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Nothing makes you feel like a geriatric like a trick back. Throwing your back out is among life's fiercest inconveniences. It can happen almost any time, and often out of the blue. And when your back goes out, it can incapacitate you. I should know. My back locked up on me for the first time when I was 13. After playing baseball one night I came home and as I exited the shower I took a deep breath in through my nose. Playing in dirt always aggravated my sinuses and instead of reaching for tissue or clearing my nose in the shower as any non-teenager would do, I just snorted my secretions back, and hoping by the gesture, if it can be called that, to clear my airways. Most mucus is after all swallowed, so there. Well, just like that, I couldn't move for two days. The middle of my back locked in contraction, and merely to breathe became a chore. I should have reached for the Kleenex.

Throughout my formative years back pain recurred numerous times, and in diverse situations. The following autumn after a soccer game I could hardly walk. This time it was my lower back, and it was stiff as a board. There was nothing the chiropractor could do to set it right. He advised I not slouch while sitting. Better still would be to minimize sitting altogether, as we'll see. Once while play-fighting with a friend I developed a stitch in the side that wrapped around to my spine and made me wince with every exhale. Game over. And so on, through college and medical school. I've thrown my back out walking the dog, making love, lifting weights, reaching for a carton of orange juice, running, swimming, shaving, and many other things besides. And I'm not alone.

Back pain is astoundingly common in modern society. It may also have been for the ancients, whose grunts and groans I wasn't around to hear. In today's world however, 4 out of 5 people suffer back pain, which is one of the most common causes of disability and doctors visits. The cause is often obvious, at least in time. You lift something too heavy, sleep improperly, or simply blow your nose too vigorously, and boom, immobility ensues.

But chances are if you have had a back spasm, and if you have, you know, more is to blame than meets the eye. Tight hips, a bulging midriff, too much time with the phone crooked in your neck or staring at the screen, or all of the above, sets in motion muscular and postural imbalances that push you to the brink, and the heavy groceries or sweaty sex are just so many straws that break the camel's back, or yours. Anything that causes an alteration in your gait, such as plantar fasciitis, some even say Morton's Toe (in which the knuckle of your second toe is farther out than your first), can cause pain much higher up your body, and usually centered around your back.

Back spasms are a very specific breed of back pain, and one which in the space that follows I should like to briefly discuss. More than merely tightness or fatigue, though these can be contributors, a spasm is a forcible and extended contraction of the muscles that won't release until the cause has been addressed or the muscle has been allowed to heal through rest, or preferably through massage. A back spasm is the body's way of protecting itself from further insults, that is to say from you. Tensing up is its method of counterbalancing a postural or musculo-mechanical wrong. I just made that word up.

One rule of thumb: Never assume the problem is at the place that hurts. For example, the buttocks muscles, and there are three of these on each side, are a frequent cause of low back pain. Also, the abdominal muscles as well as the psoas muscles, though positioned at the front of the body, often send pain to the back, or cause the back to lengthen abnormally which stresses it and brings about a contraction.

Your deep spinal muscles go up and down either side of your spine from your sacrum to your skull. Pain here can be extremely disabling. The pain is often felt very close to the spine. The superficial muscles of your back lie closer to the skin's surface. When they are tight they can bulge out in a hard contraction, causing the entire side of the back to lock up, which makes addressing the problem tricky, because usually only a small area of the lengthy muscle is irritated. It's like finding a needle in a haystack, or a knot in a long muscle. Pain in your paraspinals represents the prototypical back spasm, the paralyzing pain that causes you to move like you've just aged 50 years in a minute. And it's frustrating because it will not respond to heat and stretching. The knots must be massaged out, preferably with a lacrosse ball against the wall, or a Ma Roller. Ever since I invested in this $40 piece of wood, in early 2009, I have only had one incapacitating back spasm, which occurred after a session of overzealous stretching in preparation for a marathon which I could not run.

There are other lesser known causes or contributors to back ailments. For example irritation in the soleus muscle, which is one of the two muscles that make up your calf, can maintain a hard, spasm-like contraction in the low back muscles, making you walk around as though you've just been sitting on the toilet, as if an invisible chair were stuck to your rump. The soleus is a thick muscle that you can massage by running it along the opposite knee while lying down. And you should do more of it (lying down, that is, as we'll see).

The rectus abdominus forms the six-pack muscles, doing what the paraspinals do, only in the front. When your abs are tight, say from too much sit-ups, or weak, from too few, they can refer a spasm to the lower back. Lie flat on your back and massage the area to each side of your navel. This will address tension in the rectus abdominus as well as any problems you may have in the psoas muscle, which connects your leg to your spine and helps you flex your hips. And don't neglect your fanny, since tightness in the glutes is a major cause of both mid and low back pain. A ball against the wall works best. Although a foam roller will do, too, and allows you to address tight thighs, which are a major cause of hip pain, which can be hard on your back. See, everything's connected. Well, almost:

Interestingly, quadratus lumborum, which is the muscle of your lower back, traveling from your pelvic bones to your lower ribs, usually tenses up in response to irritation in adjacent or opposing muscles, rather than be the cause of back pain itself. But it feels good to massage here too.

And who can leave out serratus anterior, a tooth-like muscle that runs from your scapula (shoulder blades) around to your upper ribs and helps expand the rib cage when you breathe, and to stabilize the scapula when you lift things overhead. If you've ever had a spasm that prevents you from inhaling fully, trouble is likely to be found in your serratus. Pain when you breath out can be due to the posterior counterpart, which is just below your shoulder blades and assists in forced exhalation. Massaging the serratus anterior is delightful. Simply rub the area just beneath your armpits and below your nipples in short, swift finger strokes. The posterior muscle responds well to a ball against the wall.

Finally, the lat muscles. The are the biggest muscles of the body and sweep across your lower back from your spine, wrapping under your armpit and attaching to your arm. An irritated muscle causes pain in the mid back centered on the lower angle of the shoulder blade that can be murder. Your ball awaits, saying, "Lean on Me"!

I have found that the more muscle mass I carry, the worse these back spasms, which are now receding into the ever more distant past, thanks God, have been. In other words in the times I have taken to lifting heavy weights and/or eating animal protein, the price of my muscularity has been a marked increase in the length and violence of back pain. One time I couldn't run for a week. Forget having sex. A case of the body working against itself. That's what too much muscle will do. And also why women, who are less muscular, tend to have fewer episodes of back pain, which are also less incapacitating. So engage in resistance training, but gain weight only insofar as a plant-based diet allows. By consuming 10% of your calories from protein your body will pack on all the muscle you need. Anything more approaches vanity, and there was only one, God rest her.

Also, of all the postures that spell disaster for your back, sitting is by far the worst. It is worth noting that the only time your back muscles are completely relaxed, other than when you're standing perfectly upright with your weight evenly distributed on all sides of your spinal column so that the vertebral bodies neatly stack atop each other, is when you're lying flat on your back. Another reason to take it easy.


  1. Back pain is nothing to play with. It can put you down more than any other kind of pain that you will have as I have pulled muscles and have had issues with discs in my back. Thank you for giving a little insight to the causes of back pain and what to look for before going to a doctor.

  2. Your Hidden Survival Muscle (Pop Quiz)


    There's a muscle in your body that is an indicator
    of the strength and health of your whole body.

    It's been called your body's most powerful hidden
    survival muscle.

    If it's too tight, undertrained or locked up it can
    contribute to issues such as:

    + Nagging Joint Pain
    + Bad Posture
    + Trouble Sleeping
    + Sluggishness
    + High Anxiety
    + Digestive Problems
    + Weakened Immune System
    + Circulatory Issues
    + Loss of Sexual-Performance
    + Lack of Explosiveness in the Gym

    Those are some nasty problems, but when you
    unlock this muscle there are many amazing
    health benefits.

    Here's your quiz. Which muscle do you think
    we're describing in this email?

    1: Gluteus Maximus
    2: Your Heart
    3: The Psoas (Hip Flexors)
    4: The Masseter

    Let me know if you get it right.

    Sign Off

    P.S. The answer can be found on this page.



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