Hi, I’m Dr. Eric Cobb of Z-Health Performance. We are back with episode three of our series on low back pain.
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Alright. We have gone through two relatively extensive videos on an approach to looking at low back pain. We’ve talked about the eyes. We’ve talked about the inner ear. We’ve now started to add in a lot of mobility work to it. One of the unique aspects that we try to take whenever we are working on low back pain is to tell people that there is not a perfect postural position to begin with.
Instead, we have been emphasizing over the last two videos that you find for yourself, the unique position that allows you to move with the least amount of pain. So if you haven’t watched the other two videos, go back and check them out because it really sets the stage for what we’re doing.
What I’ve been demonstrating in the last couple of videos is an imaginary low back pain for myself that I found I had the greatest range of motion in comfort, with my feet turned in, my knees bent, and with my pelvis tucked a little bit.
So in other words, posterior tilt. You’ve been testing yourself, so you should already know what your safe position is. In the last video, we started trying to improve our ability to translate the spine, not bend it, but translate it as an initial stage of restoring mobility and comfort.
We looked at that from a mobility perspective as well as an isometric tension perspective.
As you are progressing in your rehab, if lateral gliding is getting better, The next motion that we want to focus on is rotation. And we’re gonna be using the same principles. But I want to show you something very specific it’s just a very simple way for you to think about what you’re trying to achieve when you’re working on rotation.
Very often people that have low back pain try to do a lot of rotational self mobilizations, which feel great.
Don’t have any problem with them and they’re very, very useful. But whenever we watch people do this on their own, they almost always use a very specific type of rotation.
It’s either a combination of lower and upper body moving at the same time, but it’s really more of a upper body rotation.
There is a great use for that, but if you’re trying to be thorough in working with low back pain, you need to fixate the pelvis and move the upper body sometimes.
Other times, you need to fixate the upper body and move the lower body. So we want to look at rotation from two different perspectives.
So for this particular exercise, what you’re gonna need is to know what your positional safety or postural safety position is. and then we’re gonna do this demonstrating with a band. Alright?
So your first job would be to get into your positionally safe position and test to see how’s your pain doing, how much range of motion do you have available, how much pain are you experiencing.
What we’re gonna do now is we’re going to begin working on rotations.
If I were to give most people a band and have them get into their position, again, for demonstration and purposes, I’m utilizing toes in, knees bent, pelvis tuck.
Let’s say that for me, this has worked the best. as well as an eyes down position.
What I that I mentioned in the last video. The first exercise I’m gonna do is I’m going to hold the band I’m just gonna push it out in front of me.
Now rotation for most people, they would immediately think, alright, if I rotate, I’m going to be pulling against the band.
This would be an example of a fixated pelvis with the spine moving on top of it, particularly if I’m focused on keeping my pelvis straight ahead.
That’s great. Alright? And that is a very useful way to approach working on rotation.
But what I want you to focus on instead is fixating the upper body and moving the lower body.
So I’m gonna get some tension on the band. I’m gonna push it out. And instead of rotating here, I’m going to now begin rotating the pelvis underneath what is hopefully a relatively stable spine.
Most people when they begin doing this will notice some very different muscular activations.
So you need to make sure that you are not losing that posturally safe position for yourself.
Because as soon as you start doing any kind of lower body or pelvic rotation, the tendency will be to drop back to your standard neutral pelvic position.
And if you do that, this may increase the amount of pain you’re feeling. So once again, the job here is first and foremost, fixate the band when you’re in that comfortable position and then slowly begin moving the pelvis underneath the stable lumbar our spine.
If this is comfortable for you, do twenty to thirty reps.
Drop the band and then go back and retest your extension, your side bend, your flexion, whatever it is that has been painful for you.
I would say probably seventy percent of the clients that we progress to this stage of work find that this particular exercise where we’re dividing the upper and lower body has a tremendous impact on the amount of pain they’re feeling.
So give this give this one a shot and let us know how it works for you in the comments. Thanks.
