Back pain sucks. Once you’ve strained your back it never seems to go away. You are stuck with a lifetime of pain and discomfort. Or so you thought. A few simple hacks in your biomechanics may alleviate the direct cause of lower back pain. I’m not a doctor or chiropractor, but I did study biomechanics at Truman State University and understand physics so don’t sue me. I’m just trying to share what I’ve learned in my decade long battle with back pain.
I experienced my first back strain as a high school senior while playing soccer about 11 years ago as a result of a slide tackle. Since then I’ve experienced severe strains that have resulted in pain, immobility, and even an ambulance ride after carrying boxes of coin at a bank. At the time I thought it was just a freak injury and that it would go away. Unfortunately, it’s been a chronic problem that was actually fairly simple to solve and had I seen a medical practitioner or chiropractor with an understanding of the full body’s biomechanics, I would likely have saved myself a lot of pain.
For those that want the solution here it is:
See a Chiropractor to see if you have Leg Length Disparity or Short Leg Syndrome. The Chiropractor will determine remedial steps that will help to align all of the various limbs that may be causing harmful torquing forces on your various joints including those in your lower back, pelvis, knees, and ankles. This will usually result in the use of relatively inexpensive orthotics or heel lifts ($10 or so) that will help you on your road to low back pain recovery. An orthopedic surgeon or other medical doctor will probably recommend some type of back surgery. This is a terrible option since they are paid A LOT of money to do back surgeries and are thus incentivized to perform surgery that may not correct the underlying problem. If you do elect for back surgery, get opinions on what is the CAUSE of the the symptoms. If the doctor does not have an explanation that makes sense in terms of mathematics and physics then run away… fast.
For the Explanation Why Read Further:
Prior to my first back strain I had torn the Anterior Cruciate Ligament in my left knee after landing on an attempted layup in a recreational basketball game. A freak accident? Maybe. But knowing what I know now, I’m guessing the ACL tear was inevitable and it could have been prevented with some research, a chiropractor visit, and a heel lift.
Leg Length Disparity / Short Leg Syndrome
I’ve found out that I have Leg Length Disparity or Short Leg Syndrome. This is a long way of saying my legs are of different lengths with my left leg being about 7mm longer than my right leg. This small disparity in length can cause huge problems in how forces are transferred up the leg and through the joints, back, and neck. Over a long period of time it can cause degeneration in important cartilage and “discs” that lubricates joints, bone spurs in places you don’t want, mis-alignment of the back and neck, improper gait, excessive heal striking, and extensive straining on muscles. In the short term it can cause torque in joints that can make you more susceptible to sports injuries like muscle strains, ligament tears, and sprains.
Biomechanics of the Foot
The foot is an amazing example of form. It is basically a spring comprised of 26 bones, 33 joints, and a multitude of nerves and muscles that transfers forces to produce locomotion. In an ideal gait, the forefoot strikes the ground relatively evenly. Nerve endings in the ball of the foot detect the force and sends signals throughout the nervous system that an impact has occurred and prepares the rest of the musculoskeletal system for the impact. An improper strike can cause the body to react differently by twisting the body, foot, or joints adversely. Below is a picture of the soles of my soccer cleats that show how my long left leg caused excessive heal striking and excessive eversion in my left foot. Notice the heel on the left sole is completely worn through and the size of wear near the ball of the foot and big toes are larger than the right foot indicating an improper foot strike with excessive load on the medial side of the foot.
The recent trend in barefoot running attempts to correct the problems in biomechanics caused by raised heels common in most athletic shoes. The raised heels cause the heel to strike the ground first instead of the forefoot and prepares the body for a jarring impact since this is not a natural impact. I’ve recently switched to some Adidas Adipure Trainers for normal running, training, and walking for this reason. Although Switching to thin-soled zero-drop shoes improves gait, it does not fix the problems caused by a short leg which I’ll describe below.
The Body is a Series of Levers
The body has evolved and optimized over millions of years to move quickly and efficiently without injury, mostly in short bursts of intense activity (think chasing after prey or being chased by predators). For those physics inclined people, you will find that our limbs are actually levers that transfer forces via the contraction of muscles. If the levers are misaligned the torque caused by the levers can magnify small forces into large problems. In my case the length of my left leg caused several problems:
- Vertical rotation of the pelvis to compensate for the short right leg.
- Improper curvature of the spine
- Improper load of femur onto the knee joint which leads to:
- Eversion of the foot and improper foot strike
All of these factors increased the probability of injury relating to knees, lower back pain, tight upper back and neck muscles, and likely an increased likelihood of ankle problems.
Factor 1 causes a number of problems mostly related to low back pain. First it may cause bone spurs along the pelvis. In my case they actually looked like devil horns which is a little scary! Second it causes the hip to rotate both back and sideways which causes the front of the “discs” to compress. Compression and degeneration of the discs that help to lubricate the joints between the back bones and sacrum lead to the constant dull pain and more importantly it impedes the transmission of important neuromuscular data between the lower extremities to the spinal cord and brain.
Factor 2 leads to the body constantly pulling in various directions to attempt to re-align the spine for optimal performance. This leads to muscle fatigue and neck pain.
Factor 3 probably led me to my ACL tear. If forces are not transferred perpendicular to the ground, the knee acts as a point of rotation and the femur acts as the lever. Since the femur is the longest bone in the body, it magnifies the force and may cause ligaments to weaken over time and eventually snap.
So the fix in the end involves a few changes to my biomechanics:
- Heel lift – The heel lift raises my entire right leg to level out the pelvis and therefore re-align the spine and lower extremities including the knee and ankle
- Pelvic Lift – This is a technique related to posture and not a product. Years of improper gait has caused compression and degeneration of the discs. I’d like the discs to regenerate and to do this I need to quit compressing them abnormally. Pelvic lift involves “pulling” the sacrum/cocyx (tail bone) up towards the belly. To do this while walking and running is a little difficult but usually involves activating lower abdomen muscles and “sucking in”. A chiropractor can do a gait analysis to determine what you can do to have a biomechanically correct gait.