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You are here: Home » Physical Therapy » The Hidden Secret to Fixing Back Pain: Part Three

The Hidden Secret to Fixing Back Pain: Part Three

By Mike Uhrlaub

Hey everybody, this is Mike Uhrlaub with Power Your Life. I truly value this time with you. Sharing my thoughts and ideas. I hope you find some value in it and that it helps you live more fully. A happy and pain-free life that you’re meant to live. In the last session, I talked about the relationship between the nervous system and your psoas muscle. I just want to reiterate it is so critical to your wellbeing, that you keep your psoas healthy. I told you in the last episode there was one activity, that we all do daily, most damaging to yourself. Can you guess what that is? It is sitting!

Sitting is Actually Killing YouMan sitting in the office

Believe it or not, sitting is actually killing you. Sitting has been determined to be more dangerous to your health than smoking. Sitting is one of the biggest culprits to creating an imbalance in the psoas muscle. Some of you might be thinking I don’t sit that much. I got a job or I’m moving around. That may be true, but I don’t think most of us realize how much we really are sitting. Obviously, it makes sense. When you’re in a desk job you’re going to be sitting a lot, possibly for seven or eight hours. You do a lot of computer work such as data entry.

When you think about it, even if you have a job where you are on your feet, you’re still driving to and from work. When you’re relaxing at home with friends, you’re sitting. What’s the first thing you do when you get home? For most of us, we sit on the couch, right? We sit to eat; go out on the weekends to the movie theaters and sit for a couple of hours. Breaking it down, most of the activities we do involves sitting.

The Effects of Sitting

I know we’ve all felt the effects of sitting at one time or another. You get up and feel the achiness in the lower back. After a long day of working at your desk, riding in the car for a long time, a long flight home, you get up and feel that tightness. You can feel this tightness all over your body. Your neck, shoulder blades, and even your hips. It doesn’t matter what position you’re sitting in. You’re putting your body in a poor position that is going to make your body stiff. When you sit for a long time, the psoas is going to shorten. Then when you stand up, you don’t stand up all the way.

This is created by a tilting of the pelvis in a backward position. We call sitting down with a tilted pelvis a posterior pelvic tilt. You can go to the gym, work out with common exercises such as crunches or sit ups, and still make the pressure on the back worse. They don’t do the psoas muscle any favors. They don’t help at all. It is important to keep your glutes and legs strong, but if you’re flexing your hips too much, you end up restricting the motion. When this happens your back and knees end up taking most of the stress. A lot of times, what people are doing at the gym is making the problem worse.

Laying Flat Becomes PainfulWoman with back pain sitting on a bed

Many times, we’re still slightly flexed at the hips because of the tightness in the psoas.  This creates a forward pull on the spine by the psoas and in turn creates compression. The tension then accumulates in the spine and hip making your muscles tight with spasms. They won’t even relax when you lay down. I’m not sure how many of you with back pain have found this out.  But I’ve had so many patients that can’t lay on their back or stomach without putting a pillow under their hips. When you put a pillow under your hips it flexes your spine a little bit and gives in to the tight psoas.

If you find out you have a hard time lying flat on your back in bed. If it doesn’t feel comfortable when you are laying down, test this out. Try laying down in bed or on the floor with your legs straight out and everything flat. If you feel like your lower back is arching, your lower back can’t relax, or you feel pain when you do that, you have a problem with your psoas.

Try laying on your stomach too. If you can’t lay in a prone position, completely flat without back pain, guess what? You have a dysfunctional psoas and that can create so many issues for you. It’s all created due to the amount of sitting and the adaptive shortening that is occurring.

The Pain Isn’t Limited to the Back

It also shows up as a deep pain in your groin and hip. If you can’t lay flat because there’s an unexciting groin pain or unexplained pain in the outside part of your hip, you might think you need a hip replacement. I’m going to tell you, it’s probably not your hip. The pain is probably coming from back pain that is stemmed from your psoas muscle.

As the psoas gets tighter and tighter you might start feeling a deep ache in your stomach and then your low back pain continues. What do most of us do when we are sore and in pain? Well, it hurts to lay flat on my back. It hurts to lay on my stomach. It hurts to stand up because we don’t realize it, but our hips are still flexed forward a little bit. We can’t get to a completely upright position. So, we sit. What does that do? What do you think that does to the psoas? It makes it even tighter.

 This is a vicious cycle and the problem will just get worse because most of us can’t stop working. We can’t stop commuting to work. You might think, “well, I’ll just start standing more.” Some employers are even starting to use standing desks. But not even that is going to fix the problem because the damage with your psoas and the spine has been going on for years. It started out when you were a kid and all the sitting that’s been accumulated. There has to be action to correct these imbalances. The bottom line is, by spending so much time sitting in a flexed position, combined with a lack of proper movement, has created a perfect storm.

The Perfect StormWoman Sitting in a Car

Not only is sitting causing the psoas to tighten, this muscle is also the first one to tighten under stress. We talked about that with the nervous system. The fight or flight response. Remember we said the psoas is one of those first muscles to react when you’re under stress. That’s because it wants to either contract, curl you up into a ball, or it wants to fire so it can kick the leg and run away from danger. Not only does the psoas tighten when you’re faced with stress, it creates a fight or flight response. That stress can be anything. Worry about your debt, finances, the fight you had with your spouse, conflict you’re facing at work, or just driving in traffic.

Someone cuts you off and that just ticks you off creating stress. The psoas tightens up into a protective posture, it’s the last muscle to let go when the stress is done.

It’s bad, but this is how many of us have been living. We’ve gotten so used to being comfortable and being inactive. The damage is happening to us without even knowing it. At least until one day, your body can’t handle it anymore and you start feeling the pain. Your body will respond and adapt to everything that happens to you in your life. The state and health of your body is a direct result of how you live. Injury, trauma, stress, posture, all of these things build up and your bodies become set in their ways and then a pattern of muscular tension develops.

Stop it Before It Progresses

The next step after the buildup of tension is chronic degenerative changes in the spine. I want you to know, not all hope is lost. I’m not trying to be gloom and doom here because all of this can be prevented and these things can be fixed. We’re going to talk more about that next time.

If you haven’t received a copy of my new eBook, The Five Best Kept Secrets to Fast Back Pain Relief, get yours simply by emailing me, Mike@flex-pt.com. Or shoot us a message on Facebook messenger.

I love to leave you with a thought-provoking quote. Rick Warren said –

“Imagine how much you could bless others if you simply cleaned your closets and passed along your abundance – giving the things you don’t use to people who will.” 

Until next time. Power Your Life and keep moving forward.

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Filed Under: Physical Therapy Tagged With: back, exercise, hip flexor, iliopsoas, pelvic tilt, Psoas, Sitting

About Mike Uhrlaub

Head physical therapist and leader of Flex PT in Council Bluffs, Iowa. Mike's a unique kind of therapist that believes everyone should be treated like they are a VIP regardless of insurance or financial status.

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