The Obstructions

It is the 171st day of the year. A palindrome that is divisible by three.

Sometimes the terminal ends of an interim are not identical. I have been fasting for the past three days, and it has been no big deal. That’s a nice change from the before, when it was a thick lens on my daily experience, an incessant distraction, even long after the hunger pangs were gone. I just kept thinking about food. Not so this time.

I have noticed this with other efforts, also, especially when practicing my handwriting: stopping for a period and restarting seems comparably beneficial to practicing throughout. There is some processing going on. Maybe it’s easier to process some material when not actually engaged in the relevant practice. It seems to me sometimes I am distracted by some awkwardness, and continuing to practice keeps triggering that feeling. There are so many distractions. Learning a new grip on the pen distracts from forming the letters. I practice it for weeks and the awkwardness doesn’t diminish. It is hard to imagine the awkwardness going away. Then I stop for a few weeks, try it again, and it feels comfortable. It took R.A. Dickey 30,000 pitches before he started to feel comfortable with his knuckleball. I wonder if he took breaks.

Years of back pain seem to have been caused, somehow, by the quadratus lumborum. I watched a video about it, and now the pain is mostly a memory and a fear. But it’s complicated. According to the NCBI:

There is no consensus in the literature whether an alteration of the tone of QL may be the primary cause of back pain. We know that the size of the quadratus lumborum is smaller in the dominant’s side leg, compared to the opposite side. We know that in case of low-back pain the QL does not vary much its size compared to people without pain.

It is likely that since the twelfth thoracic, ilioinguinal, and iliohypogastric nerves pass and give branches to the QL, the possibility exists that in cases of inflammation of the nervous tissue due to a limited excursion (entrapment), these tissues can produce a syndrome that mimics low-back pain.

We know that trigger points can involve the QL. This condition could also mimic a painful syndrome of the lumbar area.

And:

One must consider that it is difficult for a single muscle to cause pain, except with direct trauma. All the muscles interconnect as a function of the fascial system, and in a contractile area with altered function, it will lead to functional difficulty all the surrounding muscular regions.

So I have been walking, stretching, and consciously relaxing that area, keeping in mind that the muscle elevates and rotates the hips. It is an extension of the transversus abdominis. This is interesting. I’ve always found that sucking in my stomach alleviated the pain. Articles I read indicated it had something to do with aligning my spine. But I could never picture what was going so wrong when I wasn’t sucking in my gut. Was the spine pressing against a nerve, or what?

But if engaging the transversus abdominis also engages the quadratus lumborum, maybe I was just working the muscle out a bit, getting it to stop spasming?

The relationship between the transversus abdominis and lower back pain doesn’t seem clear cut, either:

From Wikipedia:

While it is true that the TVA is vital to back and core health, the muscle also has the effect of pulling in what would otherwise be a protruding abdomen(hence its nickname, the “corset muscle”). Training the rectus abdominis muscles alone will not and can not give one a “flat” belly; this effect is achieved only through training the TVA.[3] Thus to the extent that traditional abdominal exercises (e.g. crunches) or more advanced abdominal exercises tend to “flatten” the belly, this is owed to the tangential training of the TVA inherent in such exercises. Recently the transverse abdominal has become the subject of debate between Biokineticists, kinesiologists, strength trainers, and physical therapists. The two positions on the muscle are (1) that the muscle is effective and capable of bracing the human core during extremely heavy lifts and (2) that it is not. Specifically, one recent systematic review has found that the baseline dysfunction of TVA cannot predict the clinical outcomes of low back pain.[4] Similarly, another systematic review has revealed that the changes in TVA function or morphology after different nonsurgical treatments are unrelated to the improvement of pain intensity or low back pain related-disability.[5] These findings have challenged the traditional emphasis of using TVA-targeted intervention to treat low back pain.

Maybe some of this variation is that some of the reported low back pain is actually caused by the abdomen?

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