Tag Archives: back pain

Tilt is Not Game Over – Solve Back Pain

Back pain and specifically low back pain is a problem most of us will experience. But we don’t have to live with that In fact, over 80% will deal with one episode of low back pain and over 60% of us will have 2 episodes of serious low back pain.

How does low back pain start and what’s the cause?

Low back pain can be caused by a wide variety of issues, sometimes it’s a major traumatic experience such as a fall or a car accident, other times it can be a internal (visceral) issue, but most of the time low back pain is caused by repetitive stress. Basically, most people do something on a regular basis such as sitting all day or bending over at work that leads to poor bio mechanics or in other words poor posture.

Incorrect bio mechanics of the low back leads to compensation by the body, creating muscle imbalance, fascia adhesions, muscle spasm, nerve irritation, fibrotic tissue, inflammation, changes in the position of the spinal column and then ultimately pain.

One the most common causes of poor bio mechanics of the low back is due to the anterior pelvic tilt. An anterior pelvic tilt occurs when the pelvis (3 different bones) moves forward in relatio

Figure 1

n to where it normally should be, which is neutral. Common symptoms of an anterior pelvic tilt include low back pain, groin pain, tight hips, inner knee pain, and stiffness in the morning or after activity, tightness in the muscles in the low back and groin region. The image Figure 1 shows the difference between a neutral and anterior pelvis.

As a result of anterior pelvic tilt, you will generally have tight hip flexors (illopsoas) and tight low back muscles (lumbar paraspinals). These tight muscles create added stress on the low back joints and spine, causing pain, inflammation, spasm and tenderness.

So if you have anterior pelvic tilt, how do you correct the problem? Well it depends on many factors. However, for many, a weak core and glutes (butt) can be a common issue. Strengthening the abdominal region along with the gluteal region can help balance out the pelvis in many cases. In other cases, muscle weakness is not the issue, but rather muscle inhibition, meaning muscles are strong in the right areas, they are just not working in the way they are designed to or firing correctly. Sometimes an anterior pelvic tilt is due to structural imbalance, an example of this is the hips are not moving correctly (no range of motion) causing the pelvis to compensate. Often a pattern in this is due to compensation from prolonged sitting. This often shortens the psoas muscles and creates imbalance in the quadriceps and firing pattern issues in other muscle groups.

If you are dealing with low back pain talk to us, we are specialists who not only treat low back pain, but locate the source of the imbalance and work with you to return that balance. Properly getting assessed is the first step towards resolving your pain. We can help treat not only low back pain, but low back pain due to an anterior pelvic tilt.

How adductors and quadriceps affect back pain

The basis of pelvic balance relies on the ability of all the muscles which attach at the hip and groin to relax and extend after workout or exercise. But as we all know, without stretching post-workout, the muscles remain shortened and develop adhesions or contractures.



Adhesions result when a certain group of muscle fibres stay stuck together after contracting, not releasing and then acting as a group rather than as individual muscle bundles.
A contracture is a knot or trigger point which develops along the muscle belly, usually, because of repeated muscle contracting and not relaxing at that location in the muscle belly.
The result is a developing knot or trigger point in the muscle with the presence of excessive proteins binding the muscle filaments together and trapping lactic acid and other proteins in a knot.  Medically it appears the required enzymes necessary for the releasing of these muscles appears to be absent or in short supply at the knot.


Myofascial Release Therapy  and Trigger Point Therapy will release both adhesions and contractures. When the muscle doesn’t want to release, the use of these techniques will at the muscle knot locations, and attachment points assist the muscles to release.

How does tight quadriceps and adductors affect ilio-psoas?

By adding external pelvic tension against the hip bone. The attachments of the quadriceps and adductors along the pubic bone and especially upper iliac ( hip bone) pull the iliac into an outflare exerting outward pulling strain on the iliac, straining the iliac, and iliopsoas, as a consequence.

The ilio-psoas is two muscles which are hip flexors and torso flexor. The psoas is combined with the quadratus lumborum at the back of the lumbar acting as your core flexor-extensor combination. Any imbalance will often result in low back pain.
What I have discovered in performing multiple treatments on the ilio-psoas is that there is always accompanied tightness in the adductors and quadriceps on the same side as a tight ilio-psoas.

I have found that releasing the adductors and quadriceps first will result in a lessening of the tension on the iliacus, and ilio-psoas as a consequence.

If you have low back or hip tightness or pain I welcome you to try this therapy approach and be amazed at how quickly the discomfort reduces after treating the adductors and quadriceps.