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To Wendy - your back

Posted by Julie F on 10/27/00 at 12:03 (031460)

Hi Wendy

Your back sounds interesting (I'm not being funny.) I'd be almost willing to bet that there has been a knock-on effect from the problems there to your feet. If it were me, I'd carry on with regular treatment, as it always makes you feel better. I'd also be very careful in yoga practice with my SI joints. (Actually I AM very careful with my SI joints. In fact, my PF began when I was demonstrating Trikonasana (triangle pose). I did what no teacher should ever do, and what I am always warning my trainee teachers not to do; I forgot about myself, held it for too long, talked too much, and something 'went', in this case not my SI but a disc, which impinged on the sciatic nerve. Two weeks later - PF.)

But the key to solving many back problems, as most good osteopaths and chiropractors will tell you, is to stop doing whatever is causing the problem. We're 6,000 miles apart, and I'm not medically trained and am guessing, not diagnosing, but I've looked at your photograph and it looks as though your pelvis is tipped forward (i.e. hip bones in front of sitting bones). This is very common and is in my view one of the prime causes of low back problems: it compresses the lumbar discs. It often happens because the body weight is being held too far forward - i.e. too much towards the balls of the feet: the legs go off the perpendicular and the pelvis follows along, automatically tipping forward. Are you doing this? If you are, try to centre the weight between the heels and the balls. Tuck your tailbone under, and use your lower abdominal muscles to draw your pubis up. That should bring your pelvis into an upright, central position, hip bones directly above sitting bones. All this has the effect of lengthening the lower back, and helps to protect it. It also helps to strengthen it, because you're using your lower abdominals and, as you tuck the tailbone under, your gluteals and hamstrings.

Tell me if I'm way off base - of course it's hard to tell when you've only seen a photograph. But if that IS part of the problem, you do need to be careful in yoga, especially, as I said, with anything that involves outward rotation of the hip joint, which puts pressure on the lower back unless the pelvis is positioned well. Also be mindful with backward bends. You say your lumbar spine is too mobile, and your thoracic spine tight. Backbends should work the upper back, to strengthen it and increase its flexibility, without overworking the lower back, which is usually already pretty flexible and needs to be protected from over-extension;, but often that doesn't happen because the lower back bends backward so much more easily. Try to lengthen your lower back as much as possible so that you don't over-extend it (easy to do, especially if it's already hyper-mobile) and try to work the upper back (think of lifting the chest).

There's an old wives' tale that says 'you can't hurt yourself doing yoga'. But you can, and you can certainly exacerbate any existing imbalance, particularly where the pelvis is concerned.

Have you been given lower back strengthening exercises? Pelvic tilts are good. The bottom line is: strengthen the abdominals and watch the pelvic position.

I hope this makes sense. I know you didn't ask me for advice, so ignore me if I'm off base and/or if you already know all this. Do email me if you want to or if anything isn't clear.

And keep enjoying yoga!

All the best, Julie

Re: To Wendy - your back

wendyn on 10/28/00 at 11:51 (031517)

Wow Julie - you can tell all that from looking at a picture? That's pretty amazing! You've pretty much said what they told me at physio. Or at least along the same lines.

I've been given a lot of exercises to strengthen that area, including pelvic tilts and something for tranverse abdominals (?) basically you lay on your back, put you're fingers on your tummy area along the pelvic bones and SQUEEZE like you're trying not to pee. Sounds ridciculous when I try to explain it - but the idea is to isolate some abdominals in there. They also get me to do this while slowly lifting one leg. It works fine on my left side, but it's for some reason much harder to lift the right side - there was a reason for that but I can't remember what.

As for yoga and back bends etc....I am very careful now in anything that I do. I am partially to blame for my injury, because I did not listen to my body in the first place.

My yoga intructor encourages me to try things I find hard - but she is also always mindful of the 'honor your body' idea and she doesn't push me to do things I think I wrong for me.

Thanks for the advice Julie - I'll take all that I can get!!!

Re: To Wendy - your back

Julie F on 10/28/00 at 15:27 (031529)

That's a good exercise, Wendy (the transverse abdominals one, I mean). Sounds like it strengthens the pelvic floor muscles too, which is all to the good. And pelvic tilts are just what you need. It also sounds like you've got a good yoga teacher, and that's good. Keep it up and don't blame yourself for anything: it's all education, after all.

Speaking of pelvic tilts, I find it helpful to do the standing ones side on to a mirror - you can see whether or not your pelvis is upright and your lower back lengthened. Whatever you're doing - bending backwards or forwards or sideways, or twisting, or just standing or sitting - try to aim for that feeling of lengthening in your lower back.

A helpful visualization is to imagine the pelvis as a wide, shallow bowl full of spaghetti (i.e. your abdominal organs). If the bowl is held level, it contains the spaghetti as it's intended to do. But if the bowl tips forward, all the spaghetti slops over the edge. I know, ugh...but it works.

All the best, Julie

Re: To Wendy - your back

Myrt on 10/28/00 at 20:49 (031545)

I was wondering if I was the only person who had pain not only with walking and standing but also with sitting. I have a bulging disc at my SI joint and it seems to me that that is part of the foot pain that I have and have had for 2+ years. However, it seems like the drs. don't agree. I have taken up swimming lately and that(for a little while anyway ) make both my feet and back feel great.
I have tried millions of inserts, stretching, PT, a walking cast, a family Dr., a podiatrist, and a nuerologist. My nerve conduction test was abnormal but there still was no evidence of Tarsal Tunnel Syndrone, I was told. I've given up on Drs. I did take nuerotin and that helped.

Re: To Wendy - your back

Julie F on 10/29/00 at 01:10 (031552)

Hi Myrt

You say the doctors you've consulted don't agree that there may be a connection between your foot problem and your back, and perhaps they're right. But the human body is an organic whole, and everything in it is related to everything else, so lots of things that go wrong with it have their source somewhere else, and more often than not that 'somewhere else' is the spine. My podiatrist believes that many problems that arise in the feet, and most cases of PF, have their source in the back.

So why not check this out with an osteopath or chiropractor if you haven't already done so. Treatment of whatever spinal problems you have may help. A good osteo or chiro may also be able to help you identify any habits of body use that may be factors in your problems, so that you can work on them. It's hard to change habits, but ultimately that helps, because if we go on doing whatever we were doing that caused the problem, the problem will recur after treatment.

BTW, are you sure you have a bulging disc at the SI joint? As I understand it, the 5 sacral vertebrae are fused, i.e. no discs there - or have I got the wrong end of the stick?

Keep swimming if it helps and you enjoy it. Lots of people have switched to it from weight-bearing exercise.

Re: To Wendy - your back

john h on 10/30/00 at 09:35 (031626)

the L5/S1 disc is definitely not fused. i just had a discogram into that disc which was badly degenerated. this is probably the most common area to have back problems as a result of a degenerated disc or bulging disc. the doctor was able to recreate my back pain as i experience it by injecting dye into the L5/S1 and L4/L5. No leg or foot pain was experienced. the discogram is now considered the 'gold standard' test for disc problems.

Re: To John - L5/S1

Julie F on 10/31/00 at 02:51 (031680)

Hi John

Thanks, I know. I was referring to the sacral vertebrae that are fused, below L5/S1. I am very sorry about your L5/S1 disc!

Julie

Re: To Wendy - your back

wendyn on 10/28/00 at 11:51 (031517)

Wow Julie - you can tell all that from looking at a picture? That's pretty amazing! You've pretty much said what they told me at physio. Or at least along the same lines.

I've been given a lot of exercises to strengthen that area, including pelvic tilts and something for tranverse abdominals (?) basically you lay on your back, put you're fingers on your tummy area along the pelvic bones and SQUEEZE like you're trying not to pee. Sounds ridciculous when I try to explain it - but the idea is to isolate some abdominals in there. They also get me to do this while slowly lifting one leg. It works fine on my left side, but it's for some reason much harder to lift the right side - there was a reason for that but I can't remember what.

As for yoga and back bends etc....I am very careful now in anything that I do. I am partially to blame for my injury, because I did not listen to my body in the first place.

My yoga intructor encourages me to try things I find hard - but she is also always mindful of the 'honor your body' idea and she doesn't push me to do things I think I wrong for me.

Thanks for the advice Julie - I'll take all that I can get!!!

Re: To Wendy - your back

Julie F on 10/28/00 at 15:27 (031529)

That's a good exercise, Wendy (the transverse abdominals one, I mean). Sounds like it strengthens the pelvic floor muscles too, which is all to the good. And pelvic tilts are just what you need. It also sounds like you've got a good yoga teacher, and that's good. Keep it up and don't blame yourself for anything: it's all education, after all.

Speaking of pelvic tilts, I find it helpful to do the standing ones side on to a mirror - you can see whether or not your pelvis is upright and your lower back lengthened. Whatever you're doing - bending backwards or forwards or sideways, or twisting, or just standing or sitting - try to aim for that feeling of lengthening in your lower back.

A helpful visualization is to imagine the pelvis as a wide, shallow bowl full of spaghetti (i.e. your abdominal organs). If the bowl is held level, it contains the spaghetti as it's intended to do. But if the bowl tips forward, all the spaghetti slops over the edge. I know, ugh...but it works.

All the best, Julie

Re: To Wendy - your back

Myrt on 10/28/00 at 20:49 (031545)

I was wondering if I was the only person who had pain not only with walking and standing but also with sitting. I have a bulging disc at my SI joint and it seems to me that that is part of the foot pain that I have and have had for 2+ years. However, it seems like the drs. don't agree. I have taken up swimming lately and that(for a little while anyway ) make both my feet and back feel great.
I have tried millions of inserts, stretching, PT, a walking cast, a family Dr., a podiatrist, and a nuerologist. My nerve conduction test was abnormal but there still was no evidence of Tarsal Tunnel Syndrone, I was told. I've given up on Drs. I did take nuerotin and that helped.

Re: To Wendy - your back

Julie F on 10/29/00 at 01:10 (031552)

Hi Myrt

You say the doctors you've consulted don't agree that there may be a connection between your foot problem and your back, and perhaps they're right. But the human body is an organic whole, and everything in it is related to everything else, so lots of things that go wrong with it have their source somewhere else, and more often than not that 'somewhere else' is the spine. My podiatrist believes that many problems that arise in the feet, and most cases of PF, have their source in the back.

So why not check this out with an osteopath or chiropractor if you haven't already done so. Treatment of whatever spinal problems you have may help. A good osteo or chiro may also be able to help you identify any habits of body use that may be factors in your problems, so that you can work on them. It's hard to change habits, but ultimately that helps, because if we go on doing whatever we were doing that caused the problem, the problem will recur after treatment.

BTW, are you sure you have a bulging disc at the SI joint? As I understand it, the 5 sacral vertebrae are fused, i.e. no discs there - or have I got the wrong end of the stick?

Keep swimming if it helps and you enjoy it. Lots of people have switched to it from weight-bearing exercise.

Re: To Wendy - your back

john h on 10/30/00 at 09:35 (031626)

the L5/S1 disc is definitely not fused. i just had a discogram into that disc which was badly degenerated. this is probably the most common area to have back problems as a result of a degenerated disc or bulging disc. the doctor was able to recreate my back pain as i experience it by injecting dye into the L5/S1 and L4/L5. No leg or foot pain was experienced. the discogram is now considered the 'gold standard' test for disc problems.

Re: To John - L5/S1

Julie F on 10/31/00 at 02:51 (031680)

Hi John

Thanks, I know. I was referring to the sacral vertebrae that are fused, below L5/S1. I am very sorry about your L5/S1 disc!

Julie