During a recent presentation I gave for a group of personal trainers, I discussed the most common back pain issues I treat in my clinic.
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Common issues that accompany back pain
(Please excuse grammatical errors, as this is simply a transcription of conversational speaking)
The biggest thing I see with back pain, as I mentioned before, is that the hip flexors are almost always involved. Even if they weren’t part of the initial problem, they’re kind of a guarding reactive muscle, and it’s amazing how much pain can be resolved just by getting those to calm down with the right treatment—not just with stretches but you actually kind of go through the stomach and work on those. I’d say probably back strain due to core weakness and overloading the hip flexors would be the most common. Definitely plenty of joint stuff too, especially as people get older.
I use manual therapy stuff to release those, then I teach them how to stretch them, and then usually there will be some joint mobilization involved, too.
Usually if there is a problem with the hip flexors, quite often there is an issue, at some level, with the joint. You kind of test each individual level and mobilize that joint and make sure they’re just good and strong in the abs long-term so that the hip flexors aren’t doing too much work.