Our Continued Back Attack
Even after 30 years of attention by the American Chiropractic Association, the American Osteopathic Association and the American Academy of Orthopedic Surgeons, there is still an epidemic of back problems in our Western culture. Can this be helped by improved lifestyle and postural habits?
When I first went abroad to teach chiropractic in the early 1970s, there was very little public transportation available in Asia, especially China. Walking, riding a bicycle and trains were the main modes of transportation, and at that time very few Asians were overweight.
However, during a visit in 1995 there was an obvious change. The number of vehicles on the road had doubled, and not as many people were walking or riding bicycles. There were overweight individuals everywhere, especially in the cities.
Many of the doctors attending the lectures about chiropractic sports procedures knew there had been a shift in physical activity of the Chinese people but didn’t realize at that time just what was at the root of the problem.
This realization over three decades ago made me recognize why doctors of chiropractic are so busy in the United States. The backs of 8 out of 10 people hurt at some point in their adulthood. About 25 percent of our adult population experienced pain within the past three months, and about 10 to 12 percent of these episodes were severe enough to require doctor visits. When asked about types of pain over the past three months, the respondents of a National Institutes of Health statistical survey found that low-back pain was the most common at 30 percent, followed by headache at 16 percent and neck pain at 15 percent.
Biomechanics of Sitting
The increased sitting at our computers, TVs, video games, desks, etc., and not enough physical activity are at the root of the problem of back pain and obesity. The difficulty is what to do about too much sitting at home, in automobiles, at computers, etc. It seems they all require the seated position to perform the tasks correctly.
Whenever you sit, you crouch and compress your posture into a bent position in a way that involves the muscles of the low back and pelvis. Some muscles overwork and some relax, creating an imbalance. It does not matter if you are sitting on a bicycle, at your desk during work or in the stands watching a football game. These muscles are still involved and are physiologically shortened.
When the hip flexors and the psoas muscles tighten up and begin to lose functionality, the real problem begins. The psoas is a long muscle that has its origin on the lower spine and moves over the front of the hip joint and attaches at the top of your thigh. The psoas goes from the upper 4 lumbar to the lesser trochanter of the femur. Stecco has shown that deep pressure over the muscle can actually change the viscosity of the ECM and thereby increase movement between fascial layers. This appears to be the result of changes in the hyaluronic prevalence from a greater concentration prior to fascial manipulation to one of less concentration following this procedure.
Over the last 8-10 years, there has been a tremendous amount of research on the topic of fascia and its role in pain, loss of function and loss or ROM. Sitting in chairs, sofas, automobiles and airplanes causes a shortening of this set of muscles. As a result, when you stand and begin to move, it pulls down on your lower back, causing low-back pain. Sitting probably causes more low-back pain than injury does. As a result, you are in pain and don’t feel like exercising, and the less exercise the more weight gain.
Studies have linked sitting to many lifestyle risk factors such as heart disease, obesity, diabetes, gastrointestinal disease and others. Further studies show that the more you sit the shorter your life expectancy.
Better Sitting Habits
Of course as a society we cannot avoid sitting, but we can counteract the effects and learn better sitting habits. You have to master the process by changing personal biomechanical habits, like getting up from the sofa or out of the car. Try to learn to automatically arch your back and lean backward into a slow, full stretch elongating the spine and allowing the psoas and hip flexors to activate and take pressure off the low back. This should also be done before sitting down for a long meeting, trip or TV show. This diminishes the stiffness and shortening of the muscles.
You can also mechanically change the seat in your automobile if you have a commute of more than 30 minutes, by tilting the seat forward so the seat changes the pelvic position and your knees are lower in the front than the thighs. This allows an upright sitting posture with the lower spine arched into its normal lordotic curve. The old way of sitting in a reclined posture allows the pelvis and lumbar spine muscles to shorten into an abnormal crouch-type position, causing eventual low-back pain to develop.
Remember, awareness of the mechanical position of your body and what it’s doing to the low back is a big factor in preventing your low back pain from being the focal point of your life. Many in more progressive office environments allow office workers to use a stand-up desk rather than chairs. Some workers are now using a balance ball when they sit at their desk rather than a chair. Putting these lifestyle changes into effect has made a great difference in many people’s quality of life, and doing so has been fun for them.
Of course there are exercises that many will have to do throughout their lives to keep the low back and the abdominals balanced and strong. However, nearly everyone has been schooled on these, and backs still hurt. See if making these sitting changes will work for you as they have now for thousands of Americans that we have managed back to good health by getting their back problems under control, making it easier for them to lose weight at the same time.
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5. Medline Plus. Low-Back Pain-Chronic. www.nlm.nih.gov/medlineplus/ency/article/007422.htm. Accessed April 13, 2012.
6. National Institute of Neurological Disorders and Stroke. Low-Back Pain Fact Sheet. www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed April 13, 2012.
John Stump, DC, PhD, EdD, is a graduate of the University of Maryland, Palmer College of Chiropractic, Shaanxi University and the United States Sports Academy. He has been a lecturer of Sports injury and acupuncture procedures for over 30 years. He just completed a new chiropractic textbook contribution in Applied Kinesiology Essentials: The Missing Link in Healthcare. He can be contacted at Bamashogun@gmail.com or at www.alternativeconcepts.com.