Often I get asked by people why do I have back pain but my friends and family don’t? What is it about my back that is different? There are many factors that contribute to back pain – genetics, activity throughout life, nutrition, stress and rest ratios, how you perceive pain and threats to your body. In my clinical experience, I have found that lack of movement and poor posture are common with back pain.
In this article I explain a theory called Ligamentous Creep, how it occurs, how it makes the spine more vulnerable to injury and pain and what to do to minimise the chance of it happening to you. Read on to find out more…
The Poisonous Weed of Inactivity
Sounds scary right? It is true that inactivity is like a weed. It sprouts one day quietly and then before you realise it’s everywhere throughout your life. You stop going to the gym, you stop cycling to work, playing frisbee with your friends in the park and then the couch becomes the love/hate friend you spend most of your time with.
A typical inactive work day includes getting up and sitting on the tube to work. Then sitting at work for 7 hours with minimal movement throughout the day, followed by more sitting on the tube home and then sitting to watch TV on your couch. Noticing the trend here? Sitting – it’s the fertiliser for weed growth.
Ligamentous Creep – How it occurs
In the spine you have the bones (vertebrae), intervertebral discs, connective tissues (ligaments, tendons), muscles, nerves and blood supply. Ligaments are super strong cables that connect bone to bone. They respond to tensile loading – being pulled apart. When they are lax, they give no support.
In a poor sitting position (see picture right) the ligaments at the back of the spine are being stretched and the ligament at the front of the spine is lax. Ligaments can be stretched but they do not return to their original length. If you sit like this throughout the day your ligaments will gradually ‘creep’ – or stretch over time. Do this for long enough and it will create an imbalance and leave you susceptible to pain and injury.
Why it leads to injury and pain
When the ligaments are overstretched it changes the posture of the spine. Remember the body adapts to its environment. Instead of the spine maintaining a neutral alignment that helps keep all the discs, nerves and vertebrae in place the spine warps into poor posture. This poor posture can encourage the discs to push out onto the nerves. It can cause impingements (pinching) of the nerve roots. It also changes the length-tension relationships of the surrounding muscles – so muscles that help maintain good alignment become weaker or tighter, the spine can become unstable and more susceptible to injury and pain.
How long does it take to ‘creep’?
Liagmentous creep happens over years. Often in my practice, I see clients in their mid 30s to mid 40s with ‘unexplained’ back pain. One day they just crouch down to put their socks on and their back ‘goes out’. The socks are the last straw. Chances are that if you are inactive and sit for work all day, ligamentous creep will occur without you even knowing over a number of years. Serious painful problems generally occur after 10-15 years of inactivity and poor posture.