The Chain Of Events That Occur In The Slow Onset Of Chronic Pain.
This Is The Quiet Beginning Of Your Back Pain That Only Becomes
Loud Years Later When Your Symptoms Begin To Show.
Now we have a visual of a balanced skeletal system, floating inside healthy Fascia, allowing your muscles to work in a balanced way. In our search for deeper answers, we had to cross into different fields of research. The field of Functional Movement helps us to agree on what ideal function looks like, and the main lesson from it is this:
Before any movement, the body must first create stability. A good visual for this is to imagine standing up from your seat right now. Your first movement of force is actually downwards, as you push your feet into the ground.
Then, using your breathing muscles, your Diaphragm and core, you stabilise yourself in the space you occupy by squeezing into your pelvis, and as you increase the force into the ground, you find yourself rising into a standing position.
You'll have heard of the term Diaphragmatic breathing, but may not have realised that it is actually responsible for functional movement, meaning the stability phase of any movement you make. Research has confirmed this connection directly, showing that the Diaphragm functions as a postural muscle as much as a breathing muscle, and that its activity during movement is essential to spinal stability.
So let's add this to our healthy ideal. When your stability comes from your Diaphragm and core, that constant use provides a strength that keeps your pelvis well-set in a balanced position within your Fascia web.
Key Research:
The role of the Diaphragm in spinal stabilisation, Hodges et al., Journal of Applied Physiology
Altered respiratory muscle recruitment in people with low back pain, O'Sullivan et al., Spine
You stop breathing with the Diaphragm. This means you stop stabilising from the Diaphragm too. This lack of use over time allows the tissues around the Diaphragm and Pelvic Floor to weaken, and the position of the pelvis within your web can then begin to shift.
This creates the first major imbalance as you attempt to hold yourself against the forces of gravity: an imbalanced pelvis due to weakened diaphragmatic breathing.
From the age of 5 to 16, at least, we sit in an L shape for six hours a day. This position blocks the space for Diaphragmatic breathing downwards towards the pelvis, so we have to breathe up into the chest and rib cage instead.
If we're lucky, we don't have a desk job to extend this for another fifty years, six hours a day.
But for most of us, by the age of 16, our pelvic stability is weakened, and the pelvis shifts position. In most cases into a forward tilt, mimicking the chair position when we are standing up.
Now imagine standing up from your chair again, except this time with the imbalanced skeletal system. The muscles have to adopt a dysfunctional movement pattern to counteract gravity's force. That means you have muscles overworking, and the wrong muscles doing slightly wrong jobs at the wrong time.
To stabilise yourself with every movement, you have to recruit muscles that don't usually do that work, which can quickly tire and become overused.
This leaves them acidic and sticky within your web of Fascia, and thus begins the slow cycle of restrictions building.
The area that has to change its normal function the most, as it succumbs to the most restrictions, acidic buildup, slow lymph and toxin recycling, and the most overuse of muscles?
Your lower to mid back.
The result is a skeletal system that floats imbalanced inside your web of Fascia, with a muscular system forced into dysfunction just to keep you upright. Every step, every sit-down, every reach, every morning you get out of bed, your body is compensating. The wrong muscles are working too hard. The right ones have gone quiet. Restrictions are building in your Fascia, layer by layer, year by year. And one day, often with no obvious trigger, the accumulated tension finds a weak point and pain appears. Not because something suddenly broke. Because the slow accumulation finally had nowhere left to go.
The research on Fascial mechanics, diaphragmatic function, and dysfunctional movement patterns has been building for over 100 years, with the most measurable advances concentrated in the last 25. From the earliest osteopathic work of Andrew Taylor Still in the 1870s, through Ida Rolf's manual Fascial work in the mid-20th century, to Peter Huijing's biomechanical studies on force transmission through Fascia and Helene Langevin's imaging research showing measurable Fascial thickening in back pain patients, the evidence has been accumulating steadily. The Fascia Research Congresses beginning at Harvard in 2007 brought this work into the mainstream of scientific discussion. It all points clearly in the same direction.
That direction is not where your GP was trained to look.
Medical education moves slowly. Research that is well-established in specialist and elite sport circles can take 15 to 30 years to filter into GP training and NHS guidelines. The result is a generation of practitioners who are not at fault personally, but who are working with an incomplete map of how the body actually functions.
In elite sport, there is no waiting for the system to catch up. Premier League medical teams go directly to what works, because results are measured in days, not months. Physology has been applying this approach since 2013, including five years on Everton FC's first team medical staff, and the same system is what we bring to our patients in Bath and Bristol.
Continue the journey into your Chronic Back Pain education by clicking onto the next page in the series.
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