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For Back Pain Look to the Front of the Body Too

by Allan Rudolf(more info)

listed in back pain, originally published in issue 11 - April 1996

For back pain, look at the front of the body too

Bodyworkers can divide their clients loosely into two (not necessarily exclusive) groups. There are clients who want to relieve general stress and be more relaxed. And there are clients who are in pain. By far the most common type of pain is back pain. Moreover, it is the most common cause of worker absenteeism in industrial societies. You can make a difference as a bodyworker by being able to work more effectively on back pain.

A single cure for back pain?

I have in front of me about ten books and articles about curing back and neck pain. They offer various treatments for long term chronic back pain. What is remarkable, but not surprising, is each offers a different cause and solution to this serious problem. One claims the main cause of back pain is one of the vertebrae is out of alignment pinching a nerve. Another states the problem is usually in the sacro-iliac joint; another says the position of the sacrum is the culprit, yet another claims the problem is trigger points in the soft tissue of the back and buttocks. Still another points to bruised vertebrae facets which cause back muscles to spasm. And finally, another book claims the problem originates in the mind which interferes with the normal functioning of nerves and blood circulation to muscles, a situation named Tension Myositis Syndrome or TMS.

Of course, if anyone really found 'the cure' for back problems, the whole world would be beating a path to their door. Back pain does not fit in the model of a single cause. As Rene Caillet, a well known specialist in medical rehabilitation observed, "Low back pain remains an enigma of modern society and a great dilemma for the medical profession". The same statement applies to the rest of the back and neck.

But what about the front of the body?

All the books and articles, besides each offering a single answer to back pain, have another trait in common – they all neglect looking at the front of the body. They assume that if the back or neck hurts, then the answer must lie in the posterior body. In this article, I would like to focus on the idea that excess tension and contraction in the front can be a source of back and neck pain.

The bow principle

Consider the bow of a bow and arrow. The bow has two parts – the bow proper and the string. What happens to the bow when the string is shortened and tightened? The tension in the bow also increases.

The body operates in an analogous fashion. If the front shortens and contracts, the back reacts by shortening and tensing. This will bring about pressure on nerves and blood vessels, and prevent the transportation of waste products. The result is pain. The way to get rid of tension in the bow is to release the string; the way to get rid of back pain is to lengthen the front of the body.

Here are two experiments which will convince you that the analogy between bow and body is appropriate and valuable.

Experiment 1: Stand and place the back of one of your hands very firmly across the lumbar area of your back. Now consciously tighten your 'stomach muscles' (rectus abdominis) and you will feel with the back of your hand how the lower back contracts. In the analogy, the rectus is the string and the muscles in the lower back are part of the bow.

Experiment 2: Stand and look straight ahead. Place the palm of one hand on the sternum area, and the palm of the other hand at the back of your neck. Pull downward with the palm on the sternum to mimic a contracting upper chest, and you will feel the extensor muscles in the back of the neck contracting.

We all know of people who constantly need to get their spine adjusted and they do feel relief temporarily, but in a week or a month they need another adjustment. Often this can be explained by the bow principle. Working on the spine or the muscles around the spine is not reaching the underlying cause, as the underlying cause is in the front.

The bow principle also explains why I consider situps detrimental for most people. Situps lead to a shortening of the recti, and the back muscles must compensate by contracting. Thus the result of situps is shortness and tension all around, creating the climate for back pain.

Dr Ida Rolf in her book, points out very clearly how shortness in the recti pulls down the ribs, leading to strain in the cervical spine, neck problems and often Dowager's Hump. (Dowager's Hump is the body's attempt to alleviate the strain on the seventh cervical and first dorsal vertebrae by building up the flesh.) This is another example of a problem which seems to be in the back, actually originating in the front of the body.

Applying the concept in your work

So, when you are dealing with back pain, remember the bow principle and consider the front of the body. This means, at a minimum, check the tonus of the major flexors, like the stetnocleidomastoid, pectoralis major, rectus abdominis and the psoas.

You will be more successful with back pain if you remember the front too.


1. Caillet, Rene. Low Back Pain Syndrome. Philadelphia: Davis; 1962 p.v.
2. RoIf, Ida P. Rofing: The Integration of Human Structures. New York: Harper and Row; 1977 p105.

Copyright 1996 by Allan Rudolf


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About Allan Rudolf

Allan is a Rolfer and Feldenkrais practitioner and trained with both Dr Rolf and Dr Feldenkrais. He now lives in China and is not contactable.

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