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The Circle of Life

anatomy back pain advice development May 12, 2021
standing upright away from the foetal position

Don't worry. We're not about to burst into song...

Instead, we're thinking about the big picture of human development, and in turn, the big picture of what goes wrong and why. This has great relevance to low back pain and many other musculoskeletal conditions.

 

Where do we start?

We start as single cells and grow in the womb to form an embryo. As pregnancy proceeds, we become more and more recognisable as humans, as babies.

Think about that foetal position: 

  • Head tucked down to chest
  • Spine curled forwards
  • Knees pulled up to chest, legs bent

This is more or less how we enter the world, and the first few years of human development see some remarkable changes.

 

Curves, curves, curves

Human beings are unique in having spines that, in places, curve backwards.

  • We begin life with one long curve - a C-shape that curls forwards.
  • As we learn to lift our heads, we develop a backwards curve in our neck.
  • As we learn to sit upright and start to move, we develop a backwards curve in our lumbar spine.

One long, smooth curve is now five alternating arches piled on top of each other with the purpose of allowing us to stand upright on two legs with our head facing forwards. This is how we became hunter-gatherers, learnt to use tools with our hands, and developed communication.

 

What next...

Once we are fully formed, we humans are at our most active and independent. Our systems are fully developed, and we thrive as a species.

But then the return to that original shape begins.

The base of the spine is typically where things start to revert. That lovely backwards curve of our lumbar spine begins to diminish as the discs between our vertebrae age and lose their wedge-like shape. The curve lessens, and this tips the rest of our spine forwards, with our head eventually getting pushed forwards. 

From a side-on view, we want to have our head directly over our pelvis, but as we age, it tends to get pushed forwards, until it hangs somewhere in front of our pelvis. This creates more of a weight, and that makes our muscles work harder. The start of trouble.

Eventually, you see elderly people who are hunched forwards, struggling to lift their head, perhaps resting on a frame or sticks. Some will even bend their knees in order to tip their pelvis and spine backwards in an effort to pull their head back to a reasonable position. 

Does that forward curve and bent up knees sound familiar?

 

But I'll be ok, won't I?

Look at what you do day to day, and look at others around you.

  • Do you sit at a desk staring into a computer? Do you drive a car? 
  • Are you reading this on a device while sitting in a chair?
  • Do you go to the gym and squat? Do you ride a bike? Do you row?

Why do I ask? What do these activities have in common?

  • Do you see a forward curve through more of your spine than at standing?
  • Do you see your knees coming up towards you instead of being kept below you?
  • Is your head creeping forward of your pelvis?

No one is perfect, but the more we put ourselves into these positions, the more we are returning ourselves to that foetal position.

We shouldn't avoid these things entirely - that would be completely unrealistic! But we should all take steps to undo these shapes, so our natural resting place is back at our tallest posture, the peak of our development.

Take time to get up from your desk, and stretch yourself up and backwards, like in the image. Try this when you get out of the car or off the sofa. Try to find more little pockets of time that you can spend in this position, rather than being curled up. Alter any gym training to make sure you keep a balance of bending forwards and backwards. 

Get the big picture right, before worrying about the details.

Hopefully, we can slow the inevitable.

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