10 Myths About Lower Back Pain (LBP)

[VonMeister]

I can compare notes. It sounds like you did get a deep tissue massage (that term has been used at the clinic I go to every 3 weeks). So did it feel almost painful when the PT dug in? Did the PT maintain the manual pressure for something like 30 seconds or more and was there a feeling that the tense muscle eventually gave way and softened a bit? Because that's the feeling I get, although I've been getting this treatment a long time now and I have learned to relax with the knowledge that although it might leave me a bit sore the next day its not going to damage me. Its also hard to be truly objective, but my feeling is that the next day there is less of a tension/knot even if there is a little soreness.

The idea is that a muscle in spasm/tense is not operating correctly, other related muscles need to compensate and therefore the body isn't operating the way it is supposed to. So by releasing the tension the body is more likely to move properly rather than build up imbalances. I'm just being the messenger here, I don't claim ownership of the truth.

As mentioned before I am do not have the skills and background to evaluate studies of the merits or otherwise of therapies, but I do place value in practitioners who have years of experience in fixing people and also my personal experiences as a patient. I think the massage helps.

The knee to chest stretch you mention - is that done lying on the back and holding the shin with the hands? I have been prescribed that one. Not an extreme stretch in any way, no body weight load leaning forward or anything, feels safe. I still do that although not as regularly as 2 other exercise which also feel low risk and prescribed when I was in that delicate state. I continue to do them because my feeling is that they have been good for me, although I can't know for sure.

You have to do what you think is best for you, but I would not be doing anything that the PT says you shouldn't or not approved and that includes squats and the stretch that gbg does, you might set yourself back - you saw how the strongman tweaked his back with a warm up load. I like the gbg stretch and thinking about introducing some squat variation training, but I'm not in that delicate state any more.

Whoever told you the stuff above took advantage of you during a time of stress. You should go back there and give a beating.

 

[Mr J]

...
Trigger points and muscle adhesions are made up terms to sell toys and ebooks to dummies like Gbg.

I've never been told I have a muscle adhesion. Trigger point yes, and someone would have made that term up, I have heard one of more massage therapists use that term, but not heard a doc use it.

So the symptom llilibel is describing about the muscle in his back feeling tense and hard, what is the correct terminology for that? Is it a muscle spasm?

 

[VonMeister]

Muscle spasm or nocebo. Pressing into injured areas is usually going to trigger a threat response. Thing is, unless there's noticeable swelling or or a structural issue like broken bones, then it's going to hurt for a different reason. You can't press on back pain and make it hurt...but driving your fingers into a body part will generally cause a pain response.

When you get a physical and the doctor presses into your abdomen, for me it hurts and is very uncomfortable....but that doesn't mean I have a tumor. I just don't like it.

 

[Mr J]

Muscle spasm or nocebo. Pressing into injured areas is usually going to trigger a threat response. Thing is, unless there's noticeable swelling or or a structural issue like broken bones, then it's going to hurt for a different reason. You can't press on back pain and make it hurt...but driving your fingers into a body part will generally cause a pain response.

When you get a physical and the doctor presses into your abdomen, for me it hurts and is very uncomfortable....but that doesn't mean I have a tumor. I just don't like it.

Would you call a muscle that is in spasm or experiencing DOMS injured? Because that is the situation I have had deep tissue massage for. Yes, particularly when I first experienced it, there was a threat response as you call it. The muscle resists the masseur, then as the masseur persists it gives way and becomes less spasmed than prior to the massage. I'm fairly used to it now, so my threat response is generally not much or not there.

Although occasionally I will wince if a sensitive part is particularly tight. Its really only just below my hip bones which are really sensitive though, that region probably gets tight from skateboarding and surfing.

 

[Mr J]

..so the PT dug into that muscle hard. He told me to mimic that with a tennis ball at home, which I did that evening.
… .

Just comparing notes here. You should do what the PT says, however a tennis ball won't do anything for me, its too soft. I have a hard spiky ball and a firm foam roller, however I have never been successful at releasing any muscles in my back with those. The difficulty with self massage is that it is hard to relax when you are trying to support yourself on top of some massage object.

I sometimes get tight/sore glutes and sitting and rolling back and forth on the foam roller does work. Similarly I can get the spiky ball into a certain hip/glute area with my weight on top of it. The PTs and masseurs have an expert touch so it can be hard to know how much pressure to apply, but because I have had it a lot I have got a feel for whether I am successful in releasing any spasm or not. You could always ask your PT about the spiky ball if you feel the tennis ball isn't effective.

 

[VonMeister]

Would you call a muscle that is in spasm or experiencing DOMS injured? Because that is the situation I have had deep tissue massage for. Yes, particularly when I first experienced it, there was a threat response as you call it. The muscle resists the masseur, then as the masseur persists it gives way and becomes less spasmed than prior to the massage. I'm fairly used to it now, so my threat response is generally not much or not there.

Although occasionally I will wince if a sensitive part is particularly tight. Its really only just below my hip bones which are really sensitive though, that region probably gets tight from skateboarding and surfing.

This is an issue that exists in the brain, not the body part. Knowing this is true...what is the masseuse doing?

 

[VonMeister]

Just comparing notes here. You should do what the PT says, however a tennis ball won't do anything for me, its too soft. I have a hard spiky ball and a firm foam roller, however I have never been successful at releasing any muscles in my back with those. The difficulty with self massage is that it is hard to relax when you are trying to support yourself on top of some massage object.

I sometimes get tight/sore glutes and sitting and rolling back and forth on the foam roller does work. Similarly I can get the spiky ball into a certain hip/glute area with my weight on top of it. The PTs and masseurs have an expert touch so it can be hard to know how much pressure to apply, but because I have had it a lot I have got a feel for whether I am successful in releasing any spasm or not. You could always ask your PT about the spiky ball if you feel the tennis ball isn't effective.

This is important.

These are things that make you feel better. These activities are not "fixing an injury". What does this tell us? That as humans touch has an emotional response. Specific to llilbel03, your back is fine and perfectly normal. It's time to clear the mental hurdle. You can't turn it off, but knowing you are perfectly fine and there's nothing you can physically do that's going to cause a relapse is your cure. Convincing yourself of that is another story. Go do something you don't think you can do.

 

[Havoc]

I think erector spinae, the long muscles going vertically up the side of the spine- the right side was much more tense and hard and even I could feel it protruded more than the left side, so the PT dug into that muscle hard. He told me to mimic that with a tennis ball at home, which I did that evening.

I don't know if it was the massaging, but the day after (yesterday) my back was really sore again. Like, fuk me, three steps backwards. Even today, left side, above and under hip bone still really sore. It hurts when I bend over (like gbg self suck stretch, which I've also been doing). Glutes? Sacrioliac? I have been doing a lot of squats, unweighted and with 10lb dumbbells.

One thing the PT's (there were two, one was probably a supervisor/teacher) prescribed which I had not come across, either googling or in this thread, was the knee lift. They noted that the pop up involves pulling your legs up under your torso. So they recommended, first do burpees one leg at a time since I told them I'm not ready to do them both legs. And then a knee lift with a resistance band. All the squats and deadlifts (when I eventually get to them) involve pushing with the legs, not pulling them up to the chest.

The knee to chest stretch is also the one that feels the best right now...

Discuss.

If u low bar squat n do u will train those muscles. Think of ur back as a crane

 

[One-Off]

This is important.

These are things that make you feel better. These activities are not "fixing an injury". What does this tell us? That as humans touch has an emotional response. Specific to llilbel03, your back is fine and perfectly normal. It's time to clear the mental hurdle. You can't turn it off, but knowing you are perfectly fine and there's nothing you can physically do that's going to cause a relapse is your cure. Convincing yourself of that is another story. Go do something you don't think you can do.

Been thinking that when I start running my back feels sore and tender but after a while it goes away. I've tried a couple times to do pop ups and/or burpees and just winced in pain. I've been thinking I should just keep on and maybe, like the running, the pain will go away...

By the way, the hard protruding muscle was diagnosed ( and they made me feel it- "See how it is harder and more prominent than the other side?") before the massage. I felt better after the massage ( don't you always feel better after a massage?), but the next day I was more sore than usual. Tomorrow I have to sit in a meeting all day tomorrow but will try the burpees in the PM.

 

[surfbum00]

Not medical evidence. This is provable science here. Not some sh!t a guy with an online degree in some bullshit therapy or some garbage learned in strip mall college.

Unless there has been a previous surgery at the site which resulted in scar tissue, there is no such thing as a "muscle adhesion". Further, if there was previous surgery and you developed this tissue condition it is 100% impossible to relieve this condition manually and it requires further surgery....if it is decided to be medically necessary.

Trigger points and muscle adhesions are made up terms to sell toys and ebooks to dummies like Gbg.

plenty on papers state that trigger points exist

 

[VonMeister]

Nope

 

[gbg]

Know it all that knows nothing

 

[surfbum00]

Nope

There is just look for them

 

[VonMeister]

There is just look for them

There have been studies done on muscle adhesions and trigger points. Casting aside the magic hands of your favorite strip mall therapist, in a clinical setting using real scientific method it was disproven. The last one I read used several patients with trapezius pain. When the pain was localized and tested using a pressure algometer it was found that the pain points, or knots were usually the softest part of the muscle tissue. Further thirty percent of the sensitive spots identified by hand were not identified by the more accurate algometer.

It feels like we are leaving the period of fantasy explanations for real phenomena, but it's been around forever so who knows. There's a large community of "therapists" who are obsessionally committed to providing explanations for ailments and subsequent therapy that is unsupported by a scrap of evidence, NOT A SCRAP, except for their claimed therapeutic success. Even making the assumption that they are well intentioned, science is science and we know enough about muscle tissue today to cast 100% doubt on silly bullshit like random muscle adhesions.

 

[surfbum00]

There have been studies done on muscle adhesions and trigger points. Casting aside the magic hands of your favorite strip mall therapist, in a clinical setting using real scientific method it was disproven. The last one I read used several patients with trapezius pain. When the pain was localized and tested using a pressure algometer it was found that the pain points, or knots were usually the softest part of the muscle tissue. Further thirty percent of the sensitive spots identified by hand were not identified by the more accurate algometer.

It feels like we are leaving the period of fantasy explanations for real phenomena, but it's been around forever so who knows. There's a large community of "therapists" who are obsessionally committed to providing explanations for ailments and subsequent therapy that is unsupported by a scrap of evidence, NOT A SCRAP, except for their claimed therapeutic success. Even making the assumption that they are well intentioned, science is science and we know enough about muscle tissue today to cast 100% doubt on silly bullshit like random muscle adhesions.

I not suggesting either way & there needs to be more research done into this area as well as many other areas of the human body, however, a lot of the research/studies that have already been written/ conducted & published, have been carried out by people with medical degrees/phds & etc & not just ‘strip mall therapists’ as you put it.

 

[VonMeister]

I not suggesting either way & there needs to be more research done into this area as well as many other areas of the human body, however, a lot of the research/studies that have already been written/ conducted & published, have been carried out by people with medical degrees/phds & etc & not just ‘strip mall therapists’ as you put it.

The research is done. There is no such thing as a spontaneous muscle adhesion. If there were, it would be a neurological issue and then only temporary. Muscles contract and release due to inputs from the CNS. Muscle fibers can't stay in a contracted state indefinitely. Biologically, chemically, physically impossible. Muscle fibers also don't get hung up on each other. If they did everyone would be crumpled up in pain because everyone on earth contracts and releases every muscle in their body all day every day. It's a silly concept on its face and a stupid concept under scrutiny.

 

[encladd]

There have been studies done on muscle adhesions and trigger points. Casting aside the magic hands of your favorite strip mall therapist, in a clinical setting using real scientific method it was disproven. The last one I read used several patients with trapezius pain. When the pain was localized and tested using a pressure algometer it was found that the pain points, or knots were usually the softest part of the muscle tissue. Further thirty percent of the sensitive spots identified by hand were not identified by the more accurate algometer.

It feels like we are leaving the period of fantasy explanations for real phenomena, but it's been around forever so who knows. There's a large community of "therapists" who are obsessionally committed to providing explanations for ailments and subsequent therapy that is unsupported by a scrap of evidence, NOT A SCRAP, except for their claimed therapeutic success. Even making the assumption that they are well intentioned, science is science and we know enough about muscle tissue today to cast 100% doubt on silly bullshit like random muscle adhesions.

Not trolling. You seem very knowledgable about the body. Is this bullshit?

Clinical Relevance of Fascial Tissue and Dysfunctions - Current Pain and Headache Reports

Fascia is composed of collagenous connective tissue surrounding and interpenetrating skeletal muscle, joints, organs, nerves, and vascular beds. Fascial tissue forms a whole-body, continuous three-dimensional viscoelastic matrix of structural support. The classical concept of its mere passive...

link.springer.com

 

[surfbum00]

Not trolling. You seem very knowledgable about the body. Is this bullshit?

Clinical Relevance of Fascial Tissue and Dysfunctions - Current Pain and Headache Reports

Fascia is composed of collagenous connective tissue surrounding and interpenetrating skeletal muscle, joints, organs, nerves, and vascular beds. Fascial tissue forms a whole-body, continuous three-dimensional viscoelastic matrix of structural support. The classical concept of its mere passive...

link.springer.com

Quite an old paper, & there are others since that say the opposite

 

[VonMeister]

A lot of that research is driven by fibromyalgia and other chronic pain syndromes. I'll link one below. The common theme under scrutiny is that there are confounding, but leaning towards general classification as a neurological disorder. There has simply been zero evidence of a physical injury that can cause this. There are a lot of recognized diseases that can attack different parts of the body, like MS as an example. The research in this are is sound.

"Therapists" have used or misunderstood this research to come up with the trigger point or adhesion syndromes and the manual release therapies that can cure this. It helps create a false nociception of a pain stimuli and a emotional response to manual stimulation. Then they invented hard patches of muscle to defend this, but clinically these hard patches of bundled fibers have never been found.

I've always maintained that stretching, massage etc feels good and if it helps someone but all means do it. At the same time it's important to understand and convey the message that these are not cures and chronic pain goes much deeper than just tissue. Instead through ignorance (I believe this is mostly the case) or vile behavior many of these "therapists" build in the belief that a person is broken and without their services unable to live a complete and pain free life. At this point the mental or emotional hurdle of being in pain can never be cleared because the dependence is built into the patient in the same way that caused opioid addiction to become an issue.

 

[encladd]

A lot of that research is driven by fibromyalgia and other chronic pain syndromes. I'll link one below. The common theme under scrutiny is that there are confounding, but leaning towards general classification as a neurological disorder. There has simply been zero evidence of a physical injury that can cause this. There are a lot of recognized diseases that can attack different parts of the body, like MS as an example. The research in this are is sound.

"Therapists" have used or misunderstood this research to come up with the trigger point or adhesion syndromes and the manual release therapies that can cure this. It helps create a false nociception of a pain stimuli and a emotional response to manual stimulation. Then they invented hard patches of muscle to defend this, but clinically these hard patches of bundled fibers have never been found.

I've always maintained that stretching, massage etc feels good and if it helps someone but all means do it. At the same time it's important to understand and convey the message that these are not cures and chronic pain goes much deeper than just tissue. Instead through ignorance (I believe this is mostly the case) or vile behavior many of these "therapists" build in the belief that a person is broken and without their services unable to live a complete and pain free life. At this point the mental or emotional hurdle of being in pain can never be cleared because the dependence is built into the patient in the same way that caused opioid addiction to become an issue.

I agree with all of this. I also agree with treating the symptoms along with the underlying issue for the placebo benefits alone. As you've made clear, the brain is powerful, and if it can trick us into thinking we're injured we can surely 'untrick' it.