One of the most common reasons clients come to our studio is to find relief from lower back pain. We see this in clients who sit at desks all day, as well as clients who are very active either training for a race or maintaining a rigorous workout schedule. The origin of this pain often stems from the IT Band and the glutes. The IT Band, also known as the iliotibial band, runs lateral to the quads (the outside of the thigh). This band runs from the iliac crest, which is part of the pelvic-hip complex (as shown below) and around the outside of the knee. The knee is the most common place people think of when they hear the words “tight IT Band” – but the low back is just as common an area to be affected.
If you take a look at the study of movement, muscles work in conjunction in order to facilitate movement by pulling on the bone; everything within the body is somehow connected. Therefore, anything that is misaligned or tight may cause an improper movement pattern somewhere else in the body, altering proper function.
If there is tension in the IT Band or gluteus, they begin to pull on adjacent muscles within the complex of the hips, notably the Quadratus Lumborum (QL’s). The QL muscle is technically an abdominal muscle but it has tremendous impact on the lumbar region of your lower back.
The IT band provides stability at the hip during lateral movements. Other muscles that stabilize the hip includes the gluteus medius and the quadratus lumborum (QL). As the IT Band tightens due to injury or overuse, friction will cause a downwards pull of the gluteus medius and the QL, causing the upper body to laterally bend a few degrees to the right. Even a slight pull on the lumbar spine could potentially compress the nerves and lead to pain and even greater neuromuscular problems later in life.
How do we approach this in the studio? We begin with an assessment by performing various stretches on the client. First, we test the hip flexors and the muscles of the quads to determine whether these muscles contribute to the lower back pain. From this point on, we turn to the IT Band and test its range of motion. Often times the IT Band contributes to tightness in the gluteus medius. Tightness in this muscle creates tension within the rest of the gluteus muscles. After stretching the gluteus muscles, we make sure to check in with the client to see how they are feeling after the series of stretches. The last piece within this series is to target the Quadratus Lumborum. Since the QL has several attachments into the spine, we make sure to perform a light and smooth stretch in order to allow the client to relax on the table and prevent the nervous system from protecting the muscle. Once the nervous system has relaxed, we see incredible results from the stretch,relieving a great amount of tension within our client’s lower back. We then re-asses by testing the range of motion of the IT Band and see how the client feels when they get off the table. As they start walking around the studio, they experience notable relief in their lower back and improvement in their gait.
Lower back pain affects so many people – yet every body is different. Treating the whole body is key to finding the source of the pain and finding the path to relief and recovery.
Written by Noah Moore. Noah is a Stretch Therapist in our Darien, CT studio.
How one woman finally found relief after a serious horseback riding accident.
Lucia’s story, written by Christine Baer
Whether it was the stiff leather of the horse’s new tack or symptoms from undetected Lyme disease, Lucia will never know for sure. But something was causing her horse to be extra jumpy that day in February when she went out for a ride on a wooded, snow-covered trail in Bedford.
The first time that the truck backfired from a distant road, Lucia’s horse did something very out of character for the palomino mare. She bucked. “It was a vertical, ‘bucking bronco’ type of buck,” Lucia says. One that would be difficult to manage, even for an experienced rider, but Lucia managed to hang on. The second time, she wasn’t so lucky.
Lucia grew up riding horses, and the trail ride that day was one that she took regularly on her beloved Butterscotch, whom she has owned for twelve years. She rode five days a week, and the bond with her horse was strong. So the pain she felt when she landed on the frozen ground that day ran deeper than the shattered pelvis she suffered. “I was devastated that this creature did this to me.” It simply made no sense.
There was no cell phone reception on the trail, and Lucia knew that she had to find a way to get help. With no possible chance that she could walk with her injuries, she had no choice but to crawl, grateful for the cold snow that gave her some relief from the pain as she made her way to the road.
Eventually, a passerby found Lucia and she was taken to the hospital, where she learned that she had not only shattered her pelvis, but had three broken vertebrae and a torn hamstring, as well. She would spend the next two weeks in the hospital. But that was just the beginning of her recovery.
After coming home from the hospital, Lucia spent six weeks in a hospital bed at home, finding solace in reading, writing, painting and catching up on popular television series. But, with each day, Lucia realized that time was not improving the pain she was experiencing.
Still, her doctor insisted that the pain was normal, and prescribed physical therapy. Just five days into the protocol, Lucia’s pain was excruciating. She decided to seek a second opinion, and turned to a different hospital. There, she was told that her pelvis was not going to heal on its own. She needed surgery to insert eight pins and plates. This was devastating news, as Lucia would now need to spend another eight weeks in bed.
After the surgery, and now seven months post-accident, Lucia was still only getting around with the assistance of a walker, and she was still experiencing pain and weakness. “I was so broken,” she says. “I was at a point where, at age 56, I was accepting that I would never walk normally again. That’s when I found LYMBR.”
Lucia is passionate when she talks about the thing that made all the difference on her long journey to recovery – personalized stretch therapy. When Lucia walked into the newly-opened Darien CT LYMBR studio last June, she didn’t know what it was all about. But, she knew that she was willing to try just about anything to get some relief from the pain.
Certified stretch therapist Michael Eaton admits he was a little nervous to work with Lucia after hearing all that she had been through. Her long list of injuries was overwhelming. But LYMBR trains stretch therapists like Eaton to help people who need relief from sore muscles, over-use, and even injury.
“I could see that she had some discomfort when she first walked in. I remember it took a lot of effort to get on and off the table due to the injuries,” says Eaton.
“My body was so locked up from all the trauma and surgery,” Lucia recalls. “But even after the first session with Michael, it felt like a revelation that I might not have to walk like that anymore.”
LYMBR’s stretch therapists are certified, with over 100 hours of hands-on training, to use progressive dynamic stretching that helps improve flexibility. For Lucia, this was key to getting her life back.
“The first improvement I saw in Lucia was her confidence,” says Eaton. “Lucia came in very guarded and naturally protecting the injuries. After the first few sessions, she was floating in and out of the studio with a new glow to her.”
Due to the extent of her injuries, Eaton approached Lucia’s stretch therapy with great care and caution. He constantly checked in with her to make sure that she didn’t have any pain or discomfort during their sessions, keeping her informed about which muscles he was isolating and stretching. Over time, the two developed a friendship. “We talk about everything in sessions, from the latest trends to what’s going on in our personal lives. When a session is over, I’ll usually tell her what I want to work on for the next time. Lucia always responds, ‘Okay, you’re the boss. I trust you.’”
Three months after her first session with Michael at LYMBR, Lucia says she feels like she can overcome anything. “I can walk down stairs!” she exclaims. She is back to her active self, taking her dogs on long walks without the need for pain medication or a cane. She still goes in for a LYMBR stretch with Michael one to two times every week.
“Working with Lucia has opened my eyes and helped me realize just how powerful this work is…” Eaton says. “It’s bigger than just stretching people. I get to help people who have been living in discomfort for years feel some type of relief.”
Lucia won’t be riding any time soon. But she is still the owner of five horses, one of whom is Butterscotch. After the accident, a vet discovered that the mare was suffering from undiagnosed Lyme disease, which caused the uncharacteristic behavior that day on the trail. The two were reunited after the incident.
“When I discovered how sick she was with Lyme, and saw how overjoyed she was to see me when I finally visited her in my wheelchair, my disappointment in her was replaced by understanding and gratitude that my injury was not worse,” says Lucia.
“While I am very sad that I can’t ride,” she says, “I plan to just be around the horses and take care of them until I can. LYMBR has made me so well that I can do that.”
We all know, or at least have heard, about the importance of stretching. Whether it is to improve your athletic performance, for general health and wellness, or to relieve pain and tension, stretching can be the answer. The real question is what kind of stretching should we be doing to get the best results. When it comes to stretching, there are three main techniques: static, dynamic, and ballistic stretching.
Static stretching is what typically comes to mind when talking about stretching. It is a form of active or passive stretching in which you hold a position for about 30-60 seconds, allowing the muscles and their connective tissues, fascia, to lengthen. This is the most commonly known style of stretching and has been seen as the status quo for years. This style of stretching may not be the best way to improve performance before physical activity. Using a static stretching program prior to engaging in physical activity may inhibit the muscle’s ability to fire properly. The primary reason for this is a reduction in muscle tension and an increase in length between resting muscle fibers. These two factors alter the length-tension relationship of the muscle, causing a decrease in muscle excitability. This in turn can directly affect the muscle’s ability to optimally function. Think of the tension in a rubber band. When you stretch a rubber band and hold that tension for a long period of time, you cause the rubber band to increase in length but lose the stored energy. The band’s tension is what allows the band to be functional. Our bodies rely on similar forces to propel us forward during a run, or allow us to jump high during a sport like basketball. If we overstretch our muscles, this inhibits elasticity, which inhibits our performance.
Dynamic stretching is a form of active stretching that is performed by engaging the desired muscle’s antagonist through the joint’s range of motion, only holding the stretch for 2-3 seconds. Because the stretch is only held briefly, the muscle is able to increase in length without a reduction in muscle tension or muscle excitability. By preventing the reduction in muscle tension, an individual is able to improve their range of motion without a loss in force production. Dynamic stretching is the style utilized by the therapists at LYMBR. This type of stretching is also referred to as a dynamic warm-up, which athletes use to prepare their muscles for the rigorous demands of their sport.
Ballistic stretching is the most controversial form of stretching. Unlike dynamic stretching, ballistic stretching utilizes muscle activation through quick, jerky movements. This inhibits the body’s stretch reflex and increases the muscle’s range of motion through the force created by the bouncing. The extra external force produced can overload the muscle, increasing the risk for potential injury. Because the high risk of injury does not outweigh the benefits of the stretch, most fitness professionals do not recommend using this style of stretching.
When looking at the three different styles of stretching, we can see that they can all be utilized to increase range of motion. Static stretching is the more well-know style and is commonly used for general stretching, but can inhibit muscle excitability, making it unappealing to people active in fitness and athletics. Dynamic stretching increases range of motion while maintaining muscle tension, making it useful for general stretching, fitness enthusiasts and athletes. Ballistic stretching can increase range of motion quickly, but has a higher risk of injury than other effective techniques. We all know we should stretch – stretching safely and effectively will help you reach your health and wellness goals.
In our next post, we will expand on our proprietary form of dynamic stretching called Progressive Dynamic Stretching.
Written by Rick Charron. Rick is a Stretch Therapist and manager of our Newton, MA studio.