My Back Recovery: Recovering from Chronic Low Back Pain   /     05. Movement Control – Supporting Your Spine

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Movement control not only helps you control your posture and position whilst exercising but can also help you adjust exercises to your own personal needs by controlling stress and strain on the spine. This episodes guides you through impaired movement control, lists exercises to improve your ability to control movement and talks about the resulting benefits in your experience of pain and everyday activity.   Movement-Control – a Basis for Healthy Training   Therapists and trainers have always highlighted the value of good posture and position, and now science also backs up the importance of movement control for people recovering from chronic low back pain.   Traditionally movement control is taught by therapists and trainers in order to gain control over the position of your spine as a basis to: exercise in a healthy way adjust exercises to your own needs control stress and strain on your spine in your everyday activities   Your brain adapts according to your needs There is scientific evidence to promote movement control as a therapy approach. Today it is widely accepted that chronic LBP is often not caused by a single structure at fault in the back. At least this is the case with 80-95 %, which is why this group is called non specific low back pain.1,2,3,4,5,6, Recent research points out that there is growing evidence of changes in the brain with people with chronic pain.7   Chronic pain patients sometimes have a decreased cortical representation of the affected body parts8,9 - which in the case of LBP is also shown by diminished movement control.10 This means that when you want to make a movement without moving your back you are unable to do so, and instead you still move your back because you can’t control it. This movement sometimes happens without you even noticing it.   Practicing movement control can lead to a better representation of your different body parts in your sensual cortex , which is a section in your brain that makes you feel your body surface. Imagine a musician, they will have much better cortical representation of their hands than someone who has not acquired this coordinative skill. Your brain adapts to how you are using your body. What some research suggests is: The better your body is represented in this part of your brain (and you can train this through movement control) the less pain you will experience if you are suffering from chronic pain.11,10,12,   Basic Anatomy for practicing movement control: Your pelvis is connected to your thigh-bones as well as your spine. Therefore when you tilt your pelvis up or down, the position of your spine changes too. It’s also necessary to understand that the neutral position of your lower spine is a curved line (looking at it from the side). Keeping your lower back slightly curved during different exercises without moving it is often a goal in movement control. A good way to start practicing movement control is to learn how to tilt your pelvis in different positions and become conscious of the resulting movement in your lower back. Listen to the podcast, episode 05, “Movement Control" at www.mybackrecovery.com to learn more about movement control for people recovering from low back pain.   Videos: find all the resources at: http://mybackrecovery.com/resources.page watch the clip introduction quadruped - position supine side lying position seated standing position lean forward from a seated position without moving your back as a movement control exercise. If you do it correctly your back will not change its curvature while leaning forward, therefore the movement is coming from your hips. example test movement control Literature: Burton a K, Balagué F, Cardon G, et al. Chapter 2. European guidelines for prevention in low back pain : November 2004. Eur Spine J. 2006;15 Suppl 2(2006):S136-68. doi:10.1007/s00586-006-1070-3. Raspe H. Gesundheitsberichterstattung Des Bundes - Rückenschmerzen. Heft 53. Berlin: Robert Koch-Institut; 2012. Goertz M, Thorson D, Bonsell J, et al. Adult Acute and Subacute Low Back Pain. 15th ed.; 2012. Acute A, Pain M, Group G. Evidence-Based Management of Acute Musculoskeletal Pain. Pain. 2003;370(9599):63-82. doi:10.1016/S0140-6736(07)61670-5. Bernhard A, Bundesärztekammer, eds. Nationale VersorgungsLeitlinie Kreuzschmerz. Langfassun. Berlin: Ärztliches Zentrum für Qualität in der Medizin; 2015. doi:10.6101/AZQ/000250. van Tulder M, Becker A, Bekkering T, et al. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006;15 Suppl 2:S169-91. doi:10.1007/s00586-006-1071-2. Wand BM, O’Connell NE, Di Pietro F, Bulsara M. Managing chronic nonspecific low back pain with a sensorimotor retraining approach: exploratory multiple-baseline study of 3 participants. Phys Ther. 2011;91(4):535-546. doi:10.2522/ptj.20100150. Catley MJ, O’Connell NE, Berryman C, et al. Is tactile acuity altered in people with chronic pain? A systematic review and meta-analysis. J Pain. 2014;15(10):985-1000. doi:10.1016/j.jpain.2014.06.009. Moseley GL. I can’t find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain. 2008;140(1):239-243. doi:10.1016/j.pain.2008.08.001. Gutknecht M, Mannig A, Waldvogel A, et al. The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment. J Bodyw Mov Ther. 2015;19(4):722-731. doi:10.1016/j.jbmt.2014.12.003. Daffada PJ, Walsh N, McCabe CS, Palmer S. The impact of cortical remapping interventions on pain and disability in chronic low back pain: a systematic review. Physiotherapy. 2015;101(1):25-33. doi:10.1016/j.physio.2014.07.002. Luomajoki H, Kool J, de Bruin ED, Airaksinen O. Improvement in low back movement control, decreased pain and disability, resulting from specific exercise intervention. Sports Med Arthrosc Rehabil Ther Technol. 2010;2(Mc):11. doi:10.1186/1758-2555-2-11.