When people have abdominal pain from IBS, celiac, Crohn’s, colitis, ileitis or other inflammatory conditions it inhibits their abdominal muscles and creates an ongoing imbalance that lasts as long as the abdominal pain. This means that these patients must always work to correct the on the ongoing muscle imbalances or suffer the consequences of overstressed posture.
The added ongoing musculoskeletal stress is especially hard on fibromyalgia patients.
In "The relationship between incontinence, breathing disorders, gastrointestinal symptoms and back pain in women: a longitudinal cohort study", Smith et al point out that developing any of these problems increases the likelihood of developing another.
When we work with spinal stabilization we consider and rehabilitate the diaphragm and pelvic floor muscles as major stabilizing components. If you are not breathing right you are not stable. This has been a Yoga standard for a couple thousand years. Pelvic floor weakness is also associated with incontinence and multiple other problems.
Early in my chiropractic practice I noticed a large number of my chronic patients had irritable bowel syndrome, particularly those who also had fibromyalgia.
In 1988 I read a chapter by Vladamere Janda explaining what he named the lower crossed syndrome. It is a muscle imbalance where your hip flexors (psoas and rectus femoris) are tight and short which inhibits or weakens the hip extensors, your glutes. This forces your low back extensors to become overly tight to keep you upright. This inhibits the opposite muscles, the abdominals which are flexors.
Low back pain automatically inhibits your abdominals responsible for stabilizing your low back. This causes your main hip flexor, the psoas muscle, to attempt to stabilize and shorten, which inhibits your abs. Thus low back pain causes lower crossed syndrome as well which, in turn, can cause low back pain and is therefore self perpetuating.
If we sit a lot (on the job, driving or watching TV), our hip flexors become short and cause the same imbalance.
Lower crossed syndrome spreads. The inhibited glutes permit the hip to internally rotate with each step, particularly when going down stairs. When the hip rotates in, the knee collapses internally (medially) and the knee cap (patella) is pulled laterally by a retinaculum attached to the IT band. This causes the knee cap to track poorly and wear out its cartillage. Occasionally surgeons will perform a lateral release, cutting the retinaculum, which can help the patellar tracking but not the medial collapse which still pulls it off track. The IT band also pulls the tibia laterally and rotates it out along with the foot as the hip rotates in. When the foot rotates out it pronates and the arch falls, stretching the plantar fascia which can become very painful. The added torque pushes the bog toe across and increases the shearing forces at its base which produces bunions.
Lower crossed syndrome is one of the main muscle imbalance mechanisms I see contribute to IBS. When treating patients with this issue, and other pelvic pain problems, I help them improve their posture, pelvic floor strength, and abdominal strength. As the patients improve their posture, they reduce the stress on their musculoskeletal system, which improves their bowel health as well.
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