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The misalignment cause of Back Pain

        Chronic back problems exist when your pelvis tilts down in front, and your position is formed in the shape of hard fascia.  This has usually taken a long time to develop and the tilt is now the shape of your body.

        So you can’t just un-tilt to a less tense and balanced stance.  Fascia doesn't “let go” the way a muscle will when you turn off its nerve signal. You can’t think or affirm tilts away.  They are physically formed by hard, dried putty.
         So, instead, you compensate by tilting some other part of your body in the opposite direction.  You curve backward above the waist. This is how you "straighten up."  But you will have to tighten your back muscles to do this.  Then you may feel pain in your lower or middle back.
         If the compensating tilt of your back is at too sharp an angle you’ll also squeeze vertebrae together and compress the disks between them.  And that can cause injury.

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by Lou Gross, School Certified Master Postural Integrator
27 years successful track record
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        Think of your pelvis as a box.  It’s a big bony structure connected at the bottom by muscles in your legs and at the top by muscles in your abdomen, sides and back.  At the bottom, thigh bones connect at your hip joints, and at the top, the spine connects in your back.
        This box can swing and tilt.  You can lean forward and back and from side to side.  You can rotate your pelvis left and right on your legs and rotate your upper body, above the pelvis, at your waist.  You can do all this because you have conscious control over the movement of these muscles.  And when the muscles move, the bones of the pelvis, legs and spine move.  And “you” move.

        If your pelvis is tilted too far in any direction, you’ll fall over unless you compensate by tilting some other part of your body in the opposite direction.  You’ll tilt either at your waist or at your hip joints.  In both cases you will have to tighten your back muscles to do this.  If the compensating tilt is at too sharp an angle you’ll squeeze vertebrae together and compress the disks between them.  Then you may feel pain in your lower back.
        You can try it now.  Tilt your pelvis down in front and arch your back. See how you feel.  Now try tucking you buttocks down in back and letting your chest collapse into your abdomen.  In both of these “exercises,” you can easily come back to a relaxed and more balanced position since you have the muscle ability to “un” tilt. 

        But chronic back problems exist when your tilts are formed in the shape of hard fascia.  They usually have taken a long time to develop and they’re now the shape of your body.  So you can’t just un-tilt to a less tense and balanced stance.  They don’t “let go.”  You can’t think or affirm them away.  They are physically formed by hard, dried putty.  As I explain later in this book, emotional and digestive conditions do influence the amount of tightness or looseness in our backs.  But once the fascia gets bunched-up and hard, that degree of tightness is “a done deal.”  And it can only be lengthened by getting the fascia to soften and then be pushed into a longer shape.


        When we hold in emotions, much of it happens in the abdomen.  Emotions are “energy motion” in the body.  An ingrained pattern to keep emotions in check requires a person to tighten the external walls of the abdomen, the muscles of the sides and lower back, the internal and external muscles of the pelvis, the internal muscle of the diaphragm. and even the hamstrings in the back of the thigh.  It also requires tightening our old friend, the psoas.  As these structures were repeatedly tightened, the fascia around and through the muscles grew into that restricted shape.  And now the muscles have to stay tightened.
        The person’s physical body is now “designed” to hold in emotions.  Even if their mental intentions are to let the emotions out, the nerve signals to the muscles have little effect.  This is why Structural Integration Bodywork helps psychotherapy so much.  It lengthens and loosens the serious chronic shortness and compression in all these muscles.  That allows the person to feel, identify and express emotions far better than he (or she) has been able to do in years.

        In the fascia of the psoas muscles is imbedded the nerve plexus for the intestines.  So holding in our guts tightens the psoas and also creates intestinal constipation, diarrhea and/or spasms.  All this tightens the lower back.  In addition, the psoas and iliacus muscles are controlled by a subconscious reflex connected to the Chinese Medicine kidney “system.”  This “system” tightens in response to fear.  So fear, too, tightens the lower back. (And now you know a scientific reason why cartoon characters look so swaybacked when they’re running away in fear.)
       When people learn healthy ways to release the emotions they hold on to, their lower back pains often get better.  Their expression removes the direct cause of further torso tightening.  And it gives the back a chance to loosen up from some of its old tightness.  This is especially true after some of  this Bodywork has freed up the hardened fascia.


        Now I’ll spend a few sections describing the reasons people have one kind of back pain or another.  In all cases, lower and middle back pain (and most upper back pain) occurs when the back muscles are tightened - usually automatically - to compensate for shortened leg and abdominal muscles.  And it’s almost always accompanied by a tilted pelvis.  There is a very clear relationship between the way the pelvis is tilted and the kind of attitude about life the person has.  These sections will elucidate on that.
        Rather than being a second compensation on top of the first tilt, tucking the buttocks down in back can be thought of as an alternate way to compensate for short psoas and iliacus.  The person simply chooses another way to stand up against “the forces of the world.”
        The choice of tilting forward or backward occurs out of experiences in childhood, including parental and cultural conditioning.  By the time we’re seven years old, the form has been set in our fascia, and the pull of gravity, over time, increases the distortion.  This happens for both males and females and can create tension and pain after many years.  Often times, an injury or repeated intensive activity suddenly makes the condition much worse, so that it needs therapy.  High heels significantly accentuate misalignments and are often the cause of physical problems.

        Whatever physical or emotional way we “bunch up,” the major cause of back pain is always our imbalanced relationship to the pull of gravity.  Gravity is the most consistent and most pervading force on our physical bodies.  Even though we usually don’t think of it in this way, you can see from my preceding discussion that our bodies are very involved with gravity just to stand up.

        Comparing the two general patterns helps us understand them better.  Instead of curving backward above the pelvis, alternate compensation people curve backward below the pelvis.  Instead of pinching the vertebrae in the middle of the lower back, they pinch the buttocks into the hamstrings.  Curving backward above the pelvis is a “straining up” posture.  Curving backward below the pelvis is a “collapsing down” posture.
        Let’s assume the Basic Imbalance to start with; the pelvis is tilted down in front.  In the first case, the person tries to pull the front of the pelvis back up, literally, by pulling up and back against the force of gravity.  Unfortunately, the only way to do this is by also pulling down and tightening the lower back.  To lift up the front of the torso with muscular effort, you have to pull down with the muscles of the back.  It’s a lever action and the pivot occurs right at the vertebrae numbered L3, in the middle of the lower back.
        As the person bends backward with the lumbar spine, it pushes the belly out to the front and pushes the upper torso up and to the back.  Even though the chest gets tight and is pulled down by short fascia, this bending backward is also a way of pushing the chest up.  Then, because of the curve of the spine, this forces the head and neck to jut forward.  The person is straining to stand upright, and technically, is trying to pull the pelvis horizontal.

          In the other compensation, the people try to push the front of the pelvis upward, from below.  They do this by pulling the bottom of the buttocks down, which also pushes it toward the front of the upper thighs and up into the bottom front of the pelvic area.  Pulling the buttocks down also pulls down on the rest of the back.  So this, too, is a lever motion, to try to get the front of the torso up.  But it starts a little lower to the ground and significantly, occurs in the legs and lower pelvis rather than in the torso.  People who’ve done this often have exceptionally dense, tight thighs.  The pivot is at the hip joints where the thighs connect to the pelvis.  Again, it’s an unconscious attempt to correct the tilt and make the pelvis horizontal.  And like the first method of arching with the back, this dipping of the buttocks is an over compensation.
        Neither approach really corrects the original shortness.  They just add their own versions of more tightness.  And psych-somatically, the person has created a rigid stance in his or her way of relating to all his daily events and interpersonal relationships.
        The person is either straining up against things so "Nothing will pull me down.  I can stand up to all the forces of the world by myself.  I am the responsible and capable one."
         Or, the person has already given in to the forces and continually strains to stand up on top of that.  There is also resentment and resistance in the back of the thighs.  Many of these people may seem to ask for help, but then resist it as soon as it's offered.  The straining part above the pelvis is not the same "person" as the extremely tight part below the pelvis.


        Carpal Tunnel Syndrome is an inflammation of the tendons and tendon sheaths in the wrists.  This condition also originates from tight arms.  For computer data entry personnel and newspaper reporters, the latest term for the problem is “Computeritis,” because they type on computers.

        I worked on an inflamed wrist tendon problem for a 32 year old woman just out of graduate school.  She could no longer write without pain occurring in her wrists, hands and forearms.  Some of it would hurt all the time.  She was also a very “tight” person, all over her body, and had had an exceptionally tense family life.  She’d had knee problems due to tightness for years.
        After I spent three hours doing her arms, her grip was much stronger but she still had localized pain in the wrist, yet now only when she tried to write.  The tendons and their sheaths were still inflamed, but the original cause, the tight muscles from chest to shoulder to fingertips, was better.
        I did notice, though, as I worked further and further up her arm, that the tight muscles in each section had contributed to the hand and wrist problem.  Even after I’d loosened up to her shoulders, her grip did not come from her whole body, which was still chronically tight.  All she still had available to her, in large range of motion, were the arm muscles that I’d lengthened.


        The pelvis is the largest and heaviest weighted area of our bodies.  And the thigh bones are the longest bones in the body.  The hip joints connect these together, and they are very strong ball-in-socket mechanisms that allow a lot of movement.  So our pelvis and thigh area is very solid, very strong and very flexible.  Further, this powerful part of us stands on and is connected to, the ground, which is 8000 miles thick and made of rock.

        The arms and shoulders, on the other hand, are much smaller in both bone and muscle mass, and the shoulder area has a less stable but much more flexible joint system.  Your arms and shoulders are connected to the air, an enormously spacious place, but one lacking anything you can stand on the way you can stand on the ground with your legs.

        The best, and least painful, way to use our bodies is to take advantage of this situation:  How we’re built and what we’re connected to.  Since we are not fully educated in just how our body structures are designed to work, we don’t use them to the best of their abilities.  The purpose of this chapter is to clarify this anatomy so you can get a better idea of what you can be doing.  Then you can seek out Bodywork and Movement Training that will help you live to more of your potential, and with less tightness and pain.
        The major thing we do wrong is have locked and rigid pelvic-hip areas and then try to use more effort from the shoulder and arm areas than they are designed for.
          If we learn to use our pelvis, hips and thighs as the power source, and the upper limbs as the directors of this power, we’ll be able to do more with less strain.  That’s a good idea in the context of this book because much of that strain occurs in the back.



        The structure of the head, itself, gets tight.  The head is not a hard ball of bone, stuck rigidly on the end of a stick we call the spine.  The head is a dynamic structure of 25-30 inter-locking bones with interconnecting muscles, tendons, ligaments and “sheets” of tough fascia.  It’s designed to expand and contract, once every four seconds or so, to pump the cerebro-spinal fluid up the spinal column into the brain cavity.
        And all these muscles of the head end up connected to the neck.  They’re called pre- (or “in front of”) vertebral muscles.  The eyes, the facial muscles and the jaw all connect to the front side of the spine in the back of the neck.  Therefore, any tightness held in the face, skull or jaw tightens the neck by pulling the vertebrae closer together and accentuating their curve.  This tightens the rest of the spine, too, and creates tension in many muscles.  This section will describe to you the many ways it happens.

For starters, you can try it now yourself.  Tighten your face hard and sense what happens to your neck.  Now imagine what’s happening for you all the time, with your undetected, chronic head tightness.


        As I mentioned in the section on arms, energy flows run up and down the body.  Almost all of them run through the head.  And the few that don’t reach into the head do run through the shoulders and neck.  So a tight head blocks or constricts energy flow in the arms, legs and torso and creates tightness in the muscles where the flows run through.

        Of special interest are the three “yang” meridians whose energy flows start in the head and run down through the neck, torso and legs, and end in the feet.  Together, they form a “covering” over the outer portions of the body.  They run down the front, back and sides.  These are the energies of “doing outwardly” in the world.  And they indeed run through the middle of our big external “doing” muscles.

        At their terminus in the feet and head these flows connect to (or become) three “yin” energy meridians.  The yin flows then run upward from the inner arches of the feet, along the inner muscles of the legs, and up the central column of the torso to the head.

        The “yin” meridians provide energy into the functions that the “yang” meridians accomplish, sort of like supplying energy from a battery to power our motors.  So it’s a loop; nourishment coming up through the center; accomplishment flowing down the outside.
        The yin is also supposed to settle into the body and promote relaxation and rejuvenation, when we’re not busy doing.
        But a tight head and neck “locks” the energy up at the top of the body;
less continuous flow circulates.  The yang keeps pulling more and more energy from the yin sources.  This actually makes the head structure even tighter and drains our storage batteries.  People’s energies get “used up,” and they burn out.  And this is one of the physiological results of stress.


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