Lower back pain from where??

[porky789]

Hi all. I've been having really nasty lower back pain, firstly from exercise (manifesting as ITB pain on my left side) but now even just sitting sometimes. I went to see a physio and my glutes were weak, so I have been strengthening them daily for a good few months now. When I went for physio initially the back pain wasn't bad, it was more in my hamstring and I had really tight hip flexors. The back pain has come on since. So despite all the strength work, I'm in more pain now than ever.

I went to see a specialist bio mechanics lecturer and his physio colleague at work (university) and they said that the source of my problem was from my ribs. Apparently I'm really tight on one side and my left rib is slightly higher. In addition, I have and have for a long time had a weak upper back and scapular instability on my left side.

I am now going to begin strengthening my upper back and scapular, alongside using a spike ball to mobilise my hip flexors (appears to work well).

My question is....does this all sound normal. Can back pain and ITB pain during running all be coming from tight ribs and a weak upper back. I feel like I've tried everything and my physio is saying she wants to discharge me (NHS), which leaves me nowhere. My physio herself has said that the strength I have in my lower body doesn't explain the pain I'm getting. To re-iterate this is all just on my left side.

Many Thanks for any advice.

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[physikeerthi]

Why dont you check your piriformis muscle and glutius medius.Commonly piriformis courses back of thigh pains and G.medius courses ITB pains.Try some myofacial release and stretching on these musles.

[Dr Damien]

Dear Porky789

Are you better now? iT is hard to say what the likely issues are here only because your description isnt very clear, for instance is it both hamstrings or one, does the back pain hamstring pain and ITB pain occur together, do they ever dissapear,is there a position or movement thatt takes the pain off, how old are you? do pain killers help? if so what kind? are there any other joint pains? what happens when you lie down on your back , bend forward, twist etc. what about side lying? what kind of pain is it? is it sharp, dull , is it constant pain or it goes away sometimes, does it affect your sleep, when is it worse etc...i mean the list is endless, have you had any x rays or any investigations done...

to be honest, this is the problem with our profession? we are only as good as our path of developement or whatever trainings we must have had. it is possible that you would visit many different physios and they will all have a different opinion as to what the issue is...

you will need to monitor your pains carefully, then you will need a good assessment of your posture, for instance do you have any limb length issues etc. if you are having weakness in your gluts, is there obvious muscle wastage...have you had a neurological assessment as well...i think you just need a good thorough assessment...you wouldnt be having this issue if we had a standardized model of assessment and diagnoses such that the likelihood of arriving at the same conclusion would be more common than not