Dr. Dmitry's 3-part blog series on Fascial Counterstrain.
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Working as a Physical Therapist in the fast-paced style of New York City, I quickly began to appreciate the prevalence of low back pain that so many New Yorkers suffer with due to long hours sitting behind a desk. I also became acutely aware of how little time my patients have to focus on their own wellbeing. As always I recommend anyone suffering from low back pain to be evaluated by a spine specialist, but I wanted to give something back to the community that sometimes just doesn’t have the time or resources to see one.
We all work so hard to achieve financial success to have money for retirement, 401K or other financial planning. One question that begs to ask is, "What good is all this hard work and financial planning if your back hurts so much that you can’t enjoy your life?" Like a financial plan, ensuring a future without back pain and activity restrictions requires time and due diligence.
In my 17 years of experience, I have evaluated and manipulated many muscles groups to alleviate low back pain. In this blog I will outline the 3 main muscular culprits that affect millions of Americans every day and explain as well as illustrate 3 simple stretches that can be done at home to instantly relieve Low Back Pain.
The number one culprit of Low back pain is a tight or dysfunctional Psoas muscle. The Psoas is a large thick muscle located in the front of the body so it often goes overlooked when we start experiencing back pain. Overlooking this muscle is a big mistake as it originates at the lower vertebrae of our spine (T12-L5) and inserts on the posterior aspect of our femurs (thigh bone). People who have injured their Psoas muscle or have jobs that involve prolonged sitting run the risk of creating and maintaining the Psoas muscle in a shortened state, which over time creates an incorrect relationship with our brain and results in the “new normal” state for our Psoas which is a shortened tight muscle. This dysfunctional muscle pulls forward our lower vertebrae causing increase pressure on all our low back muscles and intervertebral discs.
This muscle can be stretched (Fig 1.) by kneeling on one knee, rotating the lead leg outward and tightening the gluteal muscles on the leg which is against the floor. Keep your core stabilized and lean through that hip joint. A stretch should be felt in the front of the hip. Hold the stretch for 20-30 seconds repeat 5 times per side.
The second biggest culprit of Low Back pain and more importantly sciatica is the Piriformis. The Piriformis is a uniquely shaped diagonally run muscle originating at the sacrum and running to the greater trochanter (ball) of the femur (thigh bone). Its purpose is to externally rotate your thigh bone, extend your hip slightly and keeping your hips stable while standing or walking. What this means is, when this muscle gets injured or becomes dysfunctional it can have a negative effect on a number of places, your low back being one of them. Worse than that a contracted Piriformis can easily compress the sciatic nerve thus causing the infamous “shooting leg pain” which radiates down the back of the buttock and leg. The most common cause of a tight Piriformis is prolonged sitting or quick jerky movement that promotes dysfunction in the muscle.
This muscle can be stretched (Fig 2). Lie on your back and bend the affected knee (right knee) for this example. Use the left hand to pull the right knee over to the left side. Keep your back on the ground as you do this. You should feel the stretch in the hip and buttocks. Hold the stretch for 20-30 seconds repeat 5-8 times.
The third culprit is the Quadratus Lumborum (QL) muscle, a muscle that is too often ignored when it comes to low back pain. The Quadratus Lumborum is located in the lower back and it attaches to the iliac crest and runs to the lumbar vertebrae 1-4. Its action is to side bend the spine or it lifts one side of the pelvis up in what is known as” hip hiking. This muscle is easily injured or overworked causing tightness and dysfunction, a tight muscle often times can mean a weak muscle which leads to pain with simple activities. Such as just standing. Females wearing heels that tend to stand and lean on one leg often have this problem.
This muscle can be stretched (Fig 3). In standing you can perform a side stretch. Bringing both hands over your head with palms facing each other. Keeping your thighs back. Take hold of your right wrist in your left hand and stretch to the left, thus stretching your right QL. Hold for 20-30 seconds repeat 5-8 times.
If you'd like more information on how Physical Therapy can help relieve your symptoms, please contact our office or book an appointment at Midtown East Physical Therapy You can also email me personally at Dshesta23@gmail.com
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