Low back pain

On: Bowls

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Imagine, if you will, 3 bowls. These bowls are inside you, one stacked above the other.

The first is your pelvis. Already described as a bowl, it supports and holds all above it.

The second is your diaphragm. Separating the organs in your chest from the organs in your abdomen, it forms the top of the abdominal cylinder and should move gently as you breathe.

The third is in your upper chest, at the top of your lungs and about the same level as your collarbones.

This being a conceptual experiment, fill them with water. Then, think about the way you are standing or sitting. Are those bowls going to overflow? Is the water going to run out of the front, the back, even the sides?

Stand easily if you can, weight distributed in the centre of your feet. Soften your knees and ankles.

Then, come up to the pelvic bowl. Tilt it forwards and backwards, until you find the centre, neutral position.

For the diaphragm, you can feel if it is forward or backward and correct.

Ditto the shoulders. Allow them to open, don’t force, allow. A subtle external rotation and lengthening of the clavicle.

Once reflected and considered individually, check in again with all three.

This is probably one of the quickest ways of achieving optimal posture smoothly, balance the bowls, check how they move when you breathe and then, get on with the business in hand.

Of course, if you need help balancing the bowls, can’t find a neutral position or are struggling to fix it in any other way, please book in, we are happy to help.

Tonight we dance: Lower back pain, tango and movement

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1

My friends recently bought a wii for their family and watching them play a dancing game, I noticed something that had been slowly dawning on me for a while.

One of them seemed a little more fluid than the other but as they are all very fit and active, at first I couldn’t understand why.

The answer appears to  lie in the lumbar vertebrae and their apparent lordosis. One of them had a slightly more lordotic spine, with more resulting anteriorisation in the pelvis than the other.

From that, the pieces fell into place. Shortening in the quadriceps and psoas had led to a slight increase in the anterior tilt of the pelvis, in turn reducing the available motion in the lumbar spine.

This pattern can commonly be seen in the wider population, especially those presenting clinically. On examination, we will generally find tight glutes, shortened psoas, a slight medial rotation to the thigh, hypertonicity in the superior insertion of quadratis lumborum, an anterior tilt to the pelvis and restriction motion in one or more planes in the lower lumbar spine. If active, they may also report hamstring problems.

Clinically, resolving this can have several approaches, depending on the level you wish to work. Posteriorise the pelvis (one colleague uses MET of the hamstrings, another does it manually side lying), lengthen the quadriceps, stretch or release any psoas restricitons and work on any QL points. Other, more distal, areas can then be incorporated to address the underlying issues that the body was adapting around. This is where it becomes interesting and the individual practitioners preferences come to the fore.

Once treated, this can often be prevented from returning by regular stretching and, interestingly, regular dancing or hoola-hooping! Both of these activities help keep the spine mobile and fluid, encouraging good movement patterns and core integration. And Tango? Particularly for the ladies, this elegant form of dance requires excellent upper body posture, with the ability to stabilise and extend the pelvis and leg smoothly.

As ever, all problems are individual and should be investigated professionally. None of the information above is a diagnosis or treatment plan.