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Why your Low Back Pain is not a Low Back Problem

The reason why your low back pain is not a low back problem is actually a pretty simple reason.

Not What You Think It Is

You might be experiencing pain in a specific part of your body. However, that doesn’t really mean the problem is coming from there. Contrary to what common sense might tell you most root causes of pain are not where the symptoms are at.

For instance, common sense would have us think that our low back pain is a low back problem. But this could not be further from the truth. Pain is not a good indicator of what is causing the pain. Instead, it is an indicator of how your body is compensating for dysfunction. Pain shows us how your body is dealing with another part that is not working so well.

A low back pain is most often times a hip problem with no obvious signs of dysfunction. Or perhaps a mid-back issue with also no signs of specific pain, except for the seemingly uncorrelated low back pain.

Which might leave wondering how, or why is this case?

Every part of the spine and the rest of the body has one primary function: that is either for STABILITY or for MOBILITY.

Your neck, low back, and knee should be stable first and foremost. You might feel tight or present with pain, but the reality is these symptoms are present because these areas have to compensate for the lack of movement in another area of your body.

Most of the pain that people present with it’s at these parts of the body, and it will be  natural to assume that their pain is the problem area, however, let me show you why this is not the case:

 

 

 

 

How Poor Hip Movement leads to Low Back Pain or Tightness

low back pain hip mobility
low back pain is most common a hip problem not a low back problem

When you lose your ability to move your hip through a full range of motion, you will start using your back instead. This leads you to experience low back pain or a constant sensation of tightness from overuse.

Find out how your hip hinge is related to your back tightness

How Poor Mid-back Posture leads to Neck and Shoulder Pain

a similar case is observed with a lack of mid-back mobility, leading to constant neck tightness and pain. Poor thoracic extension leads to terrible shoulder issues

As you can see, the root cause of the issue is often times missed by focusing on where the pain is at. Do not get me wrong, pain does need to be addressed but unless postural issues are addressed the root of the problem will persist and keep causing the same issues or compensating for a lack of function somewhere else.

 

Fixing a Winged Shoulder Blade

Fixing a winged shoulder blade can be one of the most challenging things to accomplish. Depending on the severity of the case. You might not realize that  An unstable shoulder blade can be the cause of shoulder pain, wrist pain, and even trap/neck pain.

 

The main job of your shoulder blade is to stabilize the shoulder when you move your arm. Without this stability, the shoulder joint is under great stress.

How can you know if you have stability on your shoulder blade?

The first part of answering that question is to observe the movement of the shoulder blade when you move your arm:

As you move your shoulder overhead it should do 2 things:

  1. It should Rotate up and to the side
  2. It also should Stay securely in the back:

You should not see the bone “come out” or protrude with any movement like push-ups, overhead movements or by putting your hand on your back.  see here

One common root cause of chronic shoulder pain comes from the shoulder blade not providing the support that is needed.

Besides shoulder pain, other symptoms of instability are a shoulder blade that “clunks”, or moves out of place. At times these painless clues are red flags that stability, more than mobility is needed.

An unstable shoulder blade will eventually lead to shoulder pain, wrist pain and even trap/neck pain.


How can we re-train shoulder blade movement?

Re-training your shoulder blade movement can be challenging depending on how much of the movement is compromised, how long have you had the problem, and how often are you loading the shoulder.

Nevertheless, it can be done even in the most challenging cases.

The key to fixing the problem lies in the ability to teach the body how to contract the right muscles to move the blade into the right direction.

We do this with 3 important steps:

  1. We adjust the spine, and sometimes the rib cage to decrease pain and improve the joint position of the mid back. A “hunched” posture leads to poor shoulder blade function.

  2. To help improve the right movement of the shoulder blade with overhead movements we can use a muscle stimulator like a Russian stim or Power Dot:

The muscle stimulator helps contract the muscle to secure the blade into position as it moves through the range of motion.

This is a great way to warm up before rehabilitation exercises or overhead movements. The idea is to help create the “right sensation” of how the shoulder blade should move to secure/stabilize the shoulder.

 

  1. We start with simple exercises that ensure the correct movement. This is very important because it is pretty easy to make the problem worse with exercises that “should” help but make it worse.

Everyone is different. Keep in mind that an exercise that might work for a patient might not work so well for you.

 

Is a Wing Scapula Serious? and What Causes it?

winged scapula serious causes

a Winged Scapula, is it Serious? What are the Causes?

A winged scapula can be serious, but it depends on the causes. There can be two main types of “injuries” that could cause you to have a winged scapula. Both of the injuries have to do with your serratus anterior. A muscle which its job is to “glue” your shoulder blade towards the midline so it doesn’t “wing-out” during shoulder movement:

What are the causes?

It could be NEUROLOGICAL, a nerve issue.

The most serious and rare reason is an injury to the nerve that activates the serratus anterior muscle. If you are suffering from nerve damage (which again, is rare) your muscle will lose its ability to contract. Therefore, there will be a winging on the shoulder blade as the muscle is unable to keep it “glued” to your back.

There are 17 different muscles that attach to your shoulder blade. At times it is not just an injury to the long thoracic nerve but an injury to other nerves that come from your neck that will lead to it. A big sign is if your winged scapula is very noticeable on overhead movement.

 

The most common cause is weakness

Weakness in the muscles that stabilize the shoulder blade will cause your scapula to move where it should not move. It will give you the appearance of a winged scapula.

Common therapy procedures are targeted towards strengthening the serratus anterior. However, sometimes the exercises that are prescribed are not efficient at solving the issue because the problem is usually more complicated than just a weakness of one muscle.

Furthermore, if the body does not know how to activate the right muscle it will compensate and use the wrong muscles to get the task done. So you might think that you are working out your serratus anterior but other muscles are taking over and the exercise is ineffective.

A common complaint is heard:

My right scapula pops out of my back continually, despite how much I work my serratus anterior; which I’m told is the cure. How can I fix my problem?

The treatment needs to be targeted towards proper muscle activation and postural correction. If your chest muscles are too tight from rounded shoulders, the shoulder blade will constantly be pulled out of alignment. If there is a rotator cuff injury, it needs to be addressed as well.

Tight shoulders are highly correlated to this condition, find out if your shoulders are tight

Fixing a winged scapula tends to be more complicated because it greatly differs from patient to patient. It could be a nerve, the shoulder blade muscles or like many times a combination of the two. You need a full movement analysis to determine the pattern that causes or aggravates the condition. Moreover, the exercises that are actually going to help fix the issue.

You need a full movement analysis to determine the pattern that causes or aggravates the condition and more importantly the exercises that are actually going to help fix the issue.

Is Low Back Pain and Soreness common after Deadlifts?

Yes. Low back pain is common after deadlifts. It is extremely common to hear people complain about low back pain after a session of deadlifts. However although common it is not ideal or normal.

You can definitely feel back soreness and pain after a session of deadlifts but many times the pain is not intense enough for you to seek help. This is unfortunate as it puts you at risk of injury.  Also, keep in mind that the muscles that you are “working out” are not being targeted properly. By using your back instead of your hips, core, and legs, you are compensating and not achieving the “full potential of the lift”.

Fixing it

The most common faults on the deadlift are:

  1. The Set-up
  2. Hip Hinge/Hip Mobility
  3. Using the wrong variation of deadlift for your body type

#1 The Set Up:

Most people set up for the deadlift with an already rounded back and then try to correct it right before they start the movement. Instead attempt to come down to the bar in an already “chest up” posture:

 

Hip Mobility:

If you are unable to push the hips back with minimal knee bend, your body will compensate by using the low back to pull.

You can read more about hip hinge here

Body Proportions

Depending on each individual’s body proportions there is an ideal form to deadlift to not only protect your back but target the muscles that should be activated through the lift.

Here is an idea

One of the most common assumptions we make is that the proper or “acceptable” form is the one used by experienced lifters on their one max rep attempt. However, this “one-rep max form” should not be the standard for training weight.

Compensations will occur when we lift a weight that we have never lifted before. However, this should not be the form we are using with lighter percentages and higher reps. This only leaves us prone to injure our back and also train the wrong muscles.

 

How to correct the knees going inward during the squat?

 How to correct the knees going inward the squat

In this follow up blog (see part 1 here) we are going to show you how to correct the knees going inward during the squat. Because finding the reason behind the problem is 50% of the solution

The main 2 reasons

There are two main reasons why the knee will move in throughout the squat movement:

#1 Mobility

Lack of mobility in the ankles will not allow for proper hip loading. Therefore, it will limit you on proper hip stabilization. The most common mobility fault, and quite honestly often overlooked, related to this problem of the knees going inward is ankle mobility. Lack of ankle mobility leads to improper load using mainly your quads or legs instead of the appropriate hip muscles:

ankle mobility knee cave inwards
knees cave in due to poor ankle mobility

 

#2 Poor Stabilization

Poor stabilization of the hips from weak glutes or a weak transfer of weight into the hips from the core. In other words, proper core stabilization will activate the gluteal muscles and provide stability in the hip. If there is poor transfer from the core, the gluteal muscles will not be cued to fire.

glutes stabilize the weight through proper core transfer
The hip muscles, specifically glutes stabilize the weight

Important clarification is the difference between knees collapsing and the “knee valgus twitch”

Here is an example of knees collapsing:

What is Knee Valgus Twitch?

Advanced lifters seem to briefly “twitch” by a slight knee “going in” when at the bottom of the squat. It is seen the most as they initiate the “coming up” part of the squat. However they usually revert back to having their knees out after they pass the sticking region.

On the other hand, just like in the video knee collapse happens throughout the movement.

What can be done?

If you already have pain in your knee, IT-band or in the side/front of the hip, the pain needs to be addressed. Exercise won’t fix the pain. The pain needs to be treated first before the poor movement pattern can be corrected.

Once the pain  has been treated we can move to correct the movement pattern. This is usually how we correct it (in order of importance):

  1. Correct the pelvic rotation.  Mobilizing or adjusting the hip will balance out the pelvis and lead to better loading into both legs.
  2. Improve Ankle mobility. If your ankle mobility is poor you will never be able to properly bear the weight in the hips since it limits the depth of the squat.
  3. Creating a stronger core by doing things like side planks, farmers carriers and counterbalance squats will lead to better weight transfer, banded push-pull.
  4. Stronger glutes or glutes that match the strength of the front of the legs (quadriceps) will create an ideal hip and knee stabilization.

How can squats cause pinching hip pain?

Causes of Hip tightness and pinching

It’s not so much that the squat in itself causes hip pinching pain. It comes from the less than ideal rotation of the hip and pelvis during the squat movement.

First of all let me state that there are actually two main types of hip pinching pain. Today we are going to address the less severe and more common.

 

Hip tightness that develops after squats

One thing that is very common among active populations is the sensation of bad tightness and even sometimes pain in the front and side of the hip. It is described as a “pinching” in the hip and travels up into the lower side of the torso.

There are different exercises (not just squats), that will cause this type of sensation, but a very common one is squats, especially barbell squats.

The body tends to show more imbalances when doing barbell movements. After some experience, many of us can tell that we have developed a “stronger side”. This sometimes is seen when only one knee deviates, or deviates more during a squat. Sometimes there is a clear hip shift either going down or up in the squat.

These side to side imbalances can be more subtle and go undetected for quite some time before they start causing any type of real signs or symptoms. But eventually, if not corrected it will lead to injuries of the hips, low back-spine and knees.

With enough stress this can develop into things like femoral acetabular impingement, MCL knee sprain or tear, or IT-band syndrome. When the pain or pinching is more intense these conditions need to be ruled out.

Core Stability

Even though the symptom is pinching in the hip, the actual cause of the problem comes from the core.

Many times what is seen is that one side is weaker than the other. One side of the core can stabilize better than the other side. This will lead to the body unequally “loading” the hip and legs.  In response the hip will fail to stabilize the knee and the knee will cave in. This ends up causing overstretching of the IT-band on the side of the leg.

After all, the job of pushing the weight up needs to get done, it will use the most efficient way to do it.

After many times of doing the same incorrect movement pattern the “most loaded” side will usually develop tightness and pinching in the hip that moves into tightness on the side of the waist.

Working on rolling the side of tightness with a foam roller or lacrosse ball sometimes will help release the pressure sensation; however, it will usually not be enough to truly address it.

There are 3 things that need to be considered to fix the problem and prevent it from becoming a more serious issue:

  1. RE-SET THE ROTATION IN THE PELVIS

The side that presents with the tightness and pain needs to be addressed first, the unbalance between the hips and core and the constant loading on one side leaves the tight hip pretty beat up. The pelvis needs to be re-aligned into the correct rotation through a proper chiropractic adjustment.

 

  1. RELEASE THE TIGHTNESS

The soft tissue that is tight and the origin of tension need to be released. Active Release Technique, Graston, and other soft tissue techniques should release the tightness.  Also, not because it feels tight means you should stretch it; many times, stretching provides temporary relief just to come back with a nagging constant tight sensation.

 

  1. FIX THE MOVEMENT

If, what actually causes the problem is poor core stabilization, then the imbalances need to be corrected and the core activation under the barbell/load needs to be strengthened. Side planks are a great body weight movement to start rehabilitation; however, there should be a more personalized and targeted approach to fixing each patient’s weak sides. It’s not an individual muscle problem; the way someone moves must be corrected. Foot arches, glute recruitment and core activation need to be addressed on an individualized basis.

The Real Reasons why your Hamstrings feel Tight

No matter how much you stretch, your hamstrings are still tight. On this blog, we discuss the real reasons why your hamstrings feel tight, despite your stretching efforts.

Among the active population, it is extremely common to hear people complain about how sore and tight their hamstrings are. I don’t think I have ever walked into a gym where I did not see at least one person attempting to bring their leg to their forehead. Blog posts constantly pop up about new and improved ways to relieve hamstring tightness.  And yet, no matter how much you stretch, the feeling of tightness continues. Before we address the real reasons why your hamstrings feel tight, we want to address whether stretching your legs is a good idea.

Should you stretch your hamstrings?

Blog posts constantly pop up about new and improved ways to relieve hamstring tightness.  And yet, no matter how much you stretch, the feeling of tightness continues. Why?

Common sense would suggest that as you train the muscle, whether be running or lifting heavy things the muscle “shortens” or gets “tight” again and again from the contractions during exercise and therefore it needs to be stretched.  Well, this might not be the case.

Having the sensation of tight hamstrings is not due to the muscle working during exercise but from having to compensate for the poor function of Hip muscles. Hamstring tightness actually originates in the hips.

Here are the real reasons why your hamstrings feel tight

There are 3 reduced hip functions that lead to the sensation of your hamstring tightness:

  • You might have Poor Hip Stability

which in less fancy words means not so hot glute activation

Do your hamstrings always take over when performing movements like squats, lunges or other leg movements? Welcome to glute amnesia. Your body is not activating the glute muscles as it should be and it is using the hamstrings instead, this is quite common.

Here is a way test if your glutes have poor activation:

This means that when you start to perform a squat, a lunge, a deadlift, or when running you move your back/spine before you move or propel with the hip: “use your legs really actually means use your HIPS”

  • You might have poor control of hip movement

which means there is no core firing when the legs are moving

Think of core stability as the foundation of your house. Without core activation, your hamstrings are in a constant state of contraction in order to take up the slack where the core cannot properly stabilize the hips.

Poor core leads to initiating movements with your back instead of your hips. This causes the hamstrings to feel tight. Read our blog on Hip hinge to understand the importance of hip movement instead of low back movement.

  • You might have poor posture of your hip joint

If there is poor posture, rotation of the joint leads to an over-lengthened hamstring muscle.
When you have an anteriorly tilted pelvis, your “butt bone” or the origin of the hamstring muscle is shifted upwards thus leading to a stretched out muscle that always feels tight. It is in fact, “weak-tight” meaning it does not need to be stretched, but more importantly, must be strengthened.

 

 

 

When tight Hamstrings is not in the Hamstrings:

Disc related injuries of the low back and nerve irritation can  make you feel a sensation of tightness in the hamstrings

Here are some red flags that indicate that the tightness might be coming as a sign of something else:

  1. Bruising, usually after an injury
  2. Numbness
  3. Burning or tingling in lower leg
  4. Weakness in the lower leg or foot drop of involved side

The Best ways to release tight shoulders

As addressed on our previous blog there are three main reasons why shoulder tightness develops

but…

How can we release tight shoulders?

1. If the problem is that the Chest muscles become overactive:

The pec minor muscles can become extremely tight when we spend countless hours sitting down. Habitually being in this position: sitting in cars, in front of computers, or the tv etc. leads to the muscle pulling the shoulder blade forward and eventually limiting full shoulder range of motion.

What to do?

                Activate the weak muscles that will limit chest compensation. It can be achieved through a sequence of posture Angel exercises:[if you are sitting constantly at your job try to put an alarm to do this sequence of exercises]

Start on the floor and week by week challenge your body to be able to do it seated against the wall:

 

2. Lat muscles become overactive:

Lats (lattisimus dorsi) tightness will limit shoulder mobility. Lats usually become tight when there are previous shoulder injuries, or the rotator cuff muscles are weak and the Lats have to compensate for this weakness.

How to know if your  Lats are the problem? here

What to do?

                If you have shoulder pain, get it treated through chiropractic care and soft tissue therapy.  Follow a protocol to strengthen the rotator cuff; incorporate internal and external rotation exercises to create a more stable shoulder: Shoulder Strength

 

Poor Mobility of mid back: Thoracic extension

This is actually the most common cause of shoulder impingement and tightness. Many people have lost the ability to extend their mid-back. This is because A: we sit too much, and B: our head is so much more forward that our mid back becomes rounded

 

What to do?

                Correct your posture, sometimes taking care of yourself does not have to be limited to when you are in pain, getting a chiropractic adjustment and making it a goal to correct your posture will lead to longevity of your spine and joints.

What does chest pain imply when is not heart related?

Most of the time chest pain is not due to a heart attack

Having chest pain is not something that anyone takes lightly. Most people’s reaction to experiencing chest pain is that of a frightened response: a heart attack. However, most of the time the chest pain that is experienced does not come from having a heart problem. Instead, it is due to rib cage misalignment and muscular tension.

Today we are going to cover where this pain comes from and what we can do to not only heal it but prevent it from happening. Pain in the chest that comes from the rib cage usually presents in the front of the chest over the sternum, or on the back between the shoulder blades.

It can be scary to have these symptoms. One way to know if this pain is due to joints and muscles is that if you move in certain patterns the pain quality changes: it either makes it worse or better. If the pain is constant and no movement changes the quality of the pain then it can mean that is something more serious.

Important things to rule out with chest pain besides a heart attack are pulmonary embolism and aortic dissection. A heart attack needs to be ruled out when it comes to chest pain.

Many people end up in the emergency room but are told that they just have a muscle spasm. Patients with chest pain go home from the ER or hospital with no definite diagnosis. Although this is considered good news, the pain can persist and if not addressed it can become quite chronic.

Where does the pain come from?

Rib cage pain comes from poor breathing patterns most of the time. There are two primary ways we tend to breathe. One way is when we use our chest for breathing so we elevate the rib cage by using our chest muscles. This pattern of breathing is inefficient it results in minimum breath into the lungs because we use the small muscles between the ribs rather than the diaphragm.

Belly or stomach breathing is the most efficient way to breathe. It uses the diaphragm to expand space so that the lungs receive the maximum volume of air.  Learning how to breathe into the belly instead of shallow chest breathing has many benefits. It has been shown to reduce symptoms of asthma and bronchitis for example. It reduces the muscular tension between the ribs and therefore it prevents the rib cage from misalignment and therefore pain.

How can the pain be treated?

When the rib cage is misaligned it can be corrected through chiropractic adjustments so that the pain subsides. Many times soft tissue is used to release the diaphragm and therapeutic exercises are utilized to re-train breathing patterns.

In practice, we teach patients different drills so that their breathing becomes more effective.