Since starting my career as a physical therapist, some 20+ years ago, I have always been amazed at some of the accommodations we as humans take to remain operational in life. There is no injury, pain or dysfunction that cannot be compensated for. But these compensations often result in additional issues we must deal with even after the immediate limitation is resolved.
Thankfully, most primary injuries are resolved quickly allowing us to return to our previous level of function, but one particular area of the body is not as fortunate—the low back. Musculoskeletal injuries (muscle joint ligament and tendons) typically result in inflammation swelling and pain. After initial care is performed to protect the injured site, early motion is typically prescribed as the next important step for recovery and return to full activity. The use of casts, splints and immobilization braces are being replaced by stationary bikes, continuous passive motion units, and therapist assisted movement, as early as immediately post injury and post operatively. Scientific evidence supports early motion as a benefit to healing, improved blood supply and reduction of unwanted scar tissue. Despite this evidence, injuries to the low back continue to receive prescriptions of bed rest, splinting and bracing. While low back injuries require their acute status to be resolved first, as with all musculoskeletal injuries, patients with low back injuries are far more likely not to break free of that limited movement pattern—resulting in future re-injury, chronic pain, and chronic dysfunction.
Low back pain is the second leading cause of patient visits to their primary healthcare provider, behind only the common cold. Costing more than $86 billion in the US alone, low back pain continues to grow as a leading cause of work loss and productivity expense. According to the National Institutes of Health, in a three month period one quarter of all US adults will suffer at least one day of low back pain. With these facts and growing statistics it is apparent that our current methods of prevention and resolution of low back pain are far from successful.
While I certainly would not suggest that all low back pain can be resolved by simply increasing the amount of motion, an increased emphasis on (proper) movement may provide big gains in avoiding the long-term dysfunction, compensations and disability that too often result from low back pain.
The low back and pelvis provide a unique connection between the lower extremities, trunk and upper extremities. Through coordinated movement the low back and pelvis provide the necessary posture and stability to sit, walk, run and perform almost every functional activity we do. Research now links the trunk not only to performance but prevention of injuries involving both the upper and lower extremities. No longer can we assume that low back pain only affects the back. We must appreciate the true dysfunction low back pain can have on the entire body.
|Anterior Tilt||Neutral Tilt||Posterior Tilt|
Once you understand the encompassing role of the lumbo-pelvic spine, one can appreciate the need for maintaining and developing the ability to position and stabilize movement around it and through it. It is for this reason that Perfect Practice was established. We are dedicated to creating tools that enable the patient to learn and improve lumbo-pelvic mobility and stability. Utilizing common technology and scientifically proven findings, Perfect Practice will teach you how to reengage the neuromotor control needed to move the lumbo-pelvic complex through its full range of motion. Once you have achieved your essential lumbo-pelvic mobility, Perfect Practice will use the same technology to guide you through a progressive trunk stabilization program to enhance your daily function by reducing unwanted stress to your low back structures.
–Chris McKenzie, PT, AT, SCS