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Low Back Assessment and Treatment

We often hear a lot of the same questions and statements:
“What can I do for my lower back pain?”
“The doctor told me I had degenerative disc disease, so my spine is shot.”
“I had a chiropractic adjust every month for 3 years but I still have pain”
“My friend used heat AND ice on their lower back and had some relief.”
“Only certain positions irritate my lower back”
“I threw out my back working in the yard”
The bottom line is that there simply is not an easy or obvious response to those questions and statements. Take the next 7 minutes and you’ll see how we typically respond to them. Here is a look into how Myomuv manages a client. The foundation is the same but in this instance we are managing back pain. Maybe you can relate or know someone who can.
When a patient first comes to see us with complaints of lower back pain causing activity limitations and movement dysfunction our first step is getting to the root cause. We do this by actively listening to you; giving you unlimited time to tell your story. We may ask a few questions along the way; but for the most part; this is your moment and we want to ensure we have every detail. Details such as:

  • Location of pain. Does your pain occur elsewhere other than your spine?
  • Aggravating and easing factors (what makes it better and what makes it worse)
  • Type of pain: Burning, shooting, dull ache, stabbing, sharp
  • How long do your symptoms last?
  • Was there a specific mechanism of injury or moment in time you noticed the start of your pain?
  • Tell us about your training and movement history? Any past injuries?
  • What have you tried so far?
  • What do you think is causing your pain?

And one of the single most important questions we always ask:

WHAT ARE YOUR EXPECTATIONS OF US?

We like to begin with the end in mind and nothing leaves us feeling more disappointed is unrealistic and unmet expectations for you.
Once we have a good understanding of your story then we dive deep into the assessment. Again, our goal is to get to the root cause of your pain and movement limitations. We may start looking at big picture movement patterns like a squat, hinge, push, or a pull. Or we may start segmentally and take things joint by joint. Bottom line is that we assess everything, leaving no stone unturned.
At this point we have allowed you to thoroughly share your story. And we have completed our part to find out what type of exercise application or mobilizations we need to perform to get you moving freely again and back to your activity.
Often times we find people get caught up in chasing symptoms, which is important; but we must address the root cause or else the pain will continue to be triggered leading to a sensitive movement system. We always find certain objective asterisk signs to to help guide our exercise selection and movement programming. We may try to avoid certain end ranges, loads, positions, and patterns to help desensitize your movement system; while also allowing you to continue moving. There are rarely cases where we will tell someone to avoid movement or pain all together. For example; if your pain is triggered by forward bending in standing; we may apply some type of forward bending motion just shy of the position where your pain starts. This may look like a Kettlebell deadlift from blocks or addressing your forward bend movement pattern to ensure a simple cue or correction may decrease your pain. The point we are trying to make here is that modifying movements before omitting movements is what we have found works best.
We do utilize manual therapy but maybe not for the same reasons you think. We aren’t magicians and we can’t put things back in place, adjust your bones, or release adhesions in your fascia with our hands. What we can do is use different manual therapy techniques to make areas or regions move more freely by decreasing guarding or tension in a problem area.
The magic happens with exercise and movement therapy. This empowers YOU as opposed to creating dependence through various passive treatments that typically yield little positive adaptation in the long run. We understand your pain may be relieved short term after we mobilize your lower back or dry needle your shoulder blade, BUT true adaptation and strength comes through movement and load management.
We keep up with your progress throughout the week. We are always available through all forms of communication. After each treatment session you will receive a detailed email follow up with exercise videos, a summary of our education and discussions from the session, and clear instructions on sets/reps/positions/coaching cues. The more variables we can control, together; the sooner your pain will be diminished.
Our end goal for you is always a combination of:

  • HAVING A DEEPER UNDERSTANDING OF YOUR BODY AND HOW TO CARE FOR IT.

  • HAVING MORE CLARITY ON EXERCISE SELECTION AND HOW YOU ARE UNIQUE IN WHAT EXERCISES ARE APPROPRIATE FOR YOU.

  • FEELING MORE CONFIDENT WITH MOVEMENT: ESPECIALLY MOVEMENTS THAT TRIGGERED YOUR PAIN IN THE ACUTE PHASE.

  • BEING MORE ADAPTABLE, STRONG, AND RESILIENT.

  • THE REALIZATION THAT MOVEMENT IS A  LIFELONG JOURNEY.

A 67 year old male with recurring lower back pain. He is an experienced mover and he regularly runs and swims weekly and follows a progressive strength and conditioning program. He has some radiating symptoms that start in his lower back and right glute and can extend all the way down into his right calf muscle. At times he has pain solely in his calf muscle or solely in his right glute. The pain has been present for 5 weeks and seems to be getting worse. He can also have some pins and needles sensations.

YouTube video

In the video you can see some examples of ways we loaded his body to create the desired adaptations. At Myomuv we believe that movement therapy is not only the most scientific way to resolve most aches and pains; but we find this way to result in the best long term resolution and abolishment of recurring pain and other movement limitations. This gives you an active role in overcoming your problem which is empowering! Nobody has ever gotten strong or been more prepared by just laying on a treatment table receiving passive treatments.

Prior to our first encounter many of these same positions and movements would aggravate and reproduce his pain; but we don’t believe in simply avoiding movement until the symptoms have resolved. “Bite the dog that bit you” is typically easier said than done; but ultimately we used many of those same triggers to desensitize his nervous system within certain parameters. Always getting feedback from him to help guide our progressions and selections.
There is no magic pill or quick fix for musculoskeletal pain and movement dysfunction. With the right treatment, movement progressions, and sound programming alongside manual therapy; we can not only fully restore function; but we can build a more capable and confident you.

THE GRACEFUL PURSUIT OF A SUPERIOR SELF IS AS MUCH MENTAL AS IT IS PHYSICAL. MOVEMENT IS ONE OF THE SINGLE MOST ARTISTIC FORMS OF SELF EXPRESSION.

So how do you choose to MUV? And what do you do when something is preventing you from moving?

AUTHOR

Dr. Bryan Keith

Myomuv PT

We help active adults and athletes return to the activities they love without pain, without taking time off, and feeling more confident and capable than ever before.