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2295 Views 5 Replies Latest reply: Sep 7, 2010 1:43 PM by Errnestinne RSS
NewYorkMB Rookie 1 posts since
Sep 3, 2010
Currently Being Moderated

Sep 3, 2010 9:53 AM

Lower back pain

My lower back has been killing me the past month.  I am training for the NYC marathon but have not been doing a ton of mileage (less than in previous years).  My back is so stiff I can barely bend over and when I do straightening up hurts.  I suppose I should see a chiropractor but does anyone have any home remedies I can try?  Heat?  Should I get some kind of support to wear during the day? Thanks!

  • Damien Howell Legend 312 posts since
    Feb 27, 2008
    Currently Being Moderated
    1. Sep 3, 2010 10:33 AM (in response to NewYorkMB)
    Re: Lower back pain

    Take a look at One Size Does Not Fit All - Low Back Pain, and Low Back Pain Rotation & Side Bending of the Spine.  In my experience low back pain is NOT a running injury it is a SITTING injury.  Take a look at Pain in the Buttocks. When it comes to most acute low back pain recognized guidlines are to encouraged walking, and minimizing sitting.  Go for long walks.  When you must sit sit well.

    Damien Howell PT, DPT, OCS - www.damienhowellpt.com 

  • Beer and Cupcakes Legend 970 posts since
    Nov 19, 2009
    Currently Being Moderated
    2. Sep 3, 2010 10:47 AM (in response to Damien Howell)
    Re: Lower back pain

    Damien Howell wrote:

     

    Take a look at One Size Does Not Fit All - Low Back Pain, and Low Back Pain Rotation & Side Bending of the Spine.  In my experience low back pain is NOT a running injury it is a SITTING injury.  Take a look at Pain in the Buttocks. When it comes to most acute low back pain recognized guidlines are to encouraged walking, and minimizing sitting.  Go for long walks.  When you must sit sit well.

    Damien Howell PT, DPT, OCS - www.damienhowellpt.com 

    Thanks, never thought of that!   I have terrible posture when I sit.   My lower back is constantly sore too, I just assumed it was from all the miles Im clocking training for a marathon next month.   I have my youngest daughter walk on peridocially to help loosen it up.  Il start sitting better and see what happens.





    Virtual Racing Antagonist.  I run for beer and cupcakes.kenyan.jpg

    1 Mile PR 6:44

    5K PR 22:21 

    10K PR 48:30

    Half Marathon PR  1:48:43 

    Marathon PR - 4:09:10  

    i before e except after c, weird?

  • JamesJohnsonLMT Legend 1,160 posts since
    Aug 23, 2009
    Currently Being Moderated
    3. Sep 4, 2010 3:05 AM (in response to NewYorkMB)
    Re: Lower back pain

    I so completely agree with Damien's post, that I will go on to say    that the chair is one of the worst inventions of all time.. despite the    fact that I'm sitting in one right now as I write this, lol. The  chair  so  pervades our modern lifestyles that many of us have no idea  what a   healthy back feels like. In contrast, I remember that during  what was   probably the fittest period of my life, I worked a job where I  stood for   12 or more hours a day, and went home to cook and eat my  dinner   standing as well. Often chained to a desk, I miss those days..  but I  digress.

     

    The only thing I would add to the   dialog so far, is that  there are a number of muscular interactions I   encounter in my line of  work which are of particular interest to  runners  experiencing lower  back pain. I'm speaking of "pain referral'"  in which  the actions or  tonic state of a particular muscle manifest  as pain  somewhere else on  the body in a way one might not expect. Two  areas of  concern I will  mention briefly are the hip flexors  (Iliopsoas) that  bring your thigh  forward and upward, and the rear  muscles of the calf  (Soleus,  Gastrocnemius) that plantarflex the foot.  Both of these muscle  groups  are of the "tonic" type that tend to  tighten and shorten with  overuse  (such as marathon training), and both  by unhappy coincidence  remain in a  contracted state while we are  sitting.

     

    Many  amateur  athletes spend a lot of time  behind a desk or behind the wheel  of a  car. We further insult our  tired and overworked muscles by spending   even more of their recovery  time behind a table, behind a home   computer, or on the couch behind a  remote control, then we retire to   sleep in the fetal position. During  all these times the muscles are   "growing" even shorter, revealing  their tightness when we attempt to   stand, stretch, or assume a better  posture. To make matters worse, these   muscles are often opposed by  "phasic" muscles that tend to weaken with   overuse, leading to further  imbalance and postural errors in a  vicious  cycle of dysfunction that  becomes most obvious in the athletic  and the aged.

     

    All   of this is entirely unnecessary, as  can be seen in aboriginal peoples   who do not use chairs, and who  maintain limber erect physiques into  old  age. Even though such peoples  are often capable of amazing feats  of  physical endurance, they tend not  to hold themselves to rigid  training  schedules and deadlines for major  sporting events like  marathons, which beat our poor muscles into  submission.  Despite the  obvious virtues and benefits of a life lived in  moderation,  we are  nevertheless doomed to our contemporary lifestyles  of relative over  and  underuse and it often shows when we attempt to  stand straight upon  rising.

     

    With  particular regard to the  hip flexor  Iliopsoas, it joins the femur to  the pelvis and lumbar  spine. This  means that the shortened muscle, when  stretched to its  "normal" length  while standing, compresses the lumbar  spine and  sacroiliac joints,  potentially affecting all other structures,  nerves  and muscles related  thereto. I'll rest my case for that muscle, only  adding a short video  below.


    When  it comes to the Soleus muscle in the calf, at the  lower  (distal)  portion lateral to the Achilles tendon, there is a  spot a few  inches  above the heel that in many persons can "refer" pain  to the  lower back,  particularly the sacrum. While the Soleus is  another  "tonic" muscle that  shortens with overuse such as hill  training and  speedwork, it should be  noted that there is often a  hyperactive  component even to "phasic"  muscles that appear weak. That  is to say  that even though tonic muscles  tend to shorten with overuse,  the often  opposite phasic muscles may  weaken due to the same kind of  stress. The  stress I'm referring to has a  strong tendency to manifest  as small  mini-spasms or knots in the muscle  (often called trigger  points) that  can produce these opposite results  of general tonicity  depending on the  type or portion of muscle in which  they occur. So  while a tonic muscle shortens with exercise and is frequently  "stretched" to compensate for this, a phasic muscle weakens with  exercise and is frequently (and ironically) exercised more in an effort  to strengthen it. In either case the  solution is the same for the  trigger  points, but opposite for the  follow-up stretches.

     

    Stretching   a tonic muscle like the  Psoas or Soleus can be a valuable  part of   rehab, but only after the  trigger points in the muscle are  released.   Stretching or exercising an active  trigger point risks making it worse,  further  tightening the  muscle. Stretching a phasic muscle is  generally a waste  of time, since  it loosens with use, but a follow-up  stretch to any  muscle can be  beneficial after trigger point release. I  define a potentially  beneficial stretch as one done with minimal props  or assistance,   preferably by using the opposing muscle alone to  perform the stretch. An   example would be to dorsiflex the foot, using  phasic muscle Tibialis   Anterior, as a way to stretch the Soleus -  without overstretching it.   This makes use of Sherrington's Law of Reciprocal Innervation,    which states how a skeletal muscle is automatically released from    conscious contraction when its opposing (antagonist) muscle is flexed.   This is also common sense, although not so common among athletes, lol.

     

    Here is a video highlighting important sections of the Soleus muscle to be aware of...

    http://www.youtube.com/watch?v=0qXdp6nI838

     

    Another short video showing a cyclist creatively working a point farther up from where you may need to work..

    http://www.youtube.com/watch?v=LvZOp5ETcNY&feature=related

     

    Some anatomical background video showing how important the Psoas muscle is to lower back pain..

    http://www.youtube.com/watch?v=AY-4aGKUJeM&feature=related

     

    In order of difficulty, a final link showing techniques for release of a shortened Iliopsoas muscle..

    http://www.youtube.com/watch?v=_1RARwli_Zs&feature=related

  • Rehab United Pro 42 posts since
    Feb 16, 2009
    Currently Being Moderated
    4. Sep 7, 2010 12:36 PM (in response to NewYorkMB)
    Re: Lower back pain

    Low back pain rarely has anything to do with the low back (previous posts support this notion).  Heat, ice, NSAID's, and low back stretches are simply band-aids and only cure the symptoms, not the cause.  I recommend seeing a Physical Therapist who specializes in functional assessments - common culprits for low back pain include: tight calves, tight hip flexors (from sitting - as discussed), and/or tight thoracic spine (which can also be from sitting).

     

    My suggestion - start with stretching your hip flexors.  Here's a post I wrote a few months ago on hip flexor and hamstring stretching: http://community.active.com/blogs/rusportsperformance/2009/09/17/tight-hip-flexors-and-hamstrings

     

    Cheers,

     

    Justin






    Rehab United
    Physical Therapy
    RU Sports Performance Center

    "Where Athletes Become Champions" (TM)

    San Diego, CA

    www.RehabUnited.com

  • Errnestinne Amateur 36 posts since
    Jan 25, 2010
    Currently Being Moderated
    5. Sep 7, 2010 1:43 PM (in response to NewYorkMB)
    Re: Lower back pain

    My chiro has said my low back pain was due to tight hip flexors.

     

    Although you may not feel your hip flexors as tightened... they probably are(especially if you sit often)

     

    Try some yoga postures to help open up the low back and stretch the hip flexors.

     

    http://http://www.yogajournal.com/practice/588 (interesting article on hip flexors/low back issues)

    http://http://www.yogajournal.com/poses/finder/anatomical_focus/lower_back (poses for lower back)

     

     

    Try an epsom salt bath too!

    Helps to relax muscles naturally.

     

    Steer clear of pain relievers(Tylenol, Advil, Etc.)

    they will just mess up your body chemistry & stomach.

     

    Good Luck!

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