Case study / lower back pain(2) ~pain appeared after exercising~

Hello!


My name is Ikuko Murata, I'm working as a physical therapist and personal trainer in Tokyo.


Today's article is a continuation of the previous one (Ms.S's lower back pain:1).


To understand today's article, it's difficult without reading previous article and "Ms.S's stiff shoulder".


Today's article would be a good information for those who are worried about lower back pain, especially one side of lower back pain.



<table of contents>


1. Mechanism of the lower back pain by the compression stress


2. Why didn't she feel the lower back pain so much?


3. OMG! After starting the exercising, lower back pain broke out!


4. Why her back pain appeared by exercising?


5. How to deal with her back pain?


6, Summary



1. Mechanism of the lower back pain by the compression stress

As I told last time, Ms. S's lumbar spine was bent to right, but in fact, she didn't feel pain so much.


Why was her pain not so serious?


To understand this, we need to understand the mechanism of the lower back pain causing by the "compression stress".


Because... After the first session, she felt the lower back pain in the right side.

Her right side, exactly that is a "compression stress side".


So today, I will explain "how dose compression stress cause a lower back pain".




The lumbar spine suffer from these force.


・Weight of upper body


・Reaction force from the sole


These are also exactly "compression stress".



Additionally, if the lumbar spine is bent to right or left, there is a compression stress in bending side.(in Ms.S's case :right side)



If her upper body is sifted to right like this picture↓, her right side of lumbar spine is suffer the compression stress so directly.


・ Vector that the upper body crushes the right lumbar joint from top to bottom


and against that


・ Vector that the right pelvis pushes up the right lumbar joint from bottom to top


Right lumbar spine is sandwiched between these two vectors.


Moreover, with a state of right bending.


In this way, the lumbar spine is a part that is exposed to compression stress from above and below, and additionally if it is bent to the side...


It is obvious that "pressure is concentrated and it easy to cause a pain!".



The lumbar spine is in a position like a cushion that responds to distortions of other parts and it's easy to suffer from a stress because of its flexibility.

The lumbar spine is a middle management position, sandwiched between a subordinate (pelvis) and a boss (chest).


2. Why didn't she feel the lower back pain so much?

Now, you understand the compression stress on the lower back, let's think about Ms. S's lower back.


Her upper body is sifted to the left and her center of gravity is also sifted to the left a lot because of her work habit.

(Ms.S's Stiff shoulder)


This upper body's sift is so strong, because of this she were worried about left stiff shoulder.

Maybe some of you have already noticed now.


Even if her lumbar spine arrangement is in a susceptible position to suffer a compression stress on the right side,


Her upper body weight is in the left side,


so her right lumbar joint didn't suffer the compression stress from upper body weight,


and her center of gravity is in left side,


so there was no vector pushing up from the right foot directly to the right lumbar joint.

In other words, there is not much force directly applied to the right lumbar spine from above and below.


Because of this, she didn't feel the pain so much even her lumbar spine is bent to the right.


3. OMG! After starting the exercising, lower back pain broke out!

It happened.


About 2 month later after the first session,


her lower back pain appeared.


・・・(;゚Д゚)



4. Why her back pain appeared by exercising?

Well, so I will summarize the problems of her body again.


She had two problems, not only one.


 (1) Upper body shift to the left (habit of her work: detail is in this article)


 (2) Pelvis tilt to the left (left leg is shorter : detail is in this article)


These two problems were intertwined.



So


 (1) Upper body left shift → correct by exercising


 (2) Pelvis left tilting  → control the length by insole (heel pad)


We should solve these two problems like this at the same time.


But...


The problem(1) is much bigger.


It means the distortion of the upper body was much more serious than pelvis.


 Pelvis < Upper body



Moreover... I didn't have a material of insole...

(It becomes an excuse, but it was sudden reservation...)




So! we decided to solve one by one from bigger one!


↓These are the self-exercise that I told her in the first session↓


 ★move the upper body to the right


 ★feel the weight on the right foot by moving the upper body to the right


These are the approaches only for the problem(1) .


Of course, I explained to her the risk of a pain in her right lower back and told her not to be too serious for exercising until the second session.


And we promised a second session to approach problem (2) as well.



Finally, About two months later....


It is reported from her that her left shoulder stiffness gradually improving and at the same time the right lower back hurting (+ o +)

As a result of the correction of the upper body, the weight increase also on the right side, the force of pushing up from the right foot to the right lower back may have become stronger.


Because we didn't correct the pelvis tilting...OMG


To be honest, this case made me think that my judgment was unsatisfactory.

(Or rather, it was too long until the second session..., or sudden session I don't have insoles...! )


5. How to deal with her back pain?

So, of course! I brought the material of insole in second session.


After the second session, her lower back pain is getting better and better, because we could adjust her leg length artificially.


If possible, we should have approached two problems at the same time, but accidentally we approached one by one.

And the result was exactly I worried.

I was surprised "Is the body so honest?" .


I learned again from her case that how important it is to consider about the mechanical stress "logically" and "objectively" .



In the next article, I would like to explain "How her gait changed by using insoles".


6. Summary

・Lumbar spine is the part that suffer the compression stress from top and bottom.

・Ms.S's lumbar spine is bent to right, but her habit is left weight, so she didn't feel lower back pain so much.

・But after starting the exercise for left shoulder stiffness, lower back pain happened.

・We should have approached for leg length problem in same time by insole.

・Her lower back pain is getting better after using the insole.

・How important it is to consider about the mechanical stress "logically" and "objectively" .




To be continued!



Thank you for reading.

I hope this article will be a helpful information to improve your body!



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