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The Good & Bad Of Spinal Mobility

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Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)

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Do you need better spinal mobility? This is something I hear A LOT in the fitness industry and more and more in the physical therapy world. At first glance, you might think, “what’s wrong with aiming to have more spinal mobility?” After all, most of us have heard the stat of 80% of people are going to have low back pain at some point in their life right?

Our fascination with mobility (it used to be flexibility but we just changed to mobility) has always been there. If you have pain and discomfort anywhere, you obviously need more mobility right? If you have low back pain, then you need better spinal mobility. Well, it isn’t as simple as that, and I wanted to explore some considerations when it comes to thinking about spinal mobility.

The Bad

Let’s see where spinal mobility could be bad out of the way! When people are diagnosed to have structural issues of their spine and there are concerns whether that is causing low back pain, spinal mobility would be a very bad idea. I’ve tried to share with people the great amount of science that shows a lot of people with low back pain actually have TOO much movement of the spine. This is why fusions are often used to stabilize the areas that are too mobile and causing issues.

low back pain

Having such people do a lot of spinal mobility work could actually cause way MORE problems! A similar issue arises when we evaluate someone’s spinal mobility. I am all for looking at spinal mobility, how we move, where do we move from, where do we lack movement, but screening/assessing and training are very different ideas.

Josh for example, has several lumbar fusions so you will see he can’t get the normal curve in his low back and this puts more work through the hamstrings and thoracic spine area. He can touch his toes but HOW he touches his toes is important. 

When we look at someone’s spinal mobility (in lateral flexion, extension, flexion, and rotation) we need to know how much pain they have first. If they have noticeable pain, then very quickly we know that the nervous system could be putting the brakes on and the lack of mobility is more of guarding than it is lack of the joint being able to move.

If there isn’t a presence of pain, but maybe past injury or instability, the body can reduce its range of motion like Michele Desser of Functional Movement Screen explains below…

In these cases, focusing on stability (especially of the core) while also working mobility will create better results.

The Good

Hopefully what you got from the above discussion is that we need to be a bit more thoughtful of what is going on with someone before we start just asking them to do tons of spinal mobility work. With that said, spinal mobility CAN be helpful if it is done in the right ways and the right circumstances.

For people with non-specific low back pain (there is no obvious structural reason they are having low back pain) specific spinal mobility methods can be helpful. If we know people either don’t move, or move in very repetitive motions (like many athletes do) they can start having alterations of their fascia. This connective tissue not only covers muscles and joints, but individual muscles fibers and our organs as well. Fascia is how our entire body becomes interconnected.

What research has shown is that if we don’t move, have an injury, or do too much of the same movement over and over, our fascia can start get “gluey”, meaning it doesn’t move like it should. In fact, new research has shown the thoracolumbar fascia actually can play a big role in non-specific low back pain. “the tightly contiguous myofascial tissue is generally recognized as possible cause of nonspecific low back pain.”

posterior oblique sling

All that “white stuff” in the middle is your thoracolumbar fascia. 

It isn’t so much the joints stop moving by themselves, but the fascia makes it difficult for all the tissues to move. Since there are also nerve fibers in the fascia, when we then try to move with the fascia in not great shape, we can experience what is known as myofascial pain. This is thought to be very common in people with non-specific low back pain because MRIs and x-rays don’t pick up such issues and yet many can experience pain.

More modern pain science is also teaching us that issues like low back pain are impacted by both social and psychological issues. Those in jobs they greatly dislike are twice as likely to experience low back pain, those with childhood traumas are more likely to experience low back pain, those in unhappy relationships have also been shown to be more likely to have low back pain. That is why Josh and I have been pushing for more of our Myofascial Integrated Movement drills.

Since research shows moving mediation, breath work, and myofascial stretching can help reduce chronic pain and improve function, it makes sense it should be an integral part of what we do in training. How do we do it? I show a few examples below, but we will cover much more detailed coaching in upcoming posts. What these movements do better for spinal mobility is that they work integrated movement with stability coming from the feet, core stability from specific breath work, integrated hip and spinal movement, as well as other limbs such as the arms helping. Such movements have been shown to be incredibly effective for helping mobility and reducing pain.

joint mobility

Once you have a better understanding of the multiple factors that impact and dictate spinal mobility, we can give better and more specific solutions for each person. That is the cool part of having a better understanding of the body and the issues we are addressing, we can help more people!

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