Do You Have a “Flexion Intolerant” Back?

GEDSC DIGITAL CAMERAYou may or may not have heard this new buzz term in the world of physical medicine and rehabilitation.  It is certainly gaining traction in my industry thanks to a couple of brilliant minds in the world of functional movement and kinesiology: Stuart McGill Ph.D.,and  Craig Liebenson D.C. for starters.

I see how  very helpful it can be, to the average person in pain, to be able to identify and label their condition.  The term “Flexion Intolerance” has come to serve that very purpose in my own practice.  In particular I’ve found it very helpful to point people to this internet resource developed by a fellow chiropractor: Fix Your Own Back dot com.  Dr. Snell provides an easy to use guide to help people in pain figure out if their back pain situation might be one that can respond very well to some basic changes to just a few everyday things.  We often take for granted these everyday activities until we’re in pain.

Pain is the primary and most effective motivation for most of us to want to investigate and learn more about our bodies. I believe it’s important that everyone realize before they are in pain, that “flexion” is not something our lower backs are very well designed to put up with in the first place, but especially not in the way that our modern lives demand.  We are all actually, by design, flexion-intolerant.  In particular, we are intolerant of the kind of flexion and the amount of flexion our modern day backs are exposed to.

What is Flexion?

It’s the technical term used to describe a forward bending motion (in the spine) which in the extreme looks like rounding.  Imagine the fetal position  – the ultimate example – full body flexion.  It’s no secret that bending to pick up something heavy can be “dicey” for the back and most of us know that this could result in pain if we’re not careful.

The unfortunate thing  is that flexion in the lumbar spine / lower back can be happening without the outward appearance of rounding – for example while sitting many of us are actually putting the lower back into flexion without meaning to – even if we’re not necessarily slouching.  The brain is pre-programmed with what can be considered our “safe” amount of flexion both in degree and frequency.  This pre-programmed set point is different for every single body, but it’s what determines when and under which conditions we suddenly experience our flexion intolerance as full blown pain.

You’ll find much more about this idea of our individual mechanical set point or blueprint for safe movement at Stop Everyday Pain dot com.  This is where my blog to book project is taking shape.  Check it out, become part of the process or just follow along to find out why things hurt that didn’t used to hurt and figure out what you can do about it.


 

[photo credit: wikimedia commons]

“It’s Probably Just Muscle Pain, Right?”

body art

image credit: wikimedia.org

This is something I hear patients say all the time when they come to see me.  Almost as if to apologize for not having something more dramatic to show for their pain or look for reassurance that it’s nothing too serious.

Guess what? It probably is “just” a muscle and that’s a perfectly adequate reason for your pain.  It may not seem serious if it’s “just” a muscle but it’s not a free pass for you to shrug it off just because it’s not life threatening.  Most of the pain that we experience when we’re talking about the everyday variety of pain is soft tissue based.  This means it’s not commonly coming from your bones or discs unless you’ve had a very distinct physical trauma recently or are in an advanced state of chronic dysfunction which you would already know about from a looong history of pain.  Of course it’s up to the professional you choose to see to find out whether or not there is a more serious underlying cause for your pain.  I can only speak of generalities based on the vast majority of pain that I treat conservatively in my chiropractic practice.

A lot of the pain I see and treat is something that sneaks up on people, for example: the pain that you wake up with after going to bed feeling fine or the pain you discover when you try to stand up from your desk or the couch.  These kinds of everyday pains  are generally being generated by the strain and damage to muscles, tendons, ligaments and joint capsules.  The reason  these structures are stressed and signaling pain is what I’m  always interested in.  The relationship between bones and joints, either during movement or at rest or during transitions from inactivity to activity, are the reasons that the soft tissues of the body start to complain with pain.  Because it’s up to the soft tissues to hold everything together they are the ones that will be the first to notice if un safe movement or positioning is happening.

Sometimes figuring out which combination of movements, habits or positions led to the irritation of these pain generating structures is the complicated part.  Determining these things is usually key to lasting relief.

What I do with chiropractic is restore normal functioning to the joints of the body that have stopped pulling their full weight.  Sometimes the joints stop working optimally because of pain in the soft tissues and sometimes other reasons cause the joints to stop working fully first and then the resulting uneven work load is the reason for the soft tissue pain.  Restoring motion is the first step.  That usually brings a lot of relief from the pain. Then comes the hard work of maintaining that healthy movement on a daily basis in order to keep those muscles from hurting.  Sometimes this requires a complete re-assessment of how to go about the daily tasks that we come to take for granted like brushing our teeth or washing the dishes or even what we think is restorative unwinding on the couch.

Read more about how to stop everyday pain here.

Are You a (Spinal) Crack Addict? Just Say No!

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photo credit: Fotolia

I fondly refer to you as a “crack” addict if you’re someone who can’t sit in front of me for even just a few minutes without tilting your head in an attempt to make your neck crack.   Like with any addiction there’s a reason it started.  It probably feels good –  it gives you relief from some discomfort you might be feeling in your head neck or shoulder.  But before you know it, you’re stuck in a vicious cycle that is out of your control and you’re cracking parts of your spine several times a day without even thinking about it.

For some people it’s the mid back crack that happens when you squeeze your shoulder blades together and stick your chest out.  For others it’s the spinal twist that you do in your chair when you get stiff instead of just getting up for a minute to move around because you don’t want to lose your train of thought.  Both are very common problems for our computer bound modern lives. Here’s more from my book preview on the danger of doing these kinds of movements.

The desire to crack comes from a sensation of tension, stiffness, or pressure.  The cracking you do to yourself helps alleviate this discomfort. The reason this self-cracking becomes an addictive habit is because it feels good but more than that, it’s because joint “cavitations” (cracks) actually access a natural pain killing chemical feedback loop.  But how long is the relief lasting for you before you need another “fix”?

The problem is that when we try to crack our own spines we are naturally not able to be very specific.  The methods we use involve long levers (movement or stretching over a long distance from point to point) and so usually what ends up releasing and cracking is an area that is already hyper-mobile in the first place. The weakest link is what yields first.  The joints that need the release can’t be accessed in this way and so, what we are doing when we crack ourselves in this non specific way is reinforcing the original reason for this tightness and pressure sensation.

Your body is really smart and when there is a hyper-mobile area of your spine that is doing an uneven, unfair extra amount of work, it’s generally because there are neighboring areas of the spine that have stopped pulling their weight – either they have jammed up or there’s been a mix-up in the messaging to that area because of prolonged one sided tasking or bad body habits. When the neural messaging gets mixed up sometimes muscles just turn off and stop working – leading to joint dysfunction. The muscles around the hyper-mobile segments of the spine will start to tighten up and over-engage in an attempt to help you stabilize this area that they are told, by the brain, is moving too much.  So, when you squeeze and twist and stretch to get those already hyper-mobile areas to crack, what you’re doing is reinforcing the need of the muscles in that area to stiffen up.  So, while the crack itself feels good because of the short lived release of pain killing endorphins, it’s actually feeding the problem.

Not only are you adding to the problem and creating a greater ongoing need for relief, your chosen method of relief (constant cracking) creates friction.  Friction causes inflammation and as that inflammation builds it causes pain – in addition to the stiffness and pressure. (You can read more about inflammation and pain in this post excerpt from my book)  Over time this friction related inflammation will cause real structural damage to your joints.  This kind of damage over time can result in things like weakened and bulging discs, facet syndrome, formation of bone callouses or osteophytes. (click here for more on this in another post excerpt from my book about everyday pain)

Now you have a joint that is over-worked and irritated and if you keep up with the cracking you’ll also be disabling the more appropriate first line of defense in spinal stability and that is the ligament system.  The ligaments are like guide wires that connect bones to bones and provide architectural integrity.  Without good tone in the ligaments your muscles have to work overtime to protect your joints from excess movement.  Your muscles should not have to do the job of your ligaments.  But that’s often what we’re experiencing when we develop that desire to crack and pop ourselves.

The only way to break this cycle and get the joints that are really stuck to move again, is to have professional help.  Chiropractors are trained to be extremely specific with spinal adjustments and our goal is to introduce movement only to areas that are not moving correctly.  Restoring motion to segments that are stuck will alleviate the work load in those areas that chronically do too much.  This is the only long term answer to the “crack” addiction that so many suffer from.

A healthy spine does not feel the need to crack.  A spine that is moving correctly and to it’s full potential does not let you know that it needs a crack.  A spine that has strong supporting muscles does not ask for this sort of attention.

If you think you might be a spinal “crack” addict, think about getting some help.  Find a chiropractor who will work with you to make it a goal to help you feel that urge to crack with decreasing frequency.  You also need to get some advice on what you can do specific to your situation, to stabilize your spine in order to help make your treatments last longer and avoid undoing all of the good work.

More on the cracking or lack of cracking of spinal adjustments in a future post…

What are your thoughts?