Joanne, suffering with persistent back pain when walking, called me and asked for help with her problem. I went to her house and asked her about her walking routine; what terrain, where, how long, and how hard? I also asked her about her work; how long – and what way – was she sitting? She was primarily walking fast up steep hills every day for 30 minutes. At work she sat most of the day, breaking only for lunch. I asked her to demonstrate how she walked and sat. Her walking form was ok, but her posture while sitting was not good. She meant well, trying to keep a straight back, but she was leaning forward at the hip while working at the computer. The flexed hip position when leaning at work and climbing up hills repetitively was taking its toll, causing hip flexor tightness and contributing to low back pain.
I spoke with her doctor and received an ok to do light resistance and flexibility training, provided we took certain precautions regarding her back. We started the new program with a non-invasive postural assessment to determine if Joanne had any structural imbalances that were visually identifiable. She clearly had an anterior pelvic tilt, meaning her upper hip tilted forward, which often is caused by tight hip flexors and/or low back muscles. I then had Joanne do some back and leg tests to determine her flexibility in these areas. She was indeed very tight in her hip flexors, as well as her low back. Next we evaluated her abdominal and low back strength. Both her transverse abdominis and multifidus back muscles were weak. Finally, I had her do a food diary, writing down a few of her typical days of eating and drinking.
As a result of my investigation, I set out to have her modify her posture at work and her cardio exercise plan, reviewed flexibility and strength exercises key to improving her back situation, and explained ways she could improve nutrition to enhance energy and thus reduce the chances of injury.
With phase one, we reviewed the results of her postural and flexibility assessments, and I began to demonstrate and have her do stretches to reduce her back pain, as well as various other stretches for the upper and lower body to go with her new overall workout plan. The key stretches for her issue were:
Lying Quadriceps:
Lying on her side, she grasped one of her ankles with her hand, and pulled the ankle toward her hip, while simultaneously drawing the thigh slightly back, to accentuate the stretch of her hip flexors.
Kneeling Fencer:
Kneeling on one leg, with the other leg bent, shin resting on the floor, she leaned forward while letting her leg resting on the floor stay put, so she isolated the stretching of her hip flexors.
Back-Pole:
Hands grasping an upright, hips and knees bent, back gently rounded, she slowly pulled her body away from the upright while keeping her hands in place, accentuating the stretch in her low back.
In just a week, Joanne showed considerable decreases in her back pain, and after adding the strength and other life style adjustments, her pain was completely gone in less than a month.
If you need help with back health like Joanne, give me a call (925-930-7560) to get assistance specific to your needs, using not just phase one concerning flexibility above, but also help from the equally important phases of strength, cardio, nutrition, and every day functionality at home and work.