Low Back Pain That Wasn’t a Back Problem

Her back hurt. But her back wasn't the problem. This is where the nuance comes in. 

In this episode, I dive into a fascinating clinical case involving a hypermobile pole dancer presenting with low back pain — where the lumbar spine was the pain generator but not the driver. The real culprits? Her knee and foot. Surprised?

I walk through the clinical reasoning process that shifted the treatment focus away from the low back and down the kinetic chain, and explore what that looked like in practice through progressive exercise programming geared towards her real drivers. 

This patient had a history of ACL surgery with lateral meniscus repair, along with a torn right AND left hamstring.  If you don't think that is relevant to her low back pain, think again. Make the connection. 

Key Takeaways:

✅ Always ask youself: "Is this the pain generator or the driver?"

✅ In hypermobile patients, control and stiffness are often the missing ingredients — not flexibility

✅ Pilates offers an exceptional framework for graded loading in hypermobile movers when applied thoughtfully

✅ Treating distally can resolve proximal pain — trust the kinetic chain 

✅ Know your patient's sport or art form — it shapes everything about your programming