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The
Hidden Prankster
By
Victoria L. Magown,
CMTPT, LMT and George S. Pellegrino, LMT, CMTPT
Hal, a
47-year-old Adaptive Physical Education teacher observed a child with
tendencies toward uncontrollable behavior running across the room.
Holding out his right arm, he caught the child as he ran by. He
immediately felt a sharp pain in his low back as his torso was twisted
to the right.
His pain
level was a constant 7 on a scale of 1 to 10, with 10 being the worse
possible pain. He had difficulty sitting down or rising from a chair
without assistance. During his initial visit, Hal said he was an avid
body builder and for a few years, he had even been a “power lifter”.
A few
years earlier, he had been diagnosed with a herniated disc in the lumbar
spine and feared he had re-injured himself. Hal had chosen not to have
back surgery and feared he may need it now.
During
examination and testing of Hal's low back, a muscle deep in the core of
his body called the iliopsoas lived up to its nickname, "The Hidden
Prankster". The iliopsoas is a combination of two muscles joined
together (see illustration).
One
part, the iliacus, is found on the inside of the hipbone. The other
half is the psoas, which attaches to the front of the lumbar spine and
the discs. It then travels down through the “well” of the pelvis where
it joins the iliacus. Together, they attach to the upper thighbone.
These two muscles make up the primary hip flexor, which brings the knee
to the chest.
In many
cases, when there is low back pain and a history of a bulging disc or
disc herniation, the psoas is found to be involved. When the psoas is
shortened on both sides of the spine, it increases lordosis, commonly
known as "sway back”.
When one
side is contracted more than the other, it narrows the spaces between
the vertebrae on one side and widens the disc space on the other side.
This creates a wedging effect that can predispose the low back to the
dreaded problem of a herniated disc.
From
years of heavy weight lifting, Hal had developed Myofascial Trigger
Points in his psoas muscle. Although other muscles were involved, the
hidden prankster was the main cause of his low back pain.
Trigger
Points are a hypersensitive focus of pain in a muscle that restricts
range of motion and refers pain in a predictable pattern usually away
from the site of the Trigger Points. They can be laid down in muscle
through direct trauma, overload or repetitive motion.
Appropriate treatment by the Certified Myofascial Trigger Point
Therapists at MyoRehab eliminated Hal's pain. A specific Home Exercise
Program and modifications to Hal's body building regime, prevent the
return of his symptoms and the need for surgery.
Do you have a "Hidden Prankster" causing your
low back pain? Give us a call at MyoRehab
OR click here to set up your thirty minute consultation |
