What Isn’t Causing Your Back Pain

At some point, almost everyone suffers from lower back pain, particularly athletes going through the rigours of their sport.

There are lots of possible reasons you might have back pain, but some causes are far more important than others. Here are six things that are often blamed but are rarely the key cause of lower back pain.

1. 1. You’re not Young Anymore: But that doesn’t mean age causes back pain. Some teenagers suffer from back pain and some 80 year-olds don’t. With back pain the amount of time your spine has been misaligned is much more important than how old you are.
   2. It’s Genetics: Some genetic conditions can predispose you to developing lower back pain. The most common one is scoliosis. But the biggest back pain cause passed down from our parents is behaviour. From childhood, we copy our parents’ habits. Bad posture and movement habits are often passed down like family heirlooms. Thankfully posture and movement patterns can be retrained.
   3. One Leg is Shorter Than The Other: It’s common for your pelvis not to be perfectly square, which can cause a slight difference in the length of your legs. More often than not, this crookedness is due to faulty alignment of bones, not a difference in bone length. Straighten the pelvis, your legs are no longer different lengths and voila, your back feels better.
   4. You Don’t Move Around Much: It is popular to blame sitting as the cause of back pain, the explanation being that prolonged sitting causes our hip flexor muscles to shorten, putting pressure on the back. I’ve seen thousands of back pain cases and know chronic hip flexion is the cause of a tiny percentage of such cases. Hyperextension of the hips is more common than chronic hip flexion. Sitting all day isn’t healthy, but correlation is not causation.
   5. You Have Weak Abs: There is a seed of truth behind this myth. Since your abs connect the ribcage to the pelvis, they need to be balanced with the muscles of your back to keep your ribcage and pelvis vertically aligned. This does not, however, mean abdominal crunches are the secret to a pain-free low back. Sometimes a diet of crunches is setting you up for herniated discs and a date with your surgeon.
   6. Your Glutes Aren’t Working: Sometimes the gluteus medius doesn’t work as it should, but it is rarely the cause of lower back pain. When the pelvis is misaligned it interrupts your body’s ability to activate many of the muscles in the middle of your body. Straighten the pelvis and your glutes magically start working again. Trying to strengthen these muscles without first straightening your pelvis and/or hips is like swimming upstream.

There is a hierarchy of importance in any rehab situation. Begin with minimizing misalignment. Then turn your attention to mobility. Movement quality (motor control), stability, strength and finally endurance. Respect that natural order and you are on the right path. Misunderstand the root cause of your pain and you are guaranteeing yourself a long and frustrating journey.