When something hurts, we want it to stop. This is a normal reaction that everyone can agree on. From the inside (you feel the pain) it is not easy to understand why being pain free does not equal pain freedom. Pain freedom is having control when pain arises to effectively shut it down, and avoid it's production in the first place. Relying on others to constantly address our "issues" may get us pain free, but that temporary fix is not a long term solution.
This theme is one that I have made a staple for my clinical practice. Understanding why your body is developing pain is the key to producing an effective long term solution. Saying "Oh this is tight, that's why your back hurts" is most certainly not identifying why your back hurts. It just adds another symptom on top of your pain. Tension, tight muscles, pain, reduced range of motion, and limited movement are all just symptoms. To identify the true cause of pain you need to have a thorough understanding of the brain, and how it drives pain producing behavior.
In order for you to survive you need a few things. Food, water, shelter and...air. You can last a few weeks without food, a few days without water and if the weather is nice, months without shelter. You cannot however, last even a few minutes without air. Therefore, it makes sense that you do whatever is necessary to continue breathing. If that means pulling your head forward (bad posture), hyperextending your low back (poor technique), or locking up your hip flexors (muscle tightness) your body will do what is necessary to breathe in the most comfortable position possible.
The connection between your hip flexors and your breathing ability may seem like a stretch. So let's break it down. As you inhale, you contract your diaphragm. Your diaphragm pulls down and forward. Where you diaphragm connects at your spine, there is another muscle. That muscle is your psoas, a flexor of the hip. As you inhale, your diaphragm pulls down and forward and if you need more air, you activate your hip flexors to help pull down and forward too. This creates some extra room in the belly, and that makes it easier to breathe.
So this information begs the question, does your back hurt because your hip flexors are tight? Or does you back hurt because your brain doesn't feel like it's having an easy time breathing and wants to open up your belly?
For the sake of science, let's test it out. Let's learn how to breathe without your hip flexors being able to contract, and see if it helps with your back pain.
If you feel your back pain still, ensure that you were utilizing the back of your thighs and your abs to maintain tension while your breathe, rather than the front of your hips and your back. If you found relief, you have taken your first step toward achieving pain freedom.
Changing the position of our body (sitting, standing, squatting, hip hinging, lunging, etc) require different strategies to keep your airway open. If you don't feel safe, you will activate a strategy to get your airway open. The strategy each one of us can use varies, therefore each one of us requires specific testing to identify not only which strategy you use, but which positions are a problem for you.
If this is something you need, reach out to a Performance Physical Therapist. We treat these issues on a daily basis. While other physical therapists, chiropractors, physicians, and trainers are more focused on making things feel better, we are focused on making things be better.
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