A simple thing like overdoing yard work or cleaning out the garage can set the stage for a major lower back pain episode. You strain your back pulling weeds, bent over for several hours, or lifting heavy boxes, things you’re not used to. The MUSCLES are sore and your movement is a little restricted as you go about your daily activity. When you begin walking, especially getting up from sitting, you notice lower back pain, maybe pain in your sacroiliac joint that makes the first few steps particularly painful. Now not only are the muscles involved but now a JOINT is not working correctly. Commonly, compensations are made in the lower back joints and from a simple muscle strain you now have “altered biomechanics.” These problems if not corrected result in other compensations, alterations in gait and further corruption of CNS programs, not only the walking program but others like bending, stooping lifting, getting up from a chair, etc.
So what’s this about “altered biomechanics” and “corrupted programs?” Biomechanics describes the movement of the human body, the muscle and bone movements that have to be coordinated to accomplish everyday activities. Your central nervous system (CNS) holds “motor programs” that control these coordinated movements. For example there is a program to climb stairs. Your CNS accesses the program and you start the stair climb but it also allows for “fine tuning” to account for varying step heights, handrail or not, etc. There are many programs! And like software programs on your computer these CNS motor programs can become corrupted.
One of the most important motor programs is the one for walking and it’s fairly complex. Both sides of your lower spine and pelvis as well as the leg muscles have to be activated in a coordinated way. When you take a step with the right leg the right hip flexors are activated to lift your leg but just as importantly the left lower back muscles as well as the left buttock muscles are also activated to hold up the left side while the right side is in mid-stride. Otherwise you would topple over to the right when you raised the right leg.
This walking program is often corrupted when you experience lower back pain. If you are a patient of mine you know that one of the first things I do is look at your pelvic level and will ask you to lift one leg, then the other, like a marching step. I am looking for the correct movement of the pelvis on each side as the opposite leg is lifted. A failure of this mechanism indicates that the lower back condition has corrupted the walking motor program. So every step you take with this condition uncorrected is not only placing stress on your lower back vertebrae and pelvis but also corrupting the CNS program for walking. The muscles are not being activated in a coordinated way and one side will be too “tonic” (tight). The joints are not moving in a coordinated way. All these movements are “data” and they get fed back to the CNS. The motor program takes in this input and over time the walking program gets corrupted.
Chiropractic adjustments are specific mechanical corrections to restore the central nervous system program back to baseline. This may require repetition of the mechanical correction to purge the corrupted program. Hence, repeat visits and specific movements we call isolation tests (“turn your head to the right” or “place your right hand behind your back”) to test the nervous system program.
Next time we get deeper into CNS programs, how they get corrupted and how our postural habits, good and bad, help or hurt us over time. Let’s talk neuroplasticity! Huh? Yup, exploring the latest research in neurophysiology (things we chiropractors have been talking about for years). Stay tuned.