Lower Back Pain? Don’t Drag Your Feet!
Okay, that sounds more like the start of the motivational speech my parents used to give me when I was younger. Many of you may be asking yourself what does shuffling my feet on the ground have to do with low back pain? Well, a lot more than you might think.
When referencing lower back pain, this is the speech I find myself giving to more and more of my patients.
When we look down at the ground, we tend to bring our body into a position of trunk flexion. By this, I mean that your chest is coming forward over your toes. When this occurs, our center of mass starts to move forward and we create an anterior tilt through our pelvis.
When our center of mass comes forward we adjust our body position to maintain our balance by extending through our lower back and, on occasion, by going up onto our toes. The body corrects its position to maintain balance with changes being processed by the change in our visual field by looking down.
When we shuffle our feet, we typically create the habit of making our initial foot contact with the toes pointed down and then sliding the foot forward instead of actually rolling across the foot as one would walk with a normal gait.
A normal gait is to make initial contact with the heel and push off the toes. When I see people shuffle their feet, there is also a tendency toward reducing the amount of contact the heel makes with the ground. We refer to this as an ‘early heel rise gait’ and will often see this gait pattern in toe walkers. These individuals will hardly make contact with the ground through their heels. When we ambulate with this gait pattern, much like when we look down, we translate our center of mass forward. Again, to correct we typically go into back extension.
These tendencies toward back extension are what lead to the long-term potential problems.
First, there are the anatomical stresses that long-term extension can create. These conditions are often seen in increased arthritic changes in the lower back due to the increased stress through the facet joints in the spine.
Next, there is the tendency toward using you back extensors to perform lifting activities. Since these muscles are already being engaged to help you maintain your balance they will often fire more when you are lifting something leading to the increased likelihood of a potential muscle strain.
The next time you are out for a run or a walk my advice is to look up and enjoy the scenery and think about that nice heel to toe gait pattern. Your back and the rest of your body will appreciate you for it in the long run!
Written By: Nick Wegener, Director of Physical Therapy – PT, ATC, OCS, CSCS