What I'd like to do over the next couple of weeks is pose a joint by joint approach to low back pain, because I am a firm believer that low back pain is the final straw in the cycle, and something else is the actual problem. Someone doesn't just wake up with low back pain that hangs around for 20 years because they slept in a strange position. Today, I want to focus on the ankle and how the mobility of the ankle can lead to movement patterns that can lead to a manifestation of low back pain. This is outside of the box thinking, because how exactly does a bum ankle cause your back to hurt? We'll get there, just hang with me.
A rolled ankle is a fairly common condition that happens to the vast majority of people at one time, or another. It can occur while playing basketball and landing on another player's foot, or it can occur simply by stepping of a curb. The point is, ankle sprains are very common and are often treated with ice, an ankle brace, and maybe some Tylenol. After the pain is gone, the issue seems to be clear. But, what you lose when your ankle is injured is range of motion. The body doesn't want the ankle to flex and extend like it did before the sprain because it hurts. We're programmed to avoid pain, and this situation is no different. When an injury occurs, the body floods the injured area with blood and an inflammatory response occurs. Pain is the result, and we do everything in our power to keep the pain at bay by not moving the area unless absolutely necessary. And when we do move it, we move it just enough to accomplish our goal, whether that be walking, running, or driving a car. When the pain subsides, our brain is re-programmed in the 'new' range of motion we created during the injury, and if not rehabilitated, we lose a little bit of the motion we had pre-injury. Now compound that with the concept that a previous injury is the greatest predictor of a future injury, and we're talking a bunch of ankle sprains adding up to a significant loss of motion in the ankle.
So what does that have to do with low back pain? Think about bending down to pick up a box or walking up a flight of stairs. What do they have in common? Your ankle is very much involved in both of these actions. If your ankle doesn't move well, the motion is going to come from another area of the body...maybe the knee, the hip, or the low back. Over time, the area doing extra work can just get tired of having to pull all the extra weight, and pain can surface. Your ankles are the foundation to all of your movement that involves the lower body, so it would be a smart thing to make sure both have equal range of motion. Have a look at these two pictures:
Clearly, the right ankle is more mobile than the left ankle. This patient has dealt with low back for about 12 years, and has a history of multiple left ankle sprains. Over time, you can see the accumulation of injuries to the left ankle have decreased the ability to flex significantly when compared to the right ankle. This patient also has a lateral shift to the right when doing a squat pattern, which in all likelihood is a result of the inability to move through the left ankle.
Think about all of the motions that require the ankle to flex and extend. Every time you walk, the ankle has to move. If it doesn't move well, some other joint or muscle is going to work that much harder to accomplish what you are doing. Again, this can lead to pain and dysfunction popping up in areas that, on the surface, don't appear to be related at all.
To check your ankle mobility, you can do the exact same thing as you see in the pictures, or measure four inches off the base of a wall. Get in the same position you see in the pictures above, place your big toe on the 4" mark and try to bend your knee forward while keeping your heel on the floor. Being able to touch the wall with the knee AND keeping the heel on the floor indicates good ankle mobility. If you're not quite there yet, there are plenty of resources to help you with it, and I will be putting together a youtube channel in the coming weeks to provide mobility help for all of those tight and painful areas of your body.
The take home message is that pain is a crazy thing, and can manifest in an area simply because another area doesn't function properly. If you're struggling with pain, I would love to help you get to the bottom of it.
Email me with any questions, and thanks for reading!
activechiromadison@gmail.com
www.actmadison.com
Find us on Facebook!
Twitter
Clearly, the right ankle is more mobile than the left ankle. This patient has dealt with low back for about 12 years, and has a history of multiple left ankle sprains. Over time, you can see the accumulation of injuries to the left ankle have decreased the ability to flex significantly when compared to the right ankle. This patient also has a lateral shift to the right when doing a squat pattern, which in all likelihood is a result of the inability to move through the left ankle.
Think about all of the motions that require the ankle to flex and extend. Every time you walk, the ankle has to move. If it doesn't move well, some other joint or muscle is going to work that much harder to accomplish what you are doing. Again, this can lead to pain and dysfunction popping up in areas that, on the surface, don't appear to be related at all.
To check your ankle mobility, you can do the exact same thing as you see in the pictures, or measure four inches off the base of a wall. Get in the same position you see in the pictures above, place your big toe on the 4" mark and try to bend your knee forward while keeping your heel on the floor. Being able to touch the wall with the knee AND keeping the heel on the floor indicates good ankle mobility. If you're not quite there yet, there are plenty of resources to help you with it, and I will be putting together a youtube channel in the coming weeks to provide mobility help for all of those tight and painful areas of your body.
The take home message is that pain is a crazy thing, and can manifest in an area simply because another area doesn't function properly. If you're struggling with pain, I would love to help you get to the bottom of it.
Email me with any questions, and thanks for reading!
activechiromadison@gmail.com
www.actmadison.com
Find us on Facebook!