Low back pain is a common issue with up to 80 percent of Americans being affected by it at some point in their lives. Opinions (and even research) on what is the best form of treatment for back pain varies slightly with different disciplines. However, in the case of pain, there is likely some kind of imbalance in the body.
What causes low back pain?
The most common cause of low back pain is the strain to local ligaments, joints or muscles. This is often due to large physical loads or a sudden movement that the body was not ready for (i.e. a slip and fall or lifting too much). The injury creates a bodily reaction telling the brain to launch an inflammatory response and promote healing. This is a normal and effective response in the case of acute injury.
The problem with chronic low back pain
The body’s response to an acute injury is important for recovery. However, this becomes a problem when the body is chronically perceiving pain. Chronic pain is defined as pain lasting more than 12 weeks. This can cause a range of issues related to poor compensatory movement patterns (i.e. limping because something hurts), chronic inflammation that can actually cause tissue damage, poor muscle motor control (see next paragraph for details), and even depression.
Core strength for back health
The “core” includes all the muscles in the mid-section of the body that help provide stability for use of the head, arms, and legs with daily movement. Research on chronic low back pain shows a correlation with delays in core muscle activation. This leaves the spine vulnerable to injury and pain with any initiation of movement. Thus, a good place to start with managing back pain is to restore muscle control and balance.
How EMG can help with muscle balance and activation
Most of us are unaware of our poor movement patterns until something is wrong, like when we experience pain. We then find ourselves scrambling to figure out how to fix the problem. This is where having an assessment tool for finding and managing the issue is so important. EMG is a way to measure muscle activity and understand muscle use patterns. It can also help determine what kind of balance (or imbalances) the body is using. Imbalances are pretty common but hard to self-assess without some help.
EMG can also be used to detect which muscles are being over and underused. With this information, it’s easier to “re-learn” muscle balance. With EMG, set an upper or lower threshold while completing a specific movement to give immediate and useful feedback. This is a great way to train the body and brain to move in a way that makes the back happy!
Hamstring Dominance Example
Hamstring Dominance is a common issue that puts excessive strain on the pelvis and low back. The hamstring is a long muscle down the back of the thigh (extending from the knee to the butt). It is meant to help extend the leg backward, but should not be the primary muscle doing this work. On the other hand, the gluts are relatively large muscles. They have a biomechanical advantage for extension due to their close proximity to the pelvis and core. EMG could easily be put on the hamstrings or gluts to assess what is dominant with extension biased exercises (i.e. walking, bridges, etc.) to address any imbalances.
Abdominal Muscle Example
Some of the key muscle groups in the core are the abdominals. The specific abdominal muscle called the transverse abdominus (TA) literally acts as the body’s own girdle. This muscle is notoriously weak, even for those who exercise regularly, due to the overuse of other abdominal muscle groups like the rectus abdominus (the muscle everyone uses to try to get a 6 pack). Biomechanically speaking this is a recipe for pain and movement that requires more energy than necessary.
The easiest way to start assessing the TA is to lie on the back with the knees bent and simply try to tighten them without squeezing all the other muscles in the body (butt, neck, etc). This is usually harder than it sounds and is a good place to start. Using an EMG sensor just inside the bony prominences of the front of the hips can measure the activity of the TA muscle. Once they are properly activated without too much noise from other muscles, you can slowly build your way back into a normal core routine that is done correctly and safely.
Back pain can be very enigmatic. The way the body moves can have a big influence on causing or perpetuating this pain. Establishing good movement patterns to manage and prevent pain is important and vital for having a good quality of life.
About the Author:
JayDee Vykoukal is a practicing Doctor of Physical Therapy and medical writer specializing in health education. As a Montana native, she loves to travel the world exploring nature and doing pretty much anything exercise related outside.
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