I was recently asked by a patient if the problem she had in her back was sprained back muscles. Now I found myself explaining that it was rare to strain or sprain back muscles. I considered how common was this misconception. It turns out very. Here’s a bit of text from a well-known American health blog:
“The back—especially the lumbar, or lower back—bears much of the body’s weight during walking, running, lifting, and other activities. It makes sense, then, that injuries to the lower back—such as strains and sprains—are common.”
Well, this would appear right on the surface but with a bit of thought you’ll understand how rare it really is.
Sprain v strain
Firstly, let’s look at what a sprain is. Again, from the health blog:
A strain is an injury to either a muscle or tendon. Tendons are the tough, fibrous bands of tissue that connect muscle to bone. With a back strain, the muscles and tendons that support the spine are twisted, pulled, or torn.
And a sprain:
A sprain is the stretching or tearing of a ligament. Ligaments are the fibrous bands of tissue that connect two or more bones at a joint and prevent excessive movement of the joint.
And your back?
Now, some of these injuries you’ll probably have experienced. But if you think what you were doing and what muscles you have sprain/strained this’ll give you an idea of the sort of forces are required to achieve this. Consider which muscles you’ve ever sprained or strained. It’ll be your calf or your thigh/glute or possibly a forearm or even a biceps. It’ll rarely be back muscle.
This is because you need to put an impressive load of force through these structures to get them to rip apart. You are designed pretty well, so will take some remarkable loads before things start to fail. To get to these fail-levels of loading you need to use levers. This is why you can sprain/strain your calf more than anything else and your hamstrings get torn. This is also why you don’t often get strained or sprained back muscles.
The levers are just too short, the muscles and tendons too strong and the ranges of motion available to create the stress too small. The back, particularly in the rib area, is designed to be fairly stiff and to protect your soft bits inside. It can’t move far enough in any direction to really tear a muscle. A leg can and, as a result, can generate enough force to pull tissues apart but a mid-back rarely can.
The common understanding is that these sprain/strains:
“…result from a fall or sudden twist, or a blow to the body that forces a joint out of its normal position. All of these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.”
I’d strongly argue that the key here is that a “joint (is) out of its normal position” and that it has nothing to do with a muscles sprain and strain.
Now, I have seen some genuine sprained back muscles. But these have been done by real athletes at the top of their games, so rowers and rugby players or by people involved in really serious physical trauma such as in a car shunt. And you should by now understand why, the force is great enough to damage the tissue over the short distance they move. But the force has to be massive and it is unlikely you have achieved this sitting at your desk, going swimming or cycling to work.
What you’ll feel is muscle tightness over the back. This, 9 times out of 10, is muscle guarding. This is where the muscles are stimulated by your very cleaver brain to tighten up and act as scaffolding. They do this to stabilise the underlying, and much more important problem, a joint injury. You will have seen this in action when people come to work saying “I must have slept funny” and are unable to move their heads left or right at all. Their neck muscles are rigid and preventing their heads from turning but there is nothing wrong with their muscles, it’s the underlying joins that are in trouble
Still, whatever it is, a good diagnosis is important followed by and some excellent care. We can provide both. So, give us a call or use our online booking form and let’s help you tackle the problem.