Back Pain Expert Dr. Sean Wheeler: The Compensations We Make for Body Stability

The BRACING Series: No. 5

By Sean M. Wheeler, M.D.

In my preceeding column in this series, we discussed the gap between the way we've learned to move throughout our lives and the ability of our bracing muscles to stabilize us enough to execute those movements.

As we grow, stability leads to coordination.  If we get injured or become sedentary, however, we lose our stability but not our coordination.

This gap between the stability we should have to move the way we do and the stability we currently have is called a bracing deficiency.

The inevitable result of this “bracing deficiency" is that our bodies must compensate or cover for our weakening bracing muscles, a process which leads to a further weakening of the bracing muscles and still more compensation. This deficiency can only be addressed with a dedicated focus on strengthening the bracing muscles in isolation.

Your body's compensations resulting from bracing deficiency occur without negotiation as the body must be stable.

For example, the hamstrings take over when the bracing muscles of the lumbar spine weaken, in an unconscious effort to stabilize the lower back. As this becomes ingrained, the hamstrings over time adjust to their new role, a job they can do better by remaining shorter and tighter, thereby causing a loss of flexibility.

A second way the body compensates for bracing muscle weakness in the lower back is by tightening the joint capsules of the lumbar spine. This process gives the spine a little more stability but takes away some of its motion. Both of these compensation scenarios are reversible.

By reclaiming the strength and endurance of your bracing muscles, you can recover from these two forms of bracing deficiency.

A third compensation scenario, however, is not reversible:

If the compensations last for years, the body will begin to build bone around the joint in an attempt to stabilize it. This bone growth is known as arthritis. Some forms of arthritis are inflammatory, but most cases of it are a form of body stabilization.

A spine which is stabilized by its bracing muscles is a spine which maintains its motion, which materially decreases the chance of experiencing chronic pain.

In contrast, a spine stabilized by inflexible action muscles, joint capsule tightening and, eventually, arthritis, achieves the "stabilization" effect through immobility. The result is a higher incidence of chronic pain.

These body compensations change the way you move, interact, play and age--in short, they change the way you live.

I see patients all the time who have bracing deficiency, patients who believe that joining a gym will somehow remedy their deficits. They begin to exercise their action muscles as a cure-all and get hurt as the compensations and lack of stability can't support their new level of activity.

I treat their pain and direct them to specialized physical therapy to re-focus on their bracing muscles to close the bracing deficiency.

This week's bracing muscle exercise targets the small muscles of the feet.

Though flexibility and mobilization of the feet are also a priority, this exercise is designed to improve endurance in the small muscles of the feet by creating oxygen debt.

When you perform the exercise in the video, remember to "dome" the foot for at least 30 seconds to achieve a prolonged decrease in blood flow in the muscle.

Do this exercise several times throughout the day.

Good luck.

Apr 28 2017
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