Category Archives: Understanding Pain Sources

Here we discuss ways to see where your low back pain is coming from.

Why Your IT Band Won’t Stop Hurting (The TFL Connection)

Posture Reprograming, Understanding Pain Sources, , , , , ,

Stop Rolling Your IT Band! Why the TFL is the Real Culprit

In my years of clinical practice, I have seen hundreds of patients “torturing” themselves on foam rollers, trying to loosen a tight IT Band. If you’ve done this, you know the cycle: it’s incredibly painful, and the relief lasts for about ten minutes before the tension returns.

Here is the clinical secret: You cannot “stretch” or “roll out” the IT Band. The Iliotibial (IT) Band is not a muscle; it’s a thick, fibrous piece of fascia with the tensile strength of soft tissue steel. If you want it to relax, you have to look at the “engine” that controls its tension. You have to look at the Tensor Fasciae Latae (TFL).

The TFL: The Tiny Muscle with a Big Ego

The TFL is a small, teardrop-shaped muscle located on the high-lateral side of your hip, attaching to the ASIS (the bony point at the front of your hip). Its primary job is to assist in hip flexion and rotation.

However, because we live in a “sitting culture,” the TFL is almost always in a shortened, hyper-tonic state. Because it is physically fused to the top of the IT Band, a tight TFL acts like a winch on a Jeep—it cranks the IT Band tight, pulling it across the lateral epicondyle of the knee. That “snapping” or “burning” you feel at your knee? That’s just the symptom. The TFL is the cause.

The “Pocket Muscle” Landmark: How to Find Your TFL Target

To fix the issue, you have to find the right target. Most people look too low on the leg. To find your TFL, put your hands in your front pockets. Where your thumbs naturally rest against the side of your hip—just below that bony “shelf” of your pelvis—that is your TFL.

Still Can’t Find Your Tensor Fasciae Latae?

Sitting in your chair, lift your bent leg slightly up toward the desk. You will feel a piece of muscle pop up on the top of your hip bone. Your TFL is just outside of that muscle that popped up.

The TFL muscle portion attaches along the side-front dip part of your hip bone and goes about 2 inches deep. The TFL muscle then goes down at an angle back to about the top of your leg bone (femur). The muscle then turns to tendon and becomes the Iliotibial band. While the band itself can get stuck and hold trigger points, most times the trigger points are in the TFL muscle itself, which sends referral pain down your IT band.

If you’ve been sitting at a computer all day, pressing into this spot will likely feel like pressing into a bruised golf ball. This is the spot that needs release, not the side of your leg.

Clinical Tools for TFL & IT Band Release

Don’t roll the side of your leg. Use these tools to target the TFL at the hip for long-term relief.

Lacrosse Massage Ball

Massage Lacrosse Ball for TFL release

The Therapist’s Secret: A foam roller is too broad. A lacrosse ball allows you to pin the TFL against the floor for a deep, “Ischemic” release.

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Theragun Relief

Theragun Percussion Massager

Best for Hyper-Tension: Percussion therapy overrides the pain signals in the TFL, allowing the IT band to “slacken” without the agony of manual rolling.

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The Stick Rolling Massage Tool

TriggerPoint Grid Foam Roller

For the Quads/Glutes: Use this for the muscles *around* the IT band. It’s excellent for warming up the tissue before targeted TFL work. I have selected the 24″ length for you as the flexibility is important. You don’t need to press hard to get results.

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The Comfort Trap: Why the TFL Locks Up

This is where my previous articles on Sitting on a Wallet and Sitting on One Leg come into play. When your pelvis is tilted, the TFL on one side is forced into a permanent “crunch.”

Furthermore, the TFL and the Gluteus Medius are supposed to work together to stabilize your hip. However, because our glutes tend to “go to sleep” when we sit, the tiny TFL has to do all the heavy lifting of balancing the weight of your leg. It becomes hyper-tonic (overactive) while the glute medius becomes inhibited. You can’t fix your IT band related knee pain until you level your pelvis and release the TFL engine.

How to Release the TFL: Ischemic Compression

To get a real clinical result at home, don’t just roll back and forth. That just irritates the fascia. Instead, follow these steps:

  • Find the “hot spot” (the pocket muscle) using your lacrosse ball.
  • Lean your weight into it until you feel a “good hurt” (about a 7/10 on the pain scale).
  • Breathe. Hold for 30–60 seconds until you feel the muscle “pulse” or melt.

This is called Ischemic Compression. Ischemic Compression is one way professionals reset a muscle’s resting length and finally allow the IT Band to go slack. While the lacrosse ball is a great way it may not be feasible at the office. In that case pick up a big fat sharpie like this one on Amazon and use it to hold pressure on the tender spot of your TFL. When the tenderness subsides you can use the TheraGun on low to pump in fresh blood.

If you’ve been rolling your leg for months with no relief, it’s time to stop attacking the rope and start addressing the TFL. Your knees—and your lower back—will thank you.

Does Your Car Seat Cause Low Back Pain? How Driving Position Affects Your Spine

Understanding Pain Sources

Understanding Pain Sources: Why Your Car Matters

Chronic pain rarely starts suddenly. It typically begins as minor discomfort – something you can ignore or work around – until one day it develops into persistent, nagging pain that affects your daily life. The period when you first notice that minor discomfort is actually more important than most people realize, because there’s an associated action or position causing your muscular pain to develop.

The challenge with driving-related back pain is that most of us can’t simply stop driving. We need our cars for work, errands, and daily life. This means we’re repeatedly putting our bodies in the same problematic position day after day, allowing minor discomfort to evolve into chronic pain patterns.

How Driving Position Creates Low Back Pain

When you sit in a car, several factors can stress your lower back:

Seat Angle and Recline

Most car seats position your hips lower than your knees, creating posterior pelvic tilt. This flattens your natural lumbar curve and puts excessive pressure on your lower back discs. Over time, this position can lead to disc compression, muscle strain, and chronic pain.

Leg and Hip Positioning

Your leg position while driving directly impacts your low back position. When your legs are cramped, extended too far, or positioned awkwardly to reach pedals, your pelvis tilts and your spine compensates. This compensation creates muscle tension that builds over weeks and months of driving.

Arm and Shoulder Reach

Reaching too far forward for the steering wheel causes you to round your upper back and shoulders forward, which in turn affects your lower back position. This full-body misalignment creates a chain of tension from your neck down to your low back.

The Size Mismatch Problem

Tall Drivers in Small Cars

If you’re a 6’6″ tall, 270-pound person trying to fit into a compact car, your body simply doesn’t have enough space. Your knees might be jammed against the dashboard, forcing your pelvis into positions that strain your low back. The lack of legroom means you can’t shift positions during long drives, and that static posture creates progressive muscle tension and pain.

Short Drivers in Large Vehicles

On the flip side, a 5′ tall, 100-pound person driving a large SUV or truck faces different but equally problematic challenges. You might need to scoot forward to reach pedals, forcing you to stretch your arms uncomfortably to reach the steering wheel. Or you might slouch down in the seat to get your feet properly positioned on pedals, creating poor spinal alignment that leads to back pain.

Both scenarios create chronic pain because they force your body into unnatural positions that your spine wasn’t designed to maintain for extended periods.

7 Ways to Fix Your Car Seat Position and Stop Low Back Pain

1. Adjust Your Seat Height

Your hips should be level with or slightly higher than your knees. Many modern cars have seat height adjustments – use them. If your car doesn’t have this feature, consider adding a firm cushion to raise your sitting position slightly.

Recommended Products: Seat support cushions with wedge design can elevate your hips and support your natural lumbar curve simultaneously. Below you’ll see three recommendations from Everlasting Comfort. The first is a standard memory foam seat cushion for people who do not think memory foam is too hot for them. Choose the second sacral cut out seat pad if you tend to think foam makes you too hot. For a seat that has a closed hip angle choose the standard wedge shape seat cushion. All three options help maintain proper pelvic alignment during long drives.

Memory Foam

Cooling Gel

Standard Wedge


Everlasting Comfort Memory Foam Seat Cushion

Everlasting Comfort Cooling Foam Cushion with Sacral Cut Out

Everlasting Comfort Memory Foam Seat Wedge

View current price on Amazon →

View current price on Amazon →

View current price on Amazon →

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2. Set Proper Seat Recline

Your seat back should be reclined about 100-110 degrees – not perfectly upright (90 degrees) and not reclined like you’re lounging (120+ degrees). This angle supports your lumbar curve while allowing your muscles to relax slightly.

3. Adjust Seat Distance from Pedals

You should be able to fully depress the brake pedal while maintaining a slight bend in your knee (about 120-130 degrees). Your knee should never be completely straight or sharply bent while driving. This position allows proper circulation and reduces hip flexor tightness that contributes to low back pain.

4. Use a Lumbar Support

Most car seats don’t provide adequate lumbar support. Adding a lumbar cushion fills the gap between your lower back and the seat, maintaining your natural spinal curve and reducing disc pressure.

Recommended Products:Lumbar cushions can provide support however it should be tailored to your need. One lumbar support will not work for all people. The first option here is from OPTP and is quite popular and provides posture guidance. The second is a self inflating style that transports easily and can be overinflated for additional support. The third is a basic memory foam support that will take up space in your lumbar region in seated, laying on your back and laying on your side. One support may not work in all chairs as well. You may have one for the car and one for the office and yet another for the home.

Lumbar Roll

Travel Lumbar

Memory Foam


The Original McKenzie Lumbar Roll – OPTP

Therm-a-Rest Self Inflating Lumbar Travel Pillow

PanDuo Memory Foam Lumbar Support Pillow

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View current price on Amazon →

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5. Position Your Steering Wheel Correctly

Your steering wheel should be close enough that your shoulders stay against the seat back when your hands are at 9 and 3 o’clock. If you’re reaching forward, you’re creating upper back tension that cascades down to your lower back.

6. Take Driving Breaks with Targeted Stretches

For drives longer than one hour, stop every 45-60 minutes to stand, stretch, and walk around for 5 minutes. This breaks up static posture and allows your muscles to reset. Even better – use these breaks to perform specific stretches that target the muscles most affected by driving.
These stretches may not be best if you have specific pain or injury. Always consult the doctor who monitors your back pain.

Standing Quad Stretch

Your hip flexors and quadriceps become shortened and tight from prolonged sitting with your knees bent. Standing quad stretches help restore length to these muscles and reduce the pulling force they create on your pelvis and low back.

How to perform: Stand next to your car for balance. Bend one knee and grab your ankle, pulling your heel toward your glutes. Keep your knees close together and avoid arching your low back. Hold for 30 seconds, then switch sides. You should feel a stretch down the front of your thigh.

Hip Flexor Lunge Stretch

Hip flexors get extremely tight from sitting, pulling your pelvis forward and creating low back compression. This stretch directly addresses one of the main culprits of driving-related back pain.

How to perform: Step forward into a lunge position. Keep your back knee straight and push your hips forward gently. You’ll feel a stretch in the front of your rear hip. Hold for 30 seconds per side. Don’t bounce – use gentle, sustained pressure.

Standing Hamstring Stretch

Tight hamstrings pull down on your pelvis, flattening your lumbar curve. Stretching them during breaks helps restore proper pelvic position.

How to perform: Place one foot on your car’s bumper or running board (or a curb if nothing’s available). Keep that leg straight and lean forward from your hips, not your waist. You should feel the stretch behind your thigh. Hold 30 seconds per leg.

Torso Rotation Stretch

Sitting creates stiffness in your spine. Gentle rotations restore mobility and release muscle tension.

How to perform: Stand with feet shoulder-width apart. Place your hands on your hips and gently rotate your upper body left, then right. Move slowly and deliberately – this isn’t about how far you can twist, but about restoring movement. Perform 10 rotations in each direction.

Cat-Cow Stretch (Modified Standing Version)

This classic yoga movement helps restore your lumbar curve and releases tight back muscles.

How to perform: Stand with hands on your thighs for support. Arch your back and look up (cow position), then round your back and drop your head (cat position). Move slowly between positions 8-10 times. This mobilizes your entire spine.

Pro tip: Set a timer on your phone for 45-minute intervals during long drives. When it goes off, find a safe place to pull over and perform all five stretches. The entire routine takes just 5 minutes but makes a significant difference in how your back feels when you reach your destination.

7. Consider Professional Seat Modifications

For severe size mismatches, a skilled mechanic can sometimes relocate seat mounting brackets backward (for tall drivers) or add pedal extenders (for short drivers). While not feasible for all vehicles, it’s worth consulting a local mechanic if standard adjustments don’t solve your pain.

When to Seek Professional Help

If you’ve optimized your car seat position and still experience low back pain while driving, you may have developed muscular imbalances or trigger points that need professional treatment. As a massage therapist, I regularly treat:

  • Hip flexor tightness from prolonged sitting
  • Piriformis syndrome causing sciatic-type pain
  • QL (quadratus lumborum) muscle spasms
  • Gluteal muscle weakness leading to compensation patterns

These issues often develop from months or years of poor driving posture and may require hands-on treatment to resolve fully.

Fix Your Seat and Drive Out Your Back Pain

Your car seat position matters more than most people realize. Chronic low back pain from driving isn’t just an inconvenience – it’s your body’s warning signal that something in your positioning needs to change. By understanding how your specific body size and car type create pain sources, you can make targeted adjustments that provide real relief.

Start with the seven adjustments listed above. If pain persists after two weeks of optimized positioning, consider consulting a massage therapist or physical therapist who specializes in postural pain to address any muscular imbalances that have already developed.

Your daily commute doesn’t have to come with a side of chronic back pain. Small changes to your driving position can create significant improvements in your comfort and long-term spinal health. Your Spine Will Thank You.

Being Overweight Causes Low Back Pain

Posture Reprograming, Understanding Pain Sources

Being Overweight

If you are overweight you can bet that is a contributing factor. People that are overweight are more prone to bad posture because of the areas where the additional weight collects. Indeed I understand how difficult it is to maintain weight in todays world. Fast food coupled with a nutritional pyramid that focuses on carbohydrates and sedentary lifestyles literally make you fat. I won’t go too far into your weight because I know everyone tells you that. Given these points, just do what you can to reduce your weight and you will moving in the right direction to stop low back pain.

Dehydration Causes Low Back Pain

Self Care, Understanding Pain Sources
Drinking Water Helps Stop Low Back Pain

The Water-Spine Connection You’re Ignoring

If you’re experiencing chronic low back pain and you’re not drinking enough water, you’re overlooking one of the simplest – and most overlooked – contributing factors to your discomfort. This might sound like an oversimplification, but the connection between hydration and spinal health is backed by anatomy and physiology.

Your intervertebral discs – the cushions between your vertebrae that absorb shock and allow movement – are composed of 70-80% water. When you’re chronically dehydrated, these discs lose water content, becoming less flexible and less effective at cushioning your spine. Over time, this dehydration contributes to disc compression, reduced shock absorption, and the kind of persistent low back pain that seems to have no obvious cause.

Why Your Discs Need Water

Understanding how your spinal discs function helps explain why hydration matters so much. Each disc has a gel-like center called the nucleus pulposus, which is primarily water. This water-rich center acts like a shock absorber, distributing pressure evenly across your spine when you move, bend, or lift.

Throughout the day, as you move and your spine bears weight, your discs compress and water is gradually squeezed out. During rest – particularly when you sleep – properly hydrated discs reabsorb water through a process called imbibition. This nightly rehydration is essential for maintaining disc height and function.

When you’re chronically dehydrated, your discs can’t fully rehydrate overnight. The nucleus pulposus becomes desiccated (dried out), reducing the disc’s ability to absorb shock. This creates a cycle: dehydrated discs compress more easily, which increases pressure on surrounding structures (nerves, joints, muscles), which creates pain and inflammation.

What Actually Counts as Hydration

Over my years as a massage therapist treating chronic pain patients, I’ve heard countless clients claim they “stay hydrated” by drinking “fluids.” Let me be direct: not all fluids hydrate your body equally, and some actively work against proper hydration.

Coffee: The Hydration Debate

Coffee is a diuretic, meaning it increases urine production and can lead to fluid loss if consumed in large quantities without adequate water intake. While moderate coffee consumption (1-2 cups) doesn’t necessarily cause dehydration in regular drinkers, relying on coffee as your primary fluid source is problematic.

The bigger issue with coffee isn’t just the diuretic effect – it’s that people often drink coffee instead of water, not in addition to it. If you’re drinking three cups of coffee but no plain water, you’re missing opportunities to properly hydrate your body and, by extension, your spinal discs.

Soda: Why It’s Terrible for Hydration

Soda is one of the worst choices for hydration, and I’m not just talking about the sugar content (though that’s certainly a problem). During my time working with beverage manufacturing, I learned something most people don’t know: soda is so acidic that the aluminum lines carrying it through bottling plants must be replaced every six months because the soda corrodes them. Not for sanitary reasons – for structural integrity. The acidity literally eats through the metal.

If soda can corrode aluminum, what do you think it’s doing inside your body? The high sugar content causes blood sugar spikes that trigger hormonal responses affecting how your body processes and distributes water. The phosphoric acid in many sodas has been linked to reduced bone density. And like coffee, people often drink soda instead of water, creating a hydration deficit.

The Pure Water Principle

Here’s my stance, and I know some people find it extreme: water is water. The moment you add anything to it – flavoring, sweetener, carbonation, tea leaves, coffee grounds – it’s no longer pure water, and your body has to process those additives.

This includes the trendy water flavor packets, vitamin waters, and “enhanced” waters marketed as healthy alternatives. While these might be better than soda, they’re still not optimal for cellular hydration. Your body processes pure water most efficiently. Everything else requires digestion, filtering, or metabolic processing that reduces the hydration benefit.

Even naturally-flavored sparkling water, while better than soda, isn’t the same as still, pure water for hydration purposes. The carbonation can cause bloating and may reduce how much you’re willing to drink. If you need flavor to drink more fluids, that’s better than drinking nothing – but recognize it’s a compromise, not optimal hydration.

How Much Water Do You Actually Need?

The old “eight glasses a day” rule is outdated and doesn’t account for individual needs. Your actual hydration requirements depend on your body weight, activity level, climate, and overall health.

A better guideline: Aim for half your body weight in ounces of water per day. If you weigh 160 pounds, that’s 80 ounces (about 10 cups). If you’re active, live in a hot climate, or have back pain, consider increasing this to 60-70% of your body weight in ounces.

Signs you’re not drinking enough water:

  • Dark yellow urine (should be pale yellow to clear)
  • Infrequent urination (less than 4-6 times per day)
  • Dry mouth, lips, or skin
  • Afternoon fatigue or headaches
  • Increased low back pain, especially in the afternoon
  • Muscle cramps or joint stiffness

Why Water Quality Matters

Not all water is created equal. The source, mineral content, and purity of your water can affect how well your body absorbs and utilizes it for cellular hydration.

My Water Recommendation:

I personally drink FIJI water and genuinely believe it provides superior hydration compared to tap water or standard filtered water. FIJI is naturally filtered through volcanic rock, which gives it a unique mineral profile and pH level. The taste is noticeably cleaner than most bottled or tap water, and I consistently feel more hydrated when I drink it versus the reverse osmosis filtered water from my under-sink unit.

I believed in this strongly enough that when I ran my massage therapy practice, I gave every client a small bottle of FIJI water after their session. This wasn’t just a nice gesture – I genuinely felt it helped them rehydrate and supported their recovery. Many of my former clients can confirm this was part of their regular treatment experience. When you’re investing in something you give away for free to help people heal, that’s belief, not marketing.

Yes, FIJI is more expensive than tap water or standard bottled water. But if better hydration helps prevent or reduce chronic low back pain, the cost becomes an investment in your health rather than an unnecessary expense. For me, the difference in how I feel makes it worth the price.


FIJI Natural Artesian 1.5 Liter Bottled Water

FIJI Natural Artesian Water delivers exceptional purity and mineral balance. While it’s not the cheapest option, I’ve found the quality difference is noticeable both in taste and in how effectively it hydrates.

View current price on Amazon →

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If FIJI is outside your budget, focus on drinking more of whatever clean water you have access to. The most important factor is drinking enough water consistently – the source matters, but volume and consistency matter more.

Practical Strategies to Drink More Water

Knowing you should drink more water and actually doing it are two different things. Here are strategies that work:

Start Your Day with Water

Drink 16-20 ounces of water within 30 minutes of waking up. Your body is naturally dehydrated after 6-8 hours of sleep, and your discs need to rehydrate. This morning water intake kickstarts the disc imbibition process and sets a hydration baseline for the day.

Use Time-Based Reminders

Set hourly reminders on your phone to drink water. When the alarm goes off, drink 8-10 ounces. This creates a consistent habit and ensures you’re spacing out your water intake rather than trying to drink large amounts all at once (which your body can’t absorb efficiently).

Tie Water to Existing Habits

Drink a full glass of water before each meal, after using the bathroom, or whenever you pour coffee. Linking water intake to actions you already perform daily makes the habit automatic.

Track Your Intake

Use a marked water bottle that shows ounce measurements. Seeing your progress throughout the day provides motivation and accountability. Apps like WaterMinder or Plant Nanny can gamify the process if you respond to digital tracking.

Adjust for Activity and Climate

On days when you exercise, work in the heat, or spend time outdoors, increase your baseline water intake by 20-30%. Your body loses more fluid through sweat and respiration, and your discs need that extra hydration to compensate for increased demand.

When Hydration Alone Isn’t Enough

Dehydration is rarely the sole cause of chronic low back pain – it’s a contributing factor that compounds other issues. If you’ve been chronically dehydrated for months or years while experiencing back pain, simply drinking more water won’t immediately fix disc damage or muscular imbalances that have developed.

As a massage therapist, I regularly work with clients whose low back pain has multiple contributing factors. Dehydration might be one piece, but they might also have:

  • Tight hip flexors or hamstrings pulling on the pelvis
  • Weak core muscles failing to support the spine
  • Poor posture creating chronic compression
  • Previous injuries that never fully healed
  • Disc degeneration beyond what hydration alone can address

Increasing your water intake should be part of a comprehensive approach to back pain management, not a standalone solution. But it’s an easy, inexpensive intervention that often yields noticeable improvement within 2-3 weeks of consistent hydration.

Start Hydrating Your Spine Today

Your spinal discs depend on consistent, adequate hydration to function properly. When you’re chronically dehydrated, you’re essentially starving your discs of their primary structural component, leading to compression, reduced shock absorption, and increased pain.

Start today with three simple actions: drink 16-20 ounces of water when you wake up, calculate your target daily water intake based on your body weight, and set hourly reminders to drink throughout the day. Give it two weeks of consistent effort before evaluating whether hydration is making a difference in your back pain.

The science is clear: your discs need water to maintain their cushioning function. The question is whether you’ll provide it. Your Spine Is Thirsty – Give It What It Needs.

Related Articles on Low Back Pain Causes

Dehydration is just one of many factors that contribute to chronic low back pain. Explore these other common causes:

Sitting On A Wallet

How your wallet creates pelvic imbalance and low back strain.

Sitting On One Leg

Why crossing your legs leads to chronic pain patterns.

Low Quality Seating

How cheap chairs cost more in back pain treatment.

Lack Of Movement

Why sitting all day destroys your spine and how to fix it.

Shoes Without Arch Support

How flat shoes create a chain reaction of pain up to your low back.

Hip Muscle Tension

The hidden connection between tight hips and chronic back pain.

Lateral Leg Rotation

How your feet pointing outward affects your entire spine.

Being Overweight

The biomechanical reality of excess weight on spinal health.

Car Seat Position

How your driving posture creates chronic pain and how to fix it.

Sitting On One Leg Causes Low Back Pain

Understanding Pain Sources, , , , ,

Sitting on One Leg: The Hidden Habit Destroying Your Pelvic Alignment

Sitting on one leg is another very common cause of low back pain. Especially in women. Folding a leg between your thigh and the chair seat also causes the same pelvic deviation as mentioned above. At first you may think sitting this way is more comfortable for you. However with the increased number of hours people are sitting at the computer the deviation created is very dangerous. Even if you switch between the left and the right leg.
The compression you are putting on your discs is multiplied far beyond normal. Then you “Switch” and amplify the compression to the opposite side. When you sit at the computer be sure to keep your feet flat on the floor. Better yet take a look at a footrest. There are multiple designs to choose from. I would recommend one that moves easily so you will be inclined to move your legs throughout your workday.

In my time of clinical practice, I’ve noticed a specific pattern of hip tension that almost exclusively affects people who ‘tuck a leg’ while working. I call it the Tucked-Leg Trap.

When you fold one leg under your thigh you are forcing your pelvis into a sustained, aggressive rotation. This creates a massive imbalance in the Psoas and Piriformis muscles. At first, it feels comfortable because you are ‘locking’ your joints, but over time, this habit creates a Pelvic Deviation that forces your lumbar discs to compress unevenly.

The Switching Myth: Many patients tell me, ‘I switch legs every 20 minutes to balance it out.’ Clinically speaking, this is actually worse. Instead of one side being tight, you are now creating a ‘shearing force’ on the sacroiliac (SI) joint, irritating the nerves on both sides.

The only clinical solution is to keep your feet flat, or better yet, use an Active Footrest that encourages movement while keeping your hips level.

Adjustable Under Desk Footrests

2026 Recommended Footrests to Stop “Leg-Tucking”

These active footrests keep your hips level and prevent the pelvic rotation caused by sitting on one leg.

Everlasting Comfort Foot Cloud

Everlasting Comfort Cloud Foot Rest

Best for Movement: The teardrop design allows you to “rock” your feet, keeping blood flowing and satisfying the urge to shift positions.

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Mind Reader Tilt

Mind Reader Adjustable Footrest

Best for Height: If your feet don’t reach the floor, you’ll naturally tuck a leg. This adjustable tilt-rest solves that height gap perfectly.

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Humanscale Foot Machine Footrest

Humanscale Foot Machine Footrest on Amazon

Firm Support: The Humanscale Foot Machine Footrest is my pick for footrests. You can not find one of better quality and firm adjustability. It is not the least expensive but it truly is the best.

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The “QL Crunch”: Why One Side Always Aches

When you tuck a leg, you are performing what therapists call a “hip hike.” This puts the Quadratus Lumborum (QL)—a powerful muscle that connects your lower ribs to your pelvis—into a constant state of contraction. This habit creates a Pelvic Deviation similar to what happens when you sit on a thick wallet, but with the added complication of muscular shortening.

On the tucked side, the QL becomes short, tight, and “angry.” On the opposite side, the muscles are overstretched and weak. This muscular tug-of-war is why you feel that deep, dull ache right at the top of your waistline after a few hours at the computer. You aren’t just sitting; you are “training” your muscles to hold your spine in a curve.

The Comfort Trap: Why Your Brain “Likes” This Position

If sitting on one leg is so bad, why does it feel so good? It’s because of Joint Locking. When you tuck a leg, you “lock” your SI joint and your hip into a stable, bone-on-bone position. This allows your core muscles to completely relax.

Essentially, you are using your skeleton to hold yourself up because your postural muscles are tired. While it feels like “rest,” you are actually placing the entire weight of your torso directly onto your spinal discs and ligaments instead of letting your muscles support you.

Clinical Self-Check: The “Level Pelvis” Test

If you’ve been a “leg-tucker” for years, your pelvis might feel “level” to you even when it’s tilted. To reset your body awareness:

Sit in your chair with both feet flat on the floor.

Place your hands on the bony points of your hips.

If one hand feels significantly higher or more “forward” than the other, your muscles have already begun to shorten.

The Fix: Beyond using a footrest, you must “re-train” your nervous system to accept a level pelvis. Every time you feel the urge to tuck your leg, it is a signal that your core is tired. Instead of tucking, stand up, take a 30-second walk, and reset.

Sitting On A Wallet Causes Back Pain

Posture Reprograming, Understanding Pain Sources, , , ,

Sitting On A Wallet Causes Back Pain

Sitting on a wallet is a sure fire way to exacerbate low back pain. Moreover is the wallet is jam packed with 3 inches of useless paper. There is absolutely no good reason to have a wallet that is inches thick. With mobile devices being what they are today anything you have stored in your wallet can be entered into your mobile device.
A thick wallet causes low back pain because the wallet pushes up on your hips unevenly. An uneven pelvis is called a Pelvic Deviation. Pelvic Deviation causes the lower lumbar vertebrae to be off center either left or right. The deviation causes low back pain because it will cause the soft fluid discs to become impinged. The impingement is what causes the pain because the nerves from your spinal cord exit between the vertebrae and the disc. Nerve impingement = pain. It’s just that simple.

In my years as a clinical therapist, I’ve seen hundreds of patients walk into my office with a slight ‘hitch’ in their gait (walk) and a tilted pelvis (usually forward and/or twisted). Sitting on a wallet is a sure-fire way to exacerbate low back pain, especially if that wallet is jam-packed with 3 inches of useless paper. There is absolutely no clinical reason to carry a wallet that thick anymore.

If for any reason you need a higher level of medical education to confirm; here is a video from Dr. Nabil Ebraheim confirming that you should pick up some RFID Sleeves, ditch your wallet and your back pain.

Front Pocket Wallets With RFID Technology

2026 Recommended Front Pocket Wallets (RFID Protected)

The Ridge Wallet

The Ridge Wallet available on Amazon

The Gold Standard: Military-grade aluminum, holds 12 cards, and is literally “un-bloatable.”

Check Price on Amazon >

Ekster Cardholder Pro

Ekster Cardholder Pro available on Amazon

The Tech Choice: Features a “pop-up” button for instant card access without fumbling.

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Silver RFID Sleeves

Generic Silver RFID Sleeves available on Amazon

Best Value: These are what I carry my cards and drivers license in. I also have one for my passport. If you can handle having separate cards in your pocket this is THE way to go.

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The Expert Edit: “The 3-Inch Obstacle to a Pain-Free Spine”
Headline: Fat Wallet Syndrome: Why Your Back Pocket is Killing Your Spine (and How to Fix It)

The Body:
“In my two decades as a clinical therapist, I’ve seen thousands of patients walk into my office with a slight ‘hitch’ in their gait and a ’tilt’ in their pelvis. Often, before I even touch their back, I look at their pants.

If you are sitting on a 3-inch stack of leather, receipts, and old business cards, you are carrying a spinal disaster.

The Clinical Reality of ‘Pelvic Deviation’
When you sit on a wallet, you are essentially forcing one hip to sit higher than the other. In clinical terms, we call this Pelvic Deviation. This uneven foundation forces your lower lumbar vertebrae to shift off-center to compensate.

Think of it like the foundation of a house. If one side of the foundation is three inches higher, the rest of the house has to bend to stay upright. In your body, that ‘bend’ happens at the soft, fluid-filled discs between your vertebrae.

This nerve impingement is what causes that familiar shooting pain, numbness, or ‘electric’ feeling down your leg. It’s not just a backache; it’s a structural crisis.

The 2026 Solution: Digital & Minimalist
There is absolutely no reason to carry ‘inches’ of paper anymore. Between mobile payments like Apple Pay and digital insurance cards (should be in your glovebox anyway), your wallet should be as thin as your smartphone. Thinner.

My clinical advice: Switch to a Front Pocket Wallet if you’re fancy or just the RFID sleeves. Moving your essentials to your front pocket keeps your ‘sit bones’ level and removes the pressure from your sciatic nerve immediately.

Below are the three styles I recommend to those who are serious about ending back-pocket sciatica.”

More Clinical Insights on Posture & Pain from StopLowBackPain.com

Assessing Low Back Pain Effectively

Assessing Low Back Pain

Posture Reprograming, Understanding Pain Sources, , , , , ,

Assessing Low Back Pain
Above all to stop low back pain you must begin assessing low back pain. It should be noted that assessment is much easier than you think. In this article I will outline way to help you assess the cause of your low back pain. By incorporating the suggestions here you will begin to gain a clearer understanding of the root cause of your low back pain.

Stop Saying My Back Hurts

The statement “Stop Saying my Back Hurts” may seem ridiculous however it is part of assessing low back pain. Albeit true, try being more specific with yourself. Replace the above statement with What Am I doing right now? Then assess your current activity. Are you sitting on one leg? Do you still have that bulky wallet? Are you sitting in a poor quality seat? Once you have an answer to the above questions there is yet another question.

What Can I Do To Correct It?

Take action immediately by asking yourself “What can I do to correct it?”. Then do it. For example, throw that wallet away and get a front pocket wallet. If you’re sitting in a poor quality, unsupportive seat, stand up or move to a different seat. While the pain may not immediately subside, identifying the contributing action and correcting it will put you on the correct path. Moreover try not to get angry when you feel your low back pain.

Anger Increases Your Low Back Pain

A common reaction to low back pain is anger. Unfortunately, pain does not correct itself because you are angry. Quite the opposite actually. When you are angry your muscles will naturally begin to tense up. Thus, anger increases your low back pain. Additionally, muscle has memory. So if you are angry at the low back pain you feel you are actually training your muscle to increase tension when you are angry.
How counterproductive is that!

Here is an example to help you get a clear picture. Think back to a repetitive motion job you did. It could be stuffing envelopes to filling jars. Any repetitive job in your past. Do you remember how the first couple times you fumbled around a bit? Then after 15- 20 minutes you seemed to be able to do the job without thinking? That experience was muscle memory at work. In that situation you literally programmed your muscles to know the exact distance to reach to grab the paper and stuff the envelope. Similarly, your back muscles can have this reaction.

Chatuchak Market Vacation Back Pain Causes
Chatuchak Market, Thailand. The juggernaut weekend market that cause my back pain to creep up.

My Process Of Assessing Low Back Pain (This really happened!)

Here is an example of my process for assessing low back pain when it creeps up on me. I’m on vacation in Thailand. We had just walked the better part of the afternoon around Chatuchak Market in Bangkok. The place is massive. Not only did we walk all afternoon but we took public transportation back to the hotel. That means more standing because the train was packed. Then my back pain started. Dull at first but began increasing pretty quick.

I paused and began to “feel” around for a cause. I know we had walked far but I had on Keen sandals which normally give me great support. Plus me feet didn’t hurt, neither did my knees. So I moved on to my hips. Ah ha! I could feel my hips were super tense. Being on the train I was able to hold onto a grab bar and stretch out my hips pretty nicely. I held the stretch on each side for a good 30 plus seconds and did that three times per side. I looked a little funny but whatever.

Again, the pain didn’t go away instantly but I was able to feel it subside rather quickly. When we stepped off the train I was able to walk easier. Also, while standing waiting for cross walks I stretched my hips again, however not as intense. By the time we hit the restaurant I was feeling much better. This is the power of assessing low back pain, without anger, at work.

Applying This Example To Your Self Assessment

In your case you may not stop at your hips. The cause of your pain may be a little higher. Regardless the assessment process is the same. “Feel” each part of your body and analyze what you are doing that is causing the pain. Refrain from anger if at all possible. Then incorporate a stretch to help alleviate the pain. The stretch can be something as simple as a Pelvic Tilt or standing up and taking a short walk using long strides. Whatever the fix is for you the goal is to identify it and take immediate corrective action.

The Positive Rest Position

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The Positive Rest Position Explained

The positive rest position is a common recommendation among Chiropractors and Physical Therapists. Chances are if you have seen one of these practitioners they have shown you this position. The idea behind The Positive Rest position is similar to that of the Lateral Stretched Leg. Similarly they both work on Positional Release.

How The The Positive Rest Position Works

During this relaxation technique you are positioning your body in what is also known as a “Zero Gravity Position”. This position places your legs higher than your torso which reduces pressure on your low back. While reducing the pressure on your low back you are allowing the muscles to relax and self heal. As with the stretched leg exercise you can maintain this position for as long as is comfortable.

Getting Into Position

In short, your torso will be on the floor and your lower legs will be elevated above you on a couch or chair. If your floor is hard you can place a pillow or two lengthwise under your torso. Similarly if the seat of your couch or chair is too high you would use the pillow to bring your legs to a 90 degree angle. You can lay in this position for as long as you like.

Add A Pelvic Tilt

For added benefit you can preform pelvic tilts. These motions are easy. Just rotate the top of your pelvis in the direction of your head. Hold the rotation for 1-2 seconds and release. First The key with pelvic tilt is to not tense too much. Second is to use your stomach muscles to initiate the motion. Using your stomach muscles will allow your back muscles to “Turn Off” thus increasing the Positive Rest Position benefits. As mentioned above, you can do this to your comfort level.

Most importantly, if you feel discomfort, stop. That should go without saying.

Finish Easy

An important note is to get up from this position slowly. Trying to get up too quickly can cause you to tighten your low back. Rather exit the position slowly. You may want to twist your torso or push away using the floor.

In conclusion The Positive Rest Position is a passive exercise designed to reduce low back pain. Likewise this position can be achieved by using a Zero Gravity Recliner.

What Is A Zero Gravity Recliner?

As I have said a Zero Gravity Recliner is simply a chair that puts you in The Positive Rest Position. While there are many versions of Zero Gravity Recliners on the market, the quality is not equal. I recommend you use Relax The Back to make your purchase. The reason is Relax The Back will handle any warranty issues you have in the future. For example, the chair breaks. No problem. Call Relax The Back and they send out a tech to fix the chair. You don’t have to deal with the manufacture. Moreover you don’t have to ship the chair.

When shopping from Zero Gravity Recliner chairs there there are two different feelings you will get. One style your will feel you are sitting ON the chair. Compared to the other feeling of sitting IN the chair. Here is an example.

This style you feel “ON” the chair

Novus Zero Gravity Recliner Positive Rest Position Chair
This Novus Zero Gravity Recliner will give you the feeling of sitting ON the chair in the Positive Rest Position.
This style you feel “IN” the chair

Perfect Chair Zero Gravity Recliner Positive Rest Position Chair
This Perfect Chair Zero Gravity Recliner will give you the feeling of sitting IN the chair.

At this point I will open up for questions about the Positive Rest Position or Zero Gravity Recliner. Leave a comment or Contact Me.

Correct Lateral Rotation Feet Facing Forward

How To Correct Lateral Rotation

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Lateral Or Outward Leg Rotation

Lateral leg rotation is point often overlooked. Standing still, look down at your feet. Do they point straight ahead or out to the side? In truth chances are if you are trying to stop low back pain your feet will point outward. Similar to a dancer in first position. When your feet point outward or have a lateral rotation your pelvis naturally will fall forward causing low back pain. This is called Anterior Pelvic Tilt. Similar to a Pelvic Deviation except
Anterior Pelvic Tilt is when your pelvis tilts forward rather than to the left or right.

Although it may be tough to understand the relationship between walking and low back pain undoubtedly there is. Correspondingly the products below will assist you in correcting lateral rotation. Basically you are going need floor guides to help you along. Provided that you practice the exercises diligently you will see results.

Read More On Correcting Lateral Rotation >


Use Tape On The Floor As A Reference.

How To Correct Lateral Rotation

It is a must that you correct lateral rotation if you want to stop low back pain. I have heard over and over “that’s just how I stand and walk”. This is false. You learned bad posture and if your mindset is “this is how it is” then chances are you will never stop low back pain. Now.

~Standing And Correcting

Standing still rotate your feet inward so they point straight in front of you. Stand in this position for 5-10 minutes. Do not allow your feet to rotate outward. Instead focus on your pelvis, attempting to tilt or rotate your pelvis backward. Relax into this position. You may feel funny at first but keep doing it. You are correcting years of bad posture that contributed to your low back pain. If your goal is to stop low back pain you must correct your posture. Practice this a minimum of 5-6 times per day if you sit for the majority of the day. If you work a job where you stand, you should focus on Standing and Correcting all the time. Feet Forward needs to become a new habit.

~Walking And Correcting

Once you have a feeling for Standing and Correcting it is time to start Walking and Correcting. At this point I strongly recommend you invest in orthotics. There are low cost orthotics available that will help correct your posture from the ground up.
From the Standing and Correcting position, feet pointed straight forward, take one step forward. Now that you have taken one step look down at your feet and make sure they are still pointing forward. Correct them to point straight if needed then take another step. Look down again and correct your feet if needed. Take another step. Correct. Take another step … and so on.

As you take each step focus on the way it feels to use your legs and feet to walk. What may feel uncomfortable to you is the body re-learning how to walk correctly. Continue to take one step at a time until your feet are still pointing forward after your step.

~What Exactly Do These Exercises Do?

Ultimately what “Standing And Correcting” and “Walking And Correcting” do is re-program your muscles to walk correctly. In the end, you are training your hip joint to move in a correct path while walking. By correcting the hip joint lateral rotation your pelvis will automatically balance itself. Re-programming your muscles may take time. Be patient with yourself and keep at it. Lateral Rotation is one a major factor in low back pain because of the Anterior Pelvic Tilt Lateral Rotation causes.

Make Movement Priority One Walking With Low Back Pain

Make Movement Priority One

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Suffering from low back pain can leave you immobile. Besides being in physical pain, energetically you may feel drained. Even so, make movement priority one. Failing to do so sooner or later can leave your completely incapable of moving at all!

Lack Of Movement

Lack of movement is another major contributor to low back pain. After all the body is not meant to sit. That is to say the human body is designed to stand and move about. Today’s stagnant computer lifestyle is not at all what we are designed for. Ask yourself, how long did a caveman sit? Not long at all is the correct answer. Now don’t be confused. Certainly I’m not saying you have to get a gym membership or anything like that. Basically just get up and walk around. Take longer strides when you walk. As you walk think about relaxing your low back and allowing your legs to work freely. When you relax and focus on walking correctly you will find will be amazed at how much better you’ll feel.

How Often Should I Walk Or Move Around?

As often as possible. Once a day is not good enough. I’ll just be honest with you. You should have a focused relaxed walk at least 2-3 times a day. Roughly 15 – 30 minutes or more each time. The idea is to get mobility and relaxation to relieve your low back pain. See the “Lateral Rotation” section below for tips on walking correctly to stop low back pain.

Make Movement Priority One Daily

There were days that crippling low back pain kept down however my goal was to minimize those days. No matter what I tried to make movement priority one daily. You should too. Despite what you may be thinking I am not telling you to run a mile. Certainly for some of my readers walking will be difficult while running will be impossible. On the contrary, any movement will do. Even if you can only make snow angels in your bed, do it. You will get significantly more benefit from moving your arms than nothing at all.

Do The Maximum Movement You Are Capable Of

Regardless of what the movement is do the maximum amount of movement you are capable of every day. To put it another way, if you can move your arms straight above your head then do it. Do it multiple times too. In the same fashion if you can walk around the block 10 times do that also. Ultimately your goal is to retain the maximum amount of movement you have at the current moment. Do not let low back pain stop you from moving the rest of your body.

Snow Angels Movement With Low Back Pain
Even if you are on bed rest try to move your arms like a Snow Angel.

Move It Or Loose It

Chances are you have heard the phrase “Move It or Loose It”. This phrase refers applies to your body too. Undeniably when you stop moving to your maximum Range Of Motion your range of motion will decrease. Additionally, prolonged periods of sedentary lifestyle can lead to Atrophy. Atrophy is a medical term for the decrease in muscle tone or mass. An example of this is a person that has had a cast on a broken arm or leg. If you have seen them when the cast is removed you will notice that the casted arm or leg will be smaller that it was before the broken bone. The reduction you see in muscle size is called Atrophy. In like manner when you don’t move for a long period of time all of your muscles are subject to Atrophy. For this reason I say make movement priority one!

If You Can, Walk!

Most effective recoveries happen when back pain suffers make movement priority one. To that end walking correctly can be instrumental to a speedy recovery. Mall walking or street walking, the choice is yours but get up and get out. A walking exercise that I do commonly is I will walk as far as I can away from my house. Then when I get too tired I get in a taxi and go home. This exercise works great if you are in an urban area however, this may not work for everyone. An alternative is to arrange a taxi to pick you up or have a friend meet you at a specified destination, like your favorite restaurant. Use your ending destination as a reward. Pick some place good. Like an ice cream shop!

Movement Is Good But Do It Correctly

To emphasize, movement is good but do it correctly. Especially if you are in a heightened state of pain. An example would be lifting with your legs. In fact, if you have low back pain you may want to practice proper lifting. A great exercise is picking up a piece of paper. There is only the weight of your body so when you squat down you only have to focus on your posture, not potential weight. Similarly walking correctly. Make sure your feet face forward with every step. If your feet turn in or out you are not moving correctly. Slowly make adjustments and get your feet to point straight ahead. Likewise, if your movement is snow angels in your bed do some with your palms together and some with your palms facing out.

Recommended Reading For Movement

Unquestionably there are hundreds of books on movement and stretching however a few of them really stand out. Among the best is “Stretching” by Bob Anderson. With simple illustrations in a large format, every stretch you’ll ever need is in this book, ironically called Stretching.
Second is “Life After Pain” by Dr Jonathan Kuttner. In this book Dr. Kuttner guides you along the path to eliminating chronic pain of all kinds. Dr. Kuttner explains what causes your pain and offers outstanding techniques to help you back to health. Most notable techniques are Dr. Kuttner’s breathing exercises.
The third book I recommend is “Mobility: A Step-by-Step Guide to Treating Musculoskeletal Pain Yourself” by Dr. Nick Chretien. Dr. Chretien writes from a perspective of crossfit/weight training however the techniques he teaches in the book are outstanding. Dr. Chretien takes you through understanding myofascial pain which is a key factor in all types of pain.

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I added the recommended reading above in the hope that you continue on the path and make movement priority one everyday. Moreover, please share this with friends and loved ones who live with pain. Friendly love and support is sometimes the second best medicine … second only to laughter 🙂