Low back pain 3- Respiraton

The diaphragm plays an important role in maintaining core stability.  It serves as the "top" of the core and its activation is timed to the activation of the abdominal muscles.  We know that in many cases, individuals with low back pain have altered respiratory patterns.  Spine. 2010 May 1;35(10):1088-94. 

In fact, some people that reach a plateau in their 'typical' treatment of low back pain respond quite well to breathing exercises.  Also, other researchers have discovered that in some individuals, problems with the diaphragm (and the subsequent low back pain), are coupled to failure to activate muscles of the pelvic floor.

We now have a picture of a person with low back pain and poor respiratory patterns (primarily chest breathing rather than using abdominal breathing techniques).  This person also fails to activate muscles of the pelvic floor.  We don't think of these muscles often unless we have a problem with urination (these muscles are trained during 'potty training') but they are also activated unconsciously as we stabilize the low back. 

The overriding question is; why do these muscles fail?  To answer that, we have to know what turns them on.  These muscles are activated by unconscious pathways from the brain and brainstem.  In other words, the nervous system turns on these muscles.  "Big deal" you could ask.  All muscles are activated by the nervous system.  The point that I want to make here is that it is generally recognized by the rehabilitation community that muscles do not fail.  Instead, the neural components that activate them will fail.  In other words, muscles don't tend to get truly "weak".  They tend to get "not activated" secondary to inhibition of those parts of the nervous system. 

As we dig deeper, we learn that the lower brainstem makes you breathe.  The lower brainstem is commanded by higher parts of the brain including the vestibular system. 

In other words a poor brain causes poor breathing which causes low back pain.  This is the missing "neuro" part that I wrote about in the previous post.  To be clear, I am not talking about a brain with true degeneration as in Parkinson disease.  I am talking about a brain that works at less efficiency or has a compromised level of integrity.