You have back pain because the muscles that are designed to support your back have let you down. Or more accurately, you have let them down, gradually over a period of time causing them to weaken and weaken to the point where…. Bang, you have bent over to turn the bath tap off, or to pick up something you dropped on the floor. Something you had down a million times before without a worry in the world, and now through reading this you have learned why this time your back spasmed leaving you in a terrible mess for a few days and now you are stuck with a nagging back ache and a feeling a vulnerability when you bend forward.

Weaknesses and postural imbalances built up over a period of time lead to an innocuous action that causes your back to go into spasm, leaving you with nagging back pain. If we took one hundred chronic back pain sufferers, put them all in the same room and asked them one by one to recount their story, 97 of them would speak of a very similar experience.

What creates weaknesses and postural imbalances?

In one word - Inactivity! Is the main culprit for most.

However, for others it is constant repetitive actions or hours spent in the one fixed position.

Such as office workers seated in a fixed position for hours on end, or a manual labourer working forward of their midline for long periods of time. They same thing can apply to athletes who carry out similar actions in their sport; think golfers, cricketers etc.

These postural imbalances weaken the muscles integral to supporting us upright. The most significant muscles we define as postural muscles are the gluteus maximus muscles. When these muscles weaken, much of the load is placed on the deeper intrinsic muscles of the hips that are designed to internally/ externally rotate the hip.  Due to being placed under excessive load these muscles shorten and contract resulting the the hips remaining in a constant internally rotated position. This has the knock on effect of tilting the pelvis into a forward position. Once the hips are internally rotated and the pelvis anteriorly tilted all of your body weight is placed forward of your midline as you walk, sit, stand, jog etc. The muscles anterior of your midline compensate by taking more load than they are designed to, with the posterior postural muscles weakening even further due to the weight shifting off them and onto the anterior muscles.

As stated early, this patterns leads to the innocuous action that sends your back into a painful spasm, which is just a protection mechanism that kicks in to force you to rest the muscles of the back that over exhausted and fatigued.

The problem here, is that the spams leads to further inactivity, that leads to a further protection of your back to prevent further pain and spasms. Everything you do, you are either consciously or unconsciously moving in a way to protect your back. The muscles anterior to your midline over work in attempt to support you when you bend down. Your body gets caught in a compensatory protective pattern that must be broken in order to address the cause of your back pain.  

Muscular weaknesses created your back pain. Muscular weaknesses keep you in chronic back pain.

In order to address the true underlying cause of your back pain you must follow the following steps:

1. Address the compensatory patterns and gain confidence in positions that will strengthen your back
2. Reinforce corrective movement patterns that will override the protective compensatory patterns.
3. As the correct movement patterns become automatic/ second nature, add resistance to make them more challenging.
4. Continue to make the exercises more challenging keeping you out of your comfort zone.
5. As your neuromuscular pathways hypertrophy you will feel greater support and confidence in your back and body.
6. Continue to increase the resistance of the postural corrective exercises up and over your own body weight. This will restore muscular symmetry and strength to the muscles that support your back.

For more information on how to overcome your chronic back pain, please refer to the relevant articles with links below.