the brain. This allows the body to adapt and react as optimally as possible!

Secondly, and this forms the crux of this post, is to improve your mobility and movement! That is the most vital for back pain. This does not mean that you improve the mobility and movement of the painful back, this means everywhere. If we were to target a few regions, it would be the trunk and hips! Here are some stretches you can do:

- Thoracic rotation with rib grab,

- Brettzel 1.0

- The Couch stretch.

Sufficient movement in the hips and trunk would mean less compensation on the lower back that often gets painful.

Let's talk about some of the exercises.

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1. Thoracic rotation with rib grab.

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The thoracic rotation with rib grab primarily targets trunk rotation and the muscles that might be inhibiting it, be it in the front or back. It may also stretch one side of your glutes. The easiest way to remember this stretch is to lie on your side, have your top leg in front of you while you hold it with your opposite hand. Your free hand then holds onto your ribs and turn out to the side.

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2. Brettzel

The Brettzel 1.0 is very similar to the thoracic rotation with rib grab, starting the same position and holding the front leg with the opposite hand, use your free hand to hold onto your free/straight leg, ensuring that knee remains pointing straight down. The Brettzel 1.0 involves the front musculature of the body, or the anterior chain musculature . If you are moving well, your thoracic rotation with rib grab and Brettzel 1.0 should reach the same amount of movement. In addition, have a look if you have a difference in movement between both sides.

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3. Couch Stretch

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The couch stretch targets primarily the hip and some of the hip muscles that attaches to the trunk. It will target the front of your thigh and hip muscles such as your hip flexors and quads. Have your foot up against a wall, bench or couch in kneeling position and sit up tall. With good movement you would be able to sit up tall while having that knee touching the couch/wall.

These stretches target the required movements needed in the hips and trunk, not specific muscles. You may find that these stretches feel like it stretches different areas when you do it on the left and right side and that would be okay. The muscle that is inhibiting or limiting that movement will most likely be the one that gets stretched first. When that muscle releases then the stretch moves onto the next muscle that is limiting that movement, they are self-progressive stretches. If you get pain or increase in pain anywhere in your body while doing any of these movements, STOP and visit your local health professional for help.

As always, this does not substitute medical advice. If you are suffering from pain and disability from lower back pain, please do seek out a qualified clinician.

Thanks for reading!

P.S For more reading and insight, check out an article from our colleagues at Fitness Volt https://fitnessvolt.com/lower-back-pain-athletes/

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