This past weekend while at the Perform Better Functional Training Summit one of the recurring themes was to stop chasing pain. What this means is that when a client's low back hurts don't look at the lower back for the problem, you won't find it there. The problem lies at the joint above and/or below the pain, in this case we would want to look at the hip and t-spine (thoracic spine).
So why does this approach work? Well to answer that question we need to look at the anatomy of the body's joints and their functions. Aside from allowing us to have movement, joints have two primary functions: mobility and stability.
Here is how they are designed to work in the body:
Foot Joints = Stable
Ankle = Mobile
Knee = Stable
Hip = Mobile
Pelvic/Lumbar = Stable
T-Spine = Mobile
Scapula = Stable
As you can see a Stable Joint is always followed by a Mobile Joint. But what happens when one of these joints is not functioning properly? We experience pain.
For example, a person experiencing low back pain will be stable in the hip, mobile at the pelvis and lumbar joint, and stable at the t-spine. They are having pain because their hips and t-spine have locked up and are not allowing the mobility they are designed for. So in order to get this mobility they are now using the pelvis and lumbar joints, which are designed to provide stability, and as a result they have pain.
In this case, you can strengthen the core and glutes as much as you want, but if you do not regain the hip and t-spine mobility you will still experience low back pain. This is seen often with golfers. They play 18 holes, their low backs hurt. So, they take 3 months off to focus on strengthening their core and glutes. Three months later their low back feels good. They then play 18 holes and the pain is back. Why? They didn't take care of the problem. They focused on strengthening the core and glutes when the core and glutes were not the problem. The problem is the hip and t-spine. You can strengthen the core and glutes all you want, but until you take care of the hip and t-spine mobility problem you will still have pain.
The same can be seen with knee pain. The ankle and hips have become locked and lose their mobility. The knee now has to become mobile. By focusing on strengthening the knee and stretching the muscles attached to the knee you will do little to improve the knee pain, because the pain is the result of the loss of ankle and hip mobility. Regain the ankle and hip mobility and you will improve the knee pain.
So why does this happen? There are many reasons. Probably the biggest reason is due to sitting. We have developed what is known as the "Sitting Posture" where our shoulders are slumped and slouched forward, and pelvis posteriorly rotated under, which takes away the natural curve of our lumbar spine. Due to sitting so much throughout the day we have changed the posture of our bodies and they no longer function properly. This has put us at an increased risk of experiencing pain and injury.