You may be shocked to hear, but for the first time this decade, disability and quality of life issues are exceeding early death as the leading cause of health concern at the moment. At the top of the list of factors effecting quality of life is pain!
When we break pain down, nothing is more prolific than back pain. In fact, 1 in 6 Australians suffer with back pain, up to 90% of Australians will suffer with back pain at some stage in their life and up to 49% of quality of life afflicting issues are associated with low back pain!
In short, back pain is a massive problem throughout Australia. It affects business productivity, relationships, fitness levels and many other aspects of health.
There has been a huge push over many decades to control the issues around back pain. Millions have been spent on studies identifying potential treatments and causes, yet still our society is burdened with the problems associated with chronic pain.
A big movement over the last few years has been around improving the strength of our core. The core is a series of muscles that surrounds our waistline and holds our upper body and lower body together.
The belief has been that if our core becomes weakened then support for the lower spine is reduced and the result is dysfunction. But is this really correct?
I always ask the question in a broader sense to determine if there is a real link. So in this case I ask why does the 65 year old lady walking down the street that is fail and somewhat degenerated have little problems and the 23 year old athlete with great tone become riddled with back pain? The problem has to be bigger than just strength.
When we look at strength there are 2 aspects to muscle function:
1 – The ability to contract a muscle hard enough to induce a motion
2 – The ability to resist a force placed on the body and prevent damage
As strange as it may seem, there seem to be two separate neurological mechanisms that govern this action and here may lie some of the problem.
In people with chronic low back pain we often see these people have multiple areas that are unable to resist force being placed upon them. This means they are unable to prevent movement if a force is being applied.
To give you an example, if I were lift a brick in my hand, I would need to contract my core to prevent myself from falling over due to the weight (the brick) in my outstretched arm. So, the brain would sequence the contraction of the core prior to lifting the brick.
If I was to hold my hand out though and have the brick dropped onto my hand, then brain would very rapidly need to assess the weight of the brick and contract the core prior to the arm catching the brick otherwise we would just be pulled over.
But what if the core was unable to contract quick enough and resist the force?
This is something I see quite commonly as a cause of back pain as is very often overlooked and underassessed by many practitioners.