Lower back pain remains the most common presentation we see in the clinic here at Absolute. Closely followed by the neck, the back presents us with numerous challenges when assessing the aetiology, or cause of the condition, exploring the possible interventions to help treat the condition, and establishing strategies for our clients to self-manage their pain. Every practitioner has their own skill set and will approach the situation from their perspective.
Over the next few entries I will demonstrate examples of assessment and treatment protocols I commonly use when exploring some of the lower back related complaints I see here at Absolute Health & Performance.
Screens & Assessment
During an initial consultation, a subjective history is taken. I listen carefully as the client details answers to specific questions related to their pain, injury, and general health. Care is made to eradicate the potential for any conditions going beyond the scope of a soft tissue treatment which may require a referral to another Allied Health Practitioner, hence the importance of using a clinic with a multidisciplinary approach for everyone. Screens and active and passive tests, are all determined by the capability and willingness of the client. A trust must occur between practitioner and client to draw as many accurate conclusions as possible.
What to Treat! Where is the force?
I look for tension and forces that are being placed on the lower back, and how they may relate to the lower back complaint. Primarily I am talking about the tension in the connective tissues. For example, although the client may be complaining about tension sitting at the bottom of their spine, I may determine that it’s the tension on the front of their pelvis, or in the hips, that is the greatest tension pulling on the lower back.
Below is an example:
Here I am working with a highly functioning athlete complaining of tension in the back after training. I use floor and table based assessments to determine where the greatest amount of muscular tension is sitting.
https://www.youtube.com/watch?v=OMC-qYwAprM
Tensions and forces are co- existing all over the body at any one time, and are a completely normal part of the way the body works. It is not my role to eradicate tension and forces all together, often that is where our stability sits. My intention is to create a change in the tension enough to improve the function or potentially desensitise the pain. It’s a tricky line to walk. Only with a thorough reassessment are we able to determine a positive result.
What techniques to use
Joining the dots between what the client reports and what I observe in the screen allows for an evidence based approach to choosing the right technique. Below is an example of various Myofascial techniques used around the body to alleviate tension from the lower back.
https://www.youtube.com/watch?v=KIdntAhKLzg
There is always more than one way to approach a Lower back problem. From my experience, there is always a soft tissue component locked in the ‘lower back pain experience’, and plenty soft tissue therapies that can help alleviate this. For more information on how soft tissue therapy can potentially help you, contact James Meredith at Absolute Health & Performance [email protected]
Next edition we will explore in more detail a few assessments for lower back pain. Furthermore I will demonstrates how aberrant forces influence the lower back during common movement patterns.
Written By James Meredith, Absolutes Massage and Soft Therapist
