Tension vs Weakness

A common prevailing view in treatment of back and neck pain is that EVERYONE with back or neck pain needs to improve their "core stability" or "posture".

This is not always the case, some people need to learn to reduce tension around their back or neck as the excess tension is putting strain on their painful area. Tightening your "core" or sitting more upright in a "better" posture might be making you worse, or at the very least, if you are "lucky", no better.

As an example think of clenching your fist as hard as you can. Imagine then maintaining this "clench" for 10 minutes, 30 minutes, 5 hours!

What do you think will happen?

It will absolutely get stiff, tight and painful. Normal blood flow will not be getting through to muscles, joints will be being compressed and nerves squeezed and pressed on. Not very pleasant. Painful in fact.

What would make your fist/hand feel better?

Some gentle movement, relaxing of your muscles, some massage/manipulation, some heat......numerous things. All of these things will get the blood flowing, the joints moving and the nerves gliding.

"Motion is Lotion"

But how do you know if your back or neck is tense vs weak?

Granted it might be both, but it is not uncommon to see some patients with whom tension is the main problem. If your pain consistently feels better with any, some or all of:

  1. Movement

  2. Stretching

  3. Exercise

  4. Massage/manipulation

  5. Heat

Then there is a fair chance that tension is a cuplrit in your presentation and you may benefit from exercises and postural strategies to reduce the tension.

You may also need to address other issues that might be increasing tension such as:

  1. Stress

  2. Anxiety

  3. Lack of sleep

  4. Fear that your back or neck has a structural problem (most of the time it doesn't by the way). This often, not surprisingly, creates overprotectiveness of the painful area.

Unfortunately I see more and more frequently patients who have tension as their key issue, yet they have been told time after time that their "core" muscles are weak, or their posture is "poor". Very frustrating. Surely people who have weak "core" muscles would not feel better with:

  1. Movement

  2. Stretching

  3. Exercise

  4. Massage/manipulation

  5. Heat

If this sounds like you, you might just need to do more to reduce the tension.

For the science relating to the above please see some of my blog posts over at markgibsonphysio.com:

http://markgibsonphysio.com/2015/05/04/core-stability-research-update-may-2015/

http://markgibsonphysio.com/2014/11/02/core-stability-problem/

Thanks for reading.

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