Here is a story I hear ALL the time. “I have a back problem. I stopped my exercise program and my back pain went away. But every time I begin my exercise program again, within days, or sometimes a week, my pain comes back and I have to quit again. I’m so frustrated because I’m out of shape and gaining weight, and I don’t know what to do about it.” After I assess them, I frequently tell them I think I can help them. There is a very good reason this happens, and there is definitely something you can do about it to get back on track.
We essentially have two muscle systems in the body – the muscles that move us (movers ), which are the muscles we tend to exercise in the gym, and the muscles that hold our joints (stabilizers), maintaining proper axis of rotation during movement at the joint. These muscle systems are quite different in how they work.
- tend to be larger
- tend to be further away from the joint (closer to the outside of the body)
- greater leverage
- can exert higher forces
- they move bones (body parts like arms, legs, the trunk, the head etc.)
- Act more like the gas pedal – you want to move, they move you
- they turn on when we need them, and turn off when we don't.
- turn on quickly (more fast twitch fibres)
- tend to be quite small
- very close to the joint so they are in an ideal position to be able to
stabilize a joint
- very little leverage
- smaller forces (just enough to do the job)
- they control the joint motion
- act more like brakes to prevent excessive joint movement, rather than
actually move bones
- they anticipate movement, so they turn on before we move
- tend to stay on at low levels most of the time
- turn on slowly (slow twitch fibres)
- Pain may result when there is an imbalance in the stabilizer function
around a particular joint, resulting in the resting bone position being
altered, or the bone movement pattern at the joint being dysfunctional
An easy example to understand is the rotator cuff of the shoulder. The job of those small muscles is not to rotate the arm, but rather to hold the arm bone (humerus) into the socket, and make sure your humerus is maintaining the proper axis of rotation in the socket while your larger muscles throw that ball.
If the rotator cuff were not there, at best your arm would have slipped in the joint, and at worst your arm would have followed the ball! If there is an imbalance in the function and/or strength of the muscles that form rotator cuff, the humerus may not sit in the socket correctly, and when one moves the arm, pain may result.
The spine and pelvis is another location where imbalances side to side in the stability muscles can result in resting position of a vertebrae, or perhaps the sacrum being altered, creating pain, often one-sided. If the stability muscles on one side if the bone or joint are not working, the bone will be pulled towards the stronger side, outside its optimal functional position.
One can go to the gym and work the mover muscles all we want, but it probably won't resolve the pain unless the underlying dysfunction in the stabilizer muscle is also addressed. And working the movers in this scenario may make the painful condition worse, as the dysfunctional stabilizer won't be able to do anything to stop the excess movement at the joint. Movers may then go into spasm trying to stabilize the area, but because they are not in the right location to do the job, frequently more pain results.
So, do you have back pain, neck pain, shoulder pain, pelvic pain? If you live in the Vancouver please don't hesitate to contact me by using the contact page on my website if you would like one-on-one help. www.wellnesstips.ca. We would be happy to assist you.
If you live elsewhere, see a good physiotherapist or CHEK Practitioner who can assess you, figure out which stabilizers are not functioning optimally, and teach you what to do about it.
If you want to search for other posts by title or by topic, go to www.wellnesstips.ca.
Lee, Diane and Lee, Linda JoyAn Integrated Approach to the Assessment and Treatment of the Lumbopelvic-Hip Region DVD, 2004
Lee, Diane and Lee, Linda Joy Postpartum Health for Moms – An Educational Package for Restoring Form and Function after Pregnancy
CD ROM 2006.
Lee, Diane Assessment Articular Function of the Sacroilac Joint VHS
Lee, Diane Exercises for the Unstable Pelvis VHS
Richardson, C, Hodges P, Hides J.Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain Churchill Livingston 2004.
DonTigny, Richard Pelvic Dynamics and the subluxation of the sacral axis at S3 The DonTigny Method.
Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Poise: Psoas-Piriformis Balance” Massage Magazine, March/April 1998.
Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Fans of the Hip Joint” Massage Magazine, Jan/Feb 1998.
Myers, Thomas Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists Churchill Livingston, 2001
Chek, Paul CHEK Level 1 Advanced Back Training Chek Institute.
The Multifidus Back Pain Solution: Simple Exercises That Target the Muscles That Count New Harbinger Publications Inc. Oakland CA, 2002.
Lee, Diane Understanding your back pain – an excellent article explaining the concept of tensegrity and its importance in stabilizing the pelvis and spine.
DeRosa, C. Functional Anatomy of the Lumbar Spine and Sacroiliac Joint 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.
Gracovetsky, S. Analysis and Interpretation of Gait in relation to lumbo pelvic function 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.
Dananberg H. Gait style and its relevance in the management of chronic lower back pain 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.
Online at www.kalindra.com A fantastic website devoted to sacroiliac dysfunction.
Copyright 2008 Vreni Gurd