Muscle weakness is a prevalent cause of unsolved low back Pain.
In our previous articles we covered:
How Does Muscle Weakness cause chronic low back pain, sciatica, and back spasm?
Each muscle is like a member of a sports team. They have individual talents but also work in synergy with teamates. When a muscle stops doing the “leg work” it was designed to, other muscle teammates have to step up their game.
In the lumbar spine, during walking the gluteal, then hamstring then erector/multifidi should fire in sequence. This is often faulty in Low Back Pain.
The body has an internal dialogue sensing balance needs, weight bearing, movement. This internal messaging is happening at all moments of the day.
To keep you moving, even if a muscle that is key in the “team” stops working the body will make compensations.
Where does Muscle Weakness come from?
Weakness happens from several causes that can be best examined by a trained professional.
Some common causes of weakness:
-Injury: Research shows that surgeries, and injuries can cause certain muscles to “turn off” or become inactive.
-Joint Imbalacne: There is some research that points to joints not moving properly causing muscles to not engage properly.
-Nerve impingment- Joints, muscles, fascia and discs can start to alter the nerve flow between the spinal cord and muscle. Disc impingment being the most serious with what is called frank neurological signals, meaning the muscle has shut off.
-Lack of use: Our sitting society creates imbalance where muscles get too tight on one side of the body (the hip flexors and quadriceps) while the posterior muscle get weak. This was best outlined in Janda’s lower cross pattern or syndrome.
-Trigger Points and Scar Tissue: Areas around scar tissue and those muscles with excessive knots have been found by the author to contribute to muscle weakness.
-Organic disorders: there are some more serious causes for muscle weakness that are rare but worth ruling out. Most are neurological based disorders.
At our Chiropractic, Soft Tissue, and Movement Center in Greenville, SC we find it is absolutely necessary to map out muscle weakness in every patient we see. We can’t always trace back where the muscle weakness began but we do know that when fixed we often see back pain come to resolution.
How do you know if you have Muscle Weakness?
A Functional Movement Examination and Focused Muscle Strength testing are great methods to map out muscle weakness.
By going through patterns such as lunging, squatting, cross body pattern movements, balance, and hip hinging we can begin to map out weak muscles and weak movement patterns.
As well, posture, and individual muscle pattern analysis as taught by Dr. Janda and Liebenson have tremendous benefit.
The functional movement screen, the TPI golf performance analysis, gait analysis and isolated muscle testing being even more options of analysis.
This has been incredibly crucial in so many cases. The Chiropractic adjustment holds longer, the muscle tightness reduces, just be engaging the right muscles to do the job they are designed to do.
Some common causes that often get overlooked.
Gluteus Medius Weakness on one or both sides:
The gluteus medius is designed to stabilize the lateral hip and pelvis. When weak we will see a dropping of the pelvis during single leg balance. You may not think its a big deal until you realize how many time we balance on one leg everyday. Each walking stride is a mini one leg balance. This means we often see muscles above the gluteus medius in the low back start to “overfire” to manage the increased load. This leads sometimes to a high pelvis and now we have compression at the lumbar joints and maybe the SI joint on the same side.
Tight Hip Flexors Inhibiting the Gluteals:
So many in modern day have tight anterior or front muscles in their hip. The two muscles often involved are the hip flexor and rectus femoris.
these muscle have been shown to “turn off” or inhibit the gluteal muscles.
This is crucial in so many lumbar cases as tight front muscles and weak gluteals cause anterior pelvic tilt. This creates a compensation in the low back muscles to deal with the center of gravity of the pelvis always being pulled forward.
Other Common Weaknesses:
Foot intrinsic arch muscles; If the foot muscles are weak, we will often see a fallen arch also known as pronation. This causes the leg and hip to rotate inward alongside the dropped arch.
This creates changes from the hip to the pelvis and eventually the lumbar spine.
Pelvic Floor: The pelvic floor is often a secret area of weakness for many. The most common populations being mothers after childbirth, and those that have had trauma to the pelvis.
Lumbar Multifidi: These support muscles have been researched as the most common cause of chronic low back pain. When these support muscles get weak, the lumbar spine joints can be stabilized. This leads to the joint constantly “slipping” causing
Transverse abdominus: The Transerve Abdominus wraps the entire abdomen and inserts into the spinal joints. It is compared often to a corset, which can tighten or become taut and prevent too much movement at the spinal joint and disc.
The Scapular Muscles: A winging scapula can make the lumbar spine overwork because the shoulder muscles can’t engage.
A More Comprehensive Chiropractic Visit:
Whether is core activation, or a gluteal or foot muscle. The key to getting your back to stop hurting is a detailed exam. At our center, we believe that a great examination leads to a proper game plan and much more efficient Chiropractic Therapy.
When the patient is doing strengthening of the proper muscles, in the office and at home their hands on treatment takes half the amount of visits to get well compared to traditional Chiropractic alone.
Often we see all of the the causes come together. Feel free to check out our other articles here
Movement patterns click HERE
Muscle Tightness click HERE
Fascia click HERE
