Back pain


Do you spend a good part of your day sitting? If you were to tally up the total hours in the seated position compared to being active what would the result be?  For a large portion of the population the majority of the day would consist of sitting down or being sedentary.

If you are desk bound at work for most of the day, get stuck in traffic or drive for profession your hips are in a flexed position for long periods.

Muscle imbalances & back pain – A simple explanation

When in a seated position for long periods, repeatedly your hip flexors become shortened and your glute muscles become increasingly inactive.  This has consequences for your biomechanics when you do move and can contribute to your back pain and/or predispose you to it.

As the hip is flexed, it causes the muscles that extend the hip (glutes) to relax.  This allows the body to work in sync when moving so it is not in conflict.  This relationship is called reciprocal inhibition.  A muscle on one side of a joint contracts while its opposite relaxes.

As well as helping us stand, walk, and run, the gluteus maximus along with other muscles help stabilise the hip. Being one of the biggest muscles in that region, its inactivity has consequences.  Other smaller muscles will have to carry out its job plus their own.  At the front, the muscles that are shortened are the hip flexors (Iliopsoas, TFL).  One of these is attached to the front of your spine and the inside of your leg.  So when you stand up it keeps your hip partially flexed and your hip will look like its tilted down or what we call anterior pelvic tilt.

This is usually accompanied with a weak core and obliques which keep your hip level and help rotate your trunk.   If such imbalances exist you may get back pain when you rotate because now the little muscles around the spine that help rotate the spine have to compensate for your major and inactive trunk rotators.  Some of the nerves that control your lower back region and legs pass through that now tight musculature and may compress them as well as blood vessels around them.  Another reason for the pain may be due muscle strain.  If the muscles exert to much force to their attachments (usually bones) it may cause a micro tear.  And because the attachment on the bone (periosteum) has many sensitive pain receptors you may feel pain.

Essentially this pain is a warning signal to get your muscle imbalances in order.

How can remedial massage help?

As experienced remedial therapists, we come across back pain regularly.  The first step is always assessment.  First, to see if its a neurological issue and if we need to refer you to a specialist such as a doctor or a allied health practitioner.  After asking you to fill in a health history form and asking some questions to help us get an idea of your presenting symptoms we proceed further by conducting some basic orthopaedic tests and observing your range of motion.

There are usual a group of muscles that are tested and released. Remedial massage utilises stretching, myofascial release, trigger point therapy, PET, MET, and other techniques to break up adhesions and increase muscle length.

During and after the bodywork, we would assess the pain, range of motion and check for any improvement in these area.

While a large part of remedial therapy is passive, a holistic approach to treatment is to advise on corrective exercise or refer you to someone to guide you to re-tension weakened or locked long muscles.

I can be found servicing most inner city areas of Melbourne with mobile remedial massage in Essendon, Brunswick or surrounds and south of the Yarra including South Melbourne to South Yarra.

If you would like to see me in the clinic please contact me to see when I’m in St Kilda or Fitzroy North.