Stability and Movement

Did you know that, in the massage therapy world, golfers are notorious for lower back pain? Massage therapists who work on golfers always know to include extra work in that area so that their clients can golf happily away (until their backs start to hurt again, that is). So in a sport where there is little bending or lifting of any kind and the impact seems rather low, what causes this frequent lower back pain?

Allow me to introduce the principle that different areas of the back have different functions. Yes, the overall and most important function is to provide your upper body with a strong support, but the back actually can be divided in terms of its functional ability. Starting from the top of the spine at the first cervical vertebra (C1), we'll work our way through the sections of the spine and briefly discuss how they are different, using the below illustration as a guide.

 

The upper five to six cervical vertebrae (C1-C6) are meant to lend support to the head as well as significant motion to the neck. Anyone who has had whiplash or a similar neck injury knows how suddenly the movement of the neck can be restricted when the muscles in that area tense up and refuse to let the vertebrae move in the way they are designed. This is a natural bodily response to keep you from injuring the neck further, but it is certainly painful and inconvenient. Most people enjoy relatively free movement of their necks and heads, however, due to the fact that these vertebrae have been designed to move freely.

The next section of vertebrae, ranging from C7-T7 (thoracic vertebra 7), is meant to offer stability to the rear of the ribcage and thoracic cavity. They can twist moderately, but are not meant to do so outside of certain limits because their main function is to protect the otherwise vulnerable lungs and heart, which sit in that body cavity. They also provide the stable base for the shoulders and arms, which branch out from the axial skeleton at that point and are the mobile portion of this body section.

Vertebrae T8-T12, on the other hand, are meant to twist more freely and allow the back some movement. If you've ever seen someone twist around to "crack" the vertebrae in their back, they are most likely doing this to the vertebrae in this section, which are supposed to provide mobility but may have become restricted over time. We would all be walking around like stiff sticks unable to turn and bend if it were not for the flexibility of the mid-back.

Finally, the L1-L5 vertebrae and the sacrum and coccyx are meant to provide a solid base for the low back. The sacrum and coccyx are also attached by ligaments to the pelvic girdle, which is the stabilizing area of the hips, protecting the genitourinary system and providing a stable anchor for the highly mobile legs, which branch from the axial skeleton at the hip joints.

So what does all this tell us about how we are supposed to move? Let us return to our golfers. The reason that the majority of them suffer from lower back pain is the fact that they are twisting a part that is meant to be a stabilizing region of the body. Of course, the lumbar vertebrae have some degree of flexibility and movement, but they are not designed to twist in the same manner as the thoracic vertebrae right above them. Many golfers will include a rather significant twist to the lower back when they follow through with their swing, resulting in the malady that afflicts them and which keeps many of them returning to their massage therapists after a weekend out on the green.

Another thing to note is that these segments of the spine alternate, and this trend actually continues down the entire body. The upper thoracic vertebrae are stabilizing, but the arms are highly mobile. The pelvic girdle is stabilizing, but the hip joints are meant for movement. The knees have significant movement in one direction (for purposes of propulsion), but twisting them significantly to either side is likely to result in a tear in the ligaments. The stabilizing knee joint, however, is followed by the very moveable ankle. As we can see, our bodies are designed in a wonderful fashion to provide just the right balance of stability and movement, and if this balance is respected, our bodies should continue to provide us with unrestricted movement for many years.