Hi.

A number of things.

Firstly, I don't think it is a nerve root problem because slump testing is negative. Neuro testing is negative. Flexion *relieves* the pain. Extension and LF and Rot make the pain worse. Also, the Wikipedia reference-linkfacet joints along the whole L/S are sore. This is not what you would expect from a disc bulge onto a nerve root.

Secondly, he is 25y.o. He would not have a fibrosed disc yet, especially without any history of trauma.

Thirdly, I did not say the spinal extensors are tight. I said they were overactive. A very important distinction should be made there. They can still be overactive with his decreased lordosis because he is probably co-contracting with his abodominals - probably external obliques. He is already overactive in his QL. His decreased bulk in the gluts is probably because he is hamstring dominant in his extension strategy.

Fourth, Extension can harm this patient. His spine is already in a compressed state. Further compression of these structures can cause sclerosis, spondyloslithesis, facet joint arthritis, disc problems, etc. Again i ask, why subject him to painful positions when his body is telling him flexion is the best place for relief.

Traction helps to decompress and relax the overactive muscles and joints. If you told him to hang from a bar, it would do the same thing.

I would still recommend that teaching how to have a relaxed posture with restoration of his spinal curves and activating his core muscles without global muscle activiation is the way to go. What i have written in this post is from learning this material from Peter O'Sullivan, Diane Lee, LJ Lee, Barbara Hungerford, Trish Wisbey-Roth, etc. Peter O'Sullivan's work on this exact type of problem has been sensational and the results in my clinic tell the story...

Lastly, electro is not going to solve his problem...

What do others think? Am I way off beam?