Question about back pain

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I had a client today that says when he stands talking to someone he gets very bad pain in his back, like it starts at his tail bone and refers to each side of his back like shooting out, I was thinking maybe his adductors are tightening and pulling but still not sure about what could cause it, only because he is saying that it is shooting side to side not up or down, he is older like late 30's he has been a carpenter for like 20 years, and not to mention he is overweight. So if anyone can help me out, I would appreciate it, if I don't respond right away it's cause i'm on my way home.Thanks,Tara :)
 
Question about back pain

The most important question, has he been seen by his doctor, chiro? How long have you worked with this client? How often? For what?How long has he been experiencing this? Is there any particular movement or stance that creates the pain? Have you performed any postural alignment tests on him yet? If yes, what were the outcomes?One obvious thing is his weight, as weak abdominals are often the culprit in lower back pain. Does he have upper or (more importantly) lower crossed syndrome?Let us know.
 
Question about back pain

He has not seen a dr or chiro yet, the good thing is that I work with a chiro so maybe he can be seen by him. Yesterday was this guy's first massage ever, so It was his first visit with me. He says that pain has been with him for a long time like 10 years when he is standing still talking to someone, if he is moving he is fine. I have not performed any tests on him yet. His abdominal muscles are defenitly weak due to him being or weight.
 
If you have experience with trigger point work, there are trigger points in the abs that refer in bands to the lower and middle back.Sounds like that could be part of the problem.  Also check his glutes, piriformis, ect.
 
Question about back pain

Does he wear a tool belt?I imagine that if he dies it is doing mean things to his glute med and sending wacked out signals to his hip rotators.Robyn
 
Hey Tara!  Try testing his hip extension firing patterns.  If the Hamstrings and or Glute are inhibited, the errector spinae muscles are overly strong due to overuse.  This could indefinately create a form of back pain.  You mentioned him being over weight, so he probably doesn't run a whole lot, in which case the most optimum pattern for him would be 1. Glute max  2.Hamstring  3. Opposite side Errector spinae.Give it a whirl!!! ;D
 
Question about back pain

I am just guessing here but would firing patterns be like an electrical charge (kind of like a tingly sensation) I'm with Stacey I don't know how to test for it either except ask the client ???Sounds interesting though!!Trish
 
Firing patterns can be tested manually by placing your hands on the appropriate muscles and having your client perform a specific function.  And no they are not an electrical charge ;D  They are simply the sequence in which  muscles fire.(Like in the case of hip extension which I have described earlier).  In order to test them though one must have a knowledge of the correct muscle firing sequence for any given  movement you are trying to test.  There are many different movements that can be tested such as knee flexion, shoulder abduction, hip abduction, knee extension, trunk flexion, and others.  When a muscle tests out of sequence, or too strong, there is going to be some dysfunction somwhere indefinately.  The key is finding where the client is over-compensating and inhibiting the muscle or muscles that are doing so. I have had huge success in correcting firing patterns, and great results.
 
I'm with cffoster on this one, but the fact that your client is overweight leads me to think that maybe he has a weak abdominal core (this isn't always the case with overweight clients, but the majority of the time it is).  And as we all know, if our agonist is weak, then our aneforum.xxxonist (the erector spinae and other trunk extensors) will be overly strong.  One of the tests that was mentioned for firing patterns was that of trunk flexion.  If you have the client supine, place your fingers of one hand deep on the transverse abdominis, the thumb of the same hand on the obliques, and then the other hand on the rectus abdominis.  Then have him do a small crunch.  Ideally, the pattern should be transverse abdominis, obliques, then rectus but in most cases of people with weak core strength rectus will fire first.  And if there is no strenght for stablilizing the body in the trunk flexors, now the trunk extensors must do all the work.  Check your clients balance - a weak core also translates to having horrible balance.  If his pattern is off, a good way to reset it is before he does his crunch, have him flatten out the small of his back or pull his belly button towards his spine.  This actively engages transverse, then have him do his small crunch several times in a row.  Recheck.  Good luck, and I hope this was of some help!
 
Is there some place (like a book)  where firing patterns are documented?Sounds really useful.
 
Yeah  The book that I used in my class has a whole bunch of firing pattern goodies in there, but Chaitow books also have some in them........
 
When a muscle tests out of sequence, or too strong, there is going to be some dysfunction somwhere indefinately.  The key is finding where the client is over-compensating and inhibiting the muscle or muscles that are doing so. I have had huge success in correcting firing patterns, and great results.
Could you elaborate on how you "correct" the dysfunctional firing patterns once you locate that the pattern is incorrect?
 
Question about back pain

You need to inhibit the muscles that are too strong e.g. applying a pressure - and then stimulate the muscles that are weak(by tapoting them) while that muscle is concentrically contracting
 
Chris puts it very well, but knowing how to apply it isn't always so easy.  Take for example the case of misfiring abdominals.  Most often rectus abdomimis is overfiring.  You don't want to necessarily apply pressure downwards into the muscle because of the organs below, but if you you bend the rectus by using a flat hand and leaning into, thus pushing it to the side, not down, you will achieve the same results.  And obviously you won't want to tapote the transverse abdominis (ouch!) but here's what I have them do:  before they do a cruch/sit up, they have to draw their navel towards their spine - this is transverse actively working to flatten out the back.  Then have them do the crunch several times while holding that bend in rectus.  Or, in the firing pattern that was mentioned earlier for hip extension, I could tapote the heck out of gluteus maximus until it starts working properly, OR i could actively have them contract glute maximus FIRST, then have them do hip extension.  Client participation in strengthening the muscle is much more useful than passively tapoting the crap out of it any day!  But in some instances that's not always an option.  Hope I didn't get too carried away with that explanation!
 
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