Adhesions are part of a family of musculo-skeletal disorders that contribute to low back pain. They are a type of internal scar tissue that builds up around the muscle fibers and connective tissue, causing them to clump together and restrict their independent movement. This often causes referred pain to other parts of the body that can further contribute to muscle imbalance and increased back pain.
Adhesions are thread-like strands of collagen produced by the body in response to healing after trauma, whether from surgery or injury or both. Adhesions may also be produced by overtraining or by chronic poor posture, for example as a result of lengthy sitting at a desk or computer. Once formed, unless action is taken, adhesions can become larger or tighter over time, further restricting back mobility and often exacerbating back pain.
Until recently, the only option to repair adhesion damage was lysis surgery which involved cutting or burning the adhesions. However this same procedure often created additional adhesions from the surgury itself. In contrast, certain kinds of specific, focused exercises have been found to reduce both the number and impact of adhesions by breaking down their web-like connections to body tissue and helping return movement to normal.
Muscle and fascial stretching with or without equipment have been shown to reduce muscle adhesions and restrictions. Self massage techniques, also known as self myofascial release, using foam rollers or Swiss balls have also been shown to reduce the severity of low back pain when targeting the back extensors or hamstring muscles.
Therapeutic exercises applied by qualified manual therapists have been found to be the most effective technique for easing low back pain. Massaging or stretching the effected tissue in this way can break some of the links between adjacent connective tissue bundles. Therapeutic exercises are particularly appropriate for adhesions to the lumbosacral junction and sacro-iliac joints, areas that are not accessible to self massage techniques but are often the root of low back pain according to therapists at Clear Passage Physical Therapy.
Risks of exercise
If an individual has low back pain as the result of adhesions, biomechanical compensations for these restrictions automatically develop in other parts of the back musculature as well as the body generally. If conventional exercise is continued, the compensations accumulate over time and become areas of pain and dysfunctional movement according to Ann and Chris Frederick, creators of Fascial Stretch Therapy and authors of the best selling book "Stretch to Win."
- Clear Passage Physical Therapy: What are adhesions?
- “Stretch to Win”, A. Frederick and C. Frederick, 2006. pp 96-101.
- “Physical Therapy”. The effects of manual therapy on connective tissue. A.J. Threlkeld, Vol. 72, pp 893-902, December 1992
- v: How to relieve your back and hip pain without drugs: Chronic back pain treatment
- “Stretch to Win” A. Frederick and C. Frederick. 2006 p. 11.