Whilst working in my pain clinic for many years and through the
forum I have on my site
, I have been asked many questions by back pain sufferers. I have answered
some of the more common ones below in case they are questions you would also
like answers to.
Q. How do I determine if I have a short leg and by how much?
A. The first thing to do is loosen up your body as much as you can perhaps with some very slow, gentle stretches on the floor so that you get an accurate picture. Then lie on your back on the floor and have someone make sure you are lying straight. Get them to check to see how your heels line up and if they don't, how much difference there is. The bone on the inside of your ankle is a good point to compare.
Another way is to stand on level ground with your weight even on both legs and have someone use a spirit level to check the alignment of the prominent hip bone on both sides of your pelvis.
From this you can determine how much higher one hip is than the other. If you put a heel lift in your shoe as a result, be sure to put it in the shoe on the same side as the lower hip because the shorter leg is pulled down when standing on the level ground remember, so it makes that side of the pelvis look lower.
Remember a rotated pelvis can be just as aggravating to the back and spine and may not show up as a short leg. When you lie comfortable on your back and relax your legs a rotated pelvis will show up because both feet will point or be heading in the same direction, the opposite direction to the forward rotation, i.e. if both feet point left you have a forward rotation of the right hip.
A short leg is not a cause of pain but more an indication that you have muscle imbalances that are present causing an uneven pressure to be applied to some of the joints in your body. Don't believe anyone who says they can fix a short leg through stretches or trying to manipulate your pelvis and pull on your leg. Similarly putting a lift in your shoe won't fix it or doing an exercise program.
If you spent your whole life on your back the short leg wouldn't matter but when you are standing or sitting all day it will cause a lot of tightness and irritation in some joints and that is why you need to take a holistic approach to removing the muscle imbalances to get rid of it.
Q. If the cause of most back pain (85%) is muscular why doesn't massage get rid of it?
A. Massage has the effect of relaxing the muscles and taking away the tension that has built up, mainly as compensations, around the painful area. It doesn't deal with the cause of that tension, normally muscle imbalances in various parts of the body. Nor does it stimulate weak flaccid muscles or restore length and function to muscles. These are both critical things when fixing (not just relieving) back pain.
Sometimes a person with back pain can find a massage makes them feel worse for a day or two. This is because the tissue around a painful area is often weak and inflamed. The massage works on already weak and inflamed tissue making you feel worse for a couple of days, until it settles down again. When this happens it just means the real problem muscles haven't been fixed and your therapist is probably on the wrong track.
Q. The other day I went to bend over and felt a slight twinge in my lower back but I stopped quickly and it didn't amount to anything. Does that mean I have to be especially careful in future or my back will go? What can I do about it?
A . Yes the tension level in your muscles is such that you do not have the flexibility needed to bend over the way you attempted to, especially if you are trying to pick up a weight at the same time.
Your back muscles are in a vulnerable state at this point and so you should be very careful to ensure you don't end up in pain. Do some loosening up exercises for the erector spinae muscles such as those in my self treatment program. Take the twinge as a tap on the shoulder and don't make the body hit you with a sledge hammer before you get the message!
Q. Why did my acute back pain turn into chronic pain?
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