Low Back Pain

At my office in Asheville, I see many people with low back pain and there are many elements that contribute to it. The anatomical component to back pain is important of course; however, there are other elements to back pain such as physiological, psychological, nutritional and biochemical elements that could be playing a role as well. For example, our gut is innervated by the same nerves as our low back, so an inflamed gut due to IBS, bloating, blood sugar dysregulation could cause low back pain.

If low back pain creeps up on you at the end of the day, you are most likely using more of your outer unit muscles to stabilize your spine, which fatigue more quickly. An example of these muscles would be your lattissimus dorsi muscle and gluteus maximus muscles which are important muscles, but a strong outer unit is only effective when it is supported by a strong inner unit. When this happens you tend to shift your position often as you fatigue in one position you move to the next and this goes on throughout the day. Outer unit adaptation is a functional compensation which is not optimal for our spines. We ideally want to use our inner unit muscles to hold ourselves up which are the transverse abdominis (TVA ) in conjunction with the multifidus, diaphragm, and pelvic floor muscles. They are our spinal stabilizer muscles that can handle postural load and fatigue later than sooner. Unfortunately, pain or irritation will inhibit or stop our inner unit muscles from firing and stabilizing us. There are forces that effect our spines, these are known as shear force which occur when one vertebrae is  sliding forward or backward on the vertebrae below it; compressive force which occurs when the vertebrae are “pressed” or compressed together; torsion force occurs when one vertebrae is rotating on top of the one below it.  When our spinal stabilizer muscles are not working there is more shear, compression and torsion thru our joints which overtime create wear and tear and an increase propensity to injury.

Postural distortions and muscle imbalances can create low back pain. For example an anterior tilt of the pelvis unlocks the sacroiliac joints and makes it more prone to injury or wear and tear. Or a posterior tilt of the pelvis locks the sacroiliac joint and tightens the ligaments.

Dysfunctional motor control could also be causing your low back pain. For example, if your rectus abdominis muscle is overactive and overpowering your transverse abdominis muscle this could load your discs and set you up for more risk of disc injury. Or if your quads are working harder than your glutes and hamstrings this will create an anterior pelvic tilt which will create more wear and tear thru your facet joints.

Faulty breathing patterns can contribute to low back pain. Our diaphragm attaches to L2 & L3. When we breathe incorrectly it pulls on L2 & L3 and decompresses L4 &L5 creating instability of the spine which in turn can cause injury.

Trigger points in muscles such as the Quadratus Lumborum, Psoas, Iliacus, Gluteus Medius and Piriformis can refer pain to the low back.

Chronic emotional stress leads to cortisol dysfunction and inflammation as well as muscle tension and reduced blood flow. All of this can manifest in the low back so it is essential to recognize this, and take steps to reduce chronic stress in your life.

Remember your spine has evolved to handle significant loads and your body can heal in the right environment. Low back pain does not have to overcome your life.

Tips on helping with your low back pain:

-Reactivating your inner unit muscles. A good exercise example of this is the bird dog. Our spines and bodies need proper movement to thrive.

-Working with a massage therapist to release the outer unit muscles, and/or trigger points and getting the inner unit muscles to fire better.

-Working with your nutrition to heal inflammation of the gut and implementing an anti-inflammatory diet.

- Getting out in nature, to relieve emotional and physical stress.

What is Fascia?

Clients often ask me, “What is fascia?”. So here is some information for all of you who would like to understand more about it.

Fascia has been a very neglected part of medicine for a long time. In fact during cadaver experiments, researchers would discard of it as they didn’t think it was important. In recent years, however, it has become more obvious by researchers and the medical world how important it is and how it is connected to so many pain syndromes.

Fascia is both a tissue and a system and is made up of collagen, elastin and ground substance. As far as the body is concerned, your fascia is all one and is not broken up into parts but one complex, self-regulating organ. It is a continuous tissue that is sometimes referred to as a fascial three-dimensional web, it surrounds and penetrates every muscle, bone, organ, every nerve and cell of your body. The fascial network has more nerve endings in it than the skin does. It is also ten times more innervated than muscle tissue.

Energy can travel through it much faster than in neurons, chemicals or hormones.  It even ferries electrons, protons, photons and phonons throughout the entire body like a superhighway. If it is dehydrated or damaged energy flow gets disrupted. When we re-hydrate our bodies through steps I will discuss below we make our fascia healthier, re-establish the energy transfer, communication, flow and coherence of our body.

Fascia’s ground substance is the fascia’s fluid component and is a liquid crystal;  just like liquid crystals in technology are used for data storage our fascia holds memory.  This is why during a myofascial release therapy session, a person can be overcome with emotions as the body recalls the memory and then let’s go of it.

Fascia is a major shock absorber of the body. It can resist both pulling and compressive forces. Your fascia should glide and be able to absorb shock from the everyday activities of life. However, fascia solidifies when there is trauma from injury and forms crosslinks or adhesions and it looses it’s glide which causes compression, pain, dehydration and inflammation in the body. The fascia can also adhere to itself or other structures, distorting the shape of the three-dimensional web of the body by pulling body segments and bony structures out of alignment.  Many pain syndromes are due to fascial restrictions in the body.

With this knowledge, just imagine it’s impact on our overall health and how necessary it is to nourish and take care of it.

Tips for healthier fascia:

Myofascial Release Therapy rehydrates the fascia, brings it back to a gel-like state so that it can glide, breaks up holding patterns and fascial restrictions in the body.

Infrared light/Sauna - Red light from the Sun or from red light panels helps stimulate water production in your mitochondria which hydrates your fascia.

Cold Plunges - Facilitate better electron flow through the mitochondrial electron transport chain which produces water which will hydrate your fascia.

Grounding - Standing barefoot on the Earth allows your body to receive electrons from it. The body soaks up and distributes the electrons to where they are needed. Grounding is the ultimate antioxidant which reduces inflammation in the body and the fascia.

Injury Prevention

Mountain bike riding, hiking, kayaking, and fly-fishing can take a toll on your body and produce shoulder, low back, knee or neck pain.  Any repetitive movements eventually will creep up on you and cause some kind of pain, that’s why it’s so important to do self-care and prevention techniques.

Countering these repetitive movements with the opposite movement patterns is essential in preventing pain. An example would be if you do a lot of mountain bike riding, your hip flexors and quadriceps will be primarily used thus it’s important to perform exercises such as deadlifts which work your posterior chain muscles which include your glutes and hamstrings to balance your body.

Pain can stop us from participating in the activities that we love. We can ignore it for so long and push through it, but eventually when it becomes too much we have to confront it.

Here are some steps you can take for prevention:

• Myofascial Release Therapy is a great method to free up any restrictions within your body. Working with a MFR therapist can be a great way to maintain the freedom that your joints and muscles need to be in balance.

• Strength training is a great way to counter the repetitive movements in the sports you participate most in which will help prevent pain syndromes and also has a lot of carryover to these sports meaning it will help you perform better in them.

• Mobilization techniques are helpful in keeping your joints free of compression and restrictions which can then cause pain in other areas of the body. For instance an ankle or hip lacking mobility can cause knee pain.

• Sauna and Cold plunge speed up healing, relieve muscle soreness, reduce inflammation.

Functioning, Healthy Feet Make Your Body Feel Good

Most people do not spend much time thinking about their feet, but our feet play an essential role in keeping our bodies functioning, healthy and feeling good! There are 26 bones, nearly 100 muscles, tendons and ligaments, 33 articulations and thousands of nerve endings in your feet. Your feet by their form and function are incredibly sensory. When you block sensory information from your feet (by wearing shoes), you have trouble maintaining stability and balance. When your feet feel the ground, that information is communicated to the brain which allows for optimal movement. If the foot moves functionally, then the muscles start to work and your overall body feels better. Badly functioning feet are frequently associated with knee, hip, back and neck pain.

Shoes strip your natural movement and make your feet weak. Shoes are seldom wide enough to allow the necessary freedom of movement to the tarsal and metatarsal bones that enables the foot to function, both as a shock absorber and a platform from which the legs must generate the necessary force to walk, run and jump. When shoes are narrow or laced too tightly, the metatarsal bones are jammed together, often pinching the nerves that run between the bones. When you are barefoot on the other hand, your brain receives better information. In no way, am I suggesting abandoning shoes completely and having a bonfire with your shoe collection, but to be aware and to implement spending less time in your shoes.

Some tips for improvement in foot function:

• Whenever you are sitting down practice spreading your toes as wide as you can and holding them open for five seconds at a time.

• Play a game of foot marble! Dump some marbles on the ground and fill up a bowl of marbles with each foot. You may be shocked to find that your feet are so stiff and uncoordinated from wearing shoes all the time that you are unable to pick up a single marble.

• Spend time doing primal movement pattern exercises (squat, hinge, lunge, twist, push, pull) being barefoot.

• Wear shoes as little as possible allowing your feet to move as nature intended. The little bones of your feet love the chance to move, which helps keep the joints lubricated. When using your bare feet to walk and play, it keeps the small intrinsic muscles strong.

• When you do wear shoes, don’t lace them too tightly and buy shoes that have room for your feet to move.