Did you know that a major cause of bad back pain is that our lower backs do not like too much bending forward (flexion). In the medical field it is well-known that in our lower backs, the lumbar discs respond better to bending backward movements rather than bending forward. Particularly in the case of someone with a disc source of back pain.
Today I will be explaining the concept of how too much flexion in our lumbar spines is causing acute lower back pain or chronic lower back in some people. There are two great videos below. One by chiropractor, Craig Liebenson, and the second by low back pain specialist and researcher, Professor Stuart McGill. Find out how Craig, who has studied at the Prague School of Rehabilitation, teaches a female marathon runner how to fix a bad back pain, fast and for the long-term.
What is The Flexion Intolerant Spine?
So why would bending forward cause back pain?
Watch this explanation by Prof. Stuart McGill. Stuart explains the answer:
In the video above Prof. Stuart McGill explain to us, why after all his years of research on the lower back, one of his main discoveries is how too much bending forward (flexion) causes low back pain.
McGill shows us how we get can get a trapped nerve in the lower back from a lumbar disc herniation and how then bending forward pushes a herniated disc or bulge out further to cause a nerve compression. Stuart does mention how this bulge and herniation process takes several years to occur.
I did a video to show you what it looks like when a disc degenerates over time from a healthy one to one with no more support.
How to Treat Lumber Flexion Instability
This next video is listening to Doctor of Chiropractic, Dr Phillip Snell. Phillip takes you through some handy tips on how to perform the McKenzie lower back exercise. This is the low back pain exercise I recommend for people with a flexion intolerant lumbar spine.
Update: I had a case history video here from Dr Craig Liebenson, but the video is no longer available. I have left the info here as the case history story is useful.
Craig is assessing “Judy” who is a serious marathon runner and who has a bad back pain for the last month. This pain is in her lower back when running. He goes looking for the reason why she has the lower back pain and then what can be done to treat a back pain like hers.
Some key points in her case history:
- She has left buttock pain when running and has a marathon race to run in 2 weeks time.
- Her pain is caused by activity like being bent over, prolonged sitting or flip turning during swimming training in the pool.
- The pain is worst in the morning.
- There is a history of a back problem with her having a previous spinal surgery for a disc herniation and right sciatica symptoms.
Craig talks to us about a flexion intolerant lower back. This is the same concept as what Prof. Stuart McGill talked about.
How To Treat a Flexion Intolerant Back Pain
For a successful flexion intolerant back pain treatment these are some good take home points:
- Maintain an arch in your lower back as much as possible during the day,
- Extension relief is also known as McKenzie exercises,
- Bending backwards stopped the pain in the left buttock now more in the spine (centralization) this is good,
- Repeated forward bending caused nerve tension in the left buttock,
- Slump Test reproduces the left trapped nerve pain in the bum,
- Stretching the hamstring muscle will make sciatica pain worse,
- Don’t sit longer than 20 minutes at a time,
- With discogenic pain perform low back extension exercises lots!
It was nice to hear from a very experienced spinal specialist, like Craig, that he felt even with Judy’s back pain coming from a disc in her spine that she would be able to run her marathon in 2 weeks time. He felt this confident because she didn’t have terrible signs of nerve damage in her leg like neurological muscle weakness.
I found a great Interview with Prof. McGill about his back pain research findings and how these research findings affect the decision as to what exercises you should do at gym to prevent back pain and the best way to strengthen the lumbar spine. The article is aimed mainly for the serious weight lifters like body builders and power lifters. This means there is a lot of technical terminology. However, if you want a simple way to see what McGill means by bending at the hips rather than your spine see how to do a hip hinge exercise.
If you are sitting there reading this with a terrible back pain coming from a slipped disc then I hope this helps your bad back pain get better soon.
If you are a chiropractor, osteopath, physiotherapist, physical therapist, personal trainer or anyone else interested in the filed of back pain rehabilitation assessment and exercises then you will
want need to buy Craig’s and Stuarts book to learn from the masters.