Cornwall Clinical Massage

Moving you spine is esssntial!

The "𝐋𝐮𝐦𝐛𝐚𝐫 𝐅𝐥𝐞𝐱𝐢𝐨𝐧 𝐀𝐯𝐨𝐢𝐝𝐚𝐧𝐜𝐞 & 𝐑𝐢𝐠𝐢𝐝 𝐁𝐫𝐚𝐜𝐢𝐧𝐠" Fallacy: Why Guarding the Spine Perpetuates Chronic Low Back Pain

-​A patient with chronic non-specific low back pain (CNSLBP) is told that bending their spine forward will "shear their discs" and that they must brace their core and maintain a rigid, neutral spine every time they pick up a grocery bag or tie their shoes. Months later, their back is stiffer, more exhausted, and more painful than ever. When they finally attempt to bend forward, their lumbar paraspinal muscles lock into a violent, aching spasm—not because their spine is structurally unstable, but because they have been trained into a maladaptive state of protective co-contraction.

-​Recent biomechanical, surface electromyography (sEMG), and clinical trial data demonstrate that patients with chronic low back pain do not suffer from "excessive lumbar flexion". Instead, they exhibit abnormally reduced lumbar flexion and a loss of the natural flexion-relaxation phenomenon—meaning rigid postural bracing and flexion-avoidance cues actively feed the biomechanical driver of their pain.

​👉 What Is the Fallacy?

​The belief that lumbar spine flexion during daily movement or lifting is inherently dangerous, and that conscious abdominal/paraspinal co-contraction ("bracing a neutral spine") protects the lower back from chronic pain.

​👉 Pathophysiology & Biomechanical Reality

-​In a healthy, pain-free spine, bending toward full trunk flexion triggers the Flexion-Relaxation Phenomenon (FRP): once the lumbar spine approaches roughly 85% to 90% of its maximum flexion, the superficial erector spinae muscles shut off electrically, transferring the load smoothly onto the passive posterior ligamentous system (thoracolumbar fascia, supraspinous, and interspinous ligaments).

-​When a patient is conditioned by fear-avoidance beliefs or clinical "neutral-spine bracing" cues, the central nervous system perceives forward bending as a tissue threat. Instead of relaxing at end-range flexion, the erector spinae and abdominal wall remain hyper-active. This continuous muscular co-contraction drastically increases compressive loading across the intervertebral discs, restricts spinal motion variability, and starves the paraspinal musculature of blood flow, triggering ischemic, nociceptive muscle pain.

​👉 Typical Pain Distribution & Clinical Signs

-​Loss of the Flexion-Relaxation Phenomenon:
In 2025–2026 kinematic and sEMG evaluations, patients with chronic low back pain spend significantly less time in maximum lumbar flexion (43.9 degree vs. 59.2 degree in healthy controls) and show an elevated erector spinae relaxation ratio—meaning their back extensors fail to switch off during forward bending.

-​The "En-Bloc" Hip-Hinge Guarding Sign: During functional tasks like picking a pen off the floor or sitting down, the patient holds their breath, locks the thoracolumbar junction into rigid extension, and compensates with exaggerated pelvic and hip motion. Palpating the lumbar paraspinals during slow forward bending reveals rock-hard, unyielding muscle tone rather than physiologicaleccentric lengthening and end-range silence.

​👉 Evidence-Based Treatment Approaches
​Conservative (De-Threatening Flexion & Cognitive Functional Therapy):

-Replacing rigid "core bracing" cues with Cognitive Functional Therapy (CFT) and graded, relaxed spinal flexion exposure. Clinicians guide patients to use diaphragmatic breathing and conscious abdominal/paraspinal relaxation while progressively flexing the lumbar spine (starting in quadruped rock-backs, progressing to seated slumped flexion, and finally relaxed Jefferson curls and stoop lifting) to restore the Flexion-Relaxation Phenomenon.

-​Sensorimotor & Biofeedback Retraining: Utilizing surface EMG biofeedback or visual-proprioceptive feedback during forward bending to help patients down-regulate paraspinal hyperactivity, expand their pain-free flexion threshold, and rebuild confidence in loaded, multi-directional spinal movement.

​✅ References

​ - Comparative Effectiveness of Tailored Exercise Therapies Alone or Combined With Psychological Interventions for Chronic, Nonspecific Low Back Pain: A Systematic Review With Network Meta-analysis. Author: Niederer D, et al. Journal: Journal of Orthopaedic & Sports Physical Therapy (2026).

​-Work-related movement and lumbar spine direction: a systematic review of lifting, posture, and pain risk. Author: Liu C, et al. Journal: International Journal of Occupational Medicine and Environmental Health (2026).

​-A new logistic regression model for the detection of chronic low back pain, based on a case-control study in the Spanish population. Author: Alberola-Zorrilla P, et al. Journal: Asian Spine Journal (2025).

​-Efficacy of cognitive functional therapy for pain intensity and disability in patients with non-specific chronic low back pain: a randomised sham-controlled trial. Author: Lira MR, et al. Journal: British Journal of Sports Medicine (2025).

Help Me Qualify — and Enjoy 33% Off Your Treatment - https://mailchi.mp/89d0c643f1d6/new-tmj-dysfunction-treatment-6430073

Lack of range and /or strength in the big toe can cause lower limb issues in runners.
Something I regularly find when treating runners prone to calf related niggles.

https://www.facebook.com/share/1LDsay2DVr/?mibextid=wwXIfr

Runners obsess over shoes, cadence, and mileage, and almost nobody trains the one body part that finishes every single stride, five minutes a few times a week is enough to feel the difference 👇

I recently completed my Level 1 TMJ dysfunction treatment certificate with the fabulous HELEN BAKER | Jaw Specialist — and have now woven this seamlessly into my pain-relief work.

TMJ issues (often tied to stress, anxiety, and emotional trauma ) can cause:

• Tension headaches
• Facial pain
• Teeth grinding/clenching
• Neck & shoulder stiffness
• Hip tension
• Tinnitus

If any of this sounds familiar, I can help — DM to learn more or book book online - link in bio.

I thought running anything over 5K was long behind me.
After all, at 53 and enjoying all the perks of perimenopause, everything gets a little stiffer and achier these days…
Especially when you stop moving and start telling yourself you’re too old to challenge yourself physically.
After spending years telling my clients that movement is what keeps you going, I figured it was time to take my own advice. So, after briefly considering giving my place away, I fully committed and started training properly for the Classic Quarter Relay 2026. 13.5 hilly miles of stunning Cornish coastline
Starting a little later than planned meant I had to put my foot down and deal with the inevitable aches and niggles as best I could. Thankfully, training consistently at over the last few years has undoubtedly helped prevent injuries that might otherwise have been inevitable.
Huge thanks to .hybridfit & Tripconey for helping keep me as fit and strong as possible. Dan — my next-door neighbour — has literally had my back from the start, and Claudia has been invaluable in keeping me moving.
The conditions on the day were a little crazy with 30mph winds and lot of rain! But
I loved every minute of it — apart from the last 20 minutes maybe 🙃 — and the wild weather only added to the adventure.
Now I’m toying with the idea of doing a little bit more next year... once my knees stop hurting 😅

I do get asked a lot about shockwave therapy but I have always been unsure about gadgets other than for temporary pain relief. Also I don’t know enough about it!
Such a good post by The Endurance Physio. Informed and evidence based 👍

With the just around the corner, fatigue and niggles are kicking in. Remember, recovery is just as crucial as training. Don't underestimate the power of sleep, nutrition, and hydration - your body will thank you.
My client here has been prioritizing their recovery, and it's paid off.
While regular sports massage may not be necessary for everyone, it can be a game-changer when sets in.
Get in touch if you feel you would benefit from a pre marathon MOT 👍

The Science Behind Exercise & Trauma Recovery 🧠 Your brain literally rewires itself through movement. Here’s the peer-reviewed science behind why exercise is powerful medicine for trauma recovery.