Pain – where is it coming from?

The source and root cause of your pain may not be what you think…..

What do you see in the picture – do you see chess pieces or people?

I love those things – I love having to look at them and ‘waiting’ to see or be able to see what the other image is. Sometimes you can do it straight away and sometimes it may just take a bit of time….

Chronic injuries and pain are exactly the same.

You may have had an initial problem here, but over time that does actually heal and where you feelĀ  your pain and what it is actually coming from can be quite different.

A case in hand is my son. He’s a swimmer. He does swim squads training 6-7 times a week.

He’s also had a growth spurt hitting 6 ‘ 3″ at 14.

He was complaining of left sided low back pain. His pain was along the quadratus lumborum muscle (QL) and lats and also on the lumbar vertebrae and lower ribs which were stiff and sore to move.

He had also been doing heaps of butterfly stroke which causes a hinge at the level which was sore, and on testing extension was reproducing his pain.

The pain was there and present for about 3 weeks on and off, but had now become an issue which interfered with his fly training which he could no longer do – hence I stepped into physio mum mode and actually looked at him properly as my quick 5-10 mins before bed obviously weren’t gonna cut it!

So my initial management was along the lines of soft tissue work, local joint mobilisations, strapping for support and stretches.

NB – the kinesio tape was done with a caudad glide to help the vertebrae as a mulligans style thought process with a sling support along lats to help glide the lower ribs also… it worked to allow him to train pain free as it replicated the local joint mobs I was doing and ensured he wasn’t over using lats to cause compression

Rationale – he’s had a major growth spurt,he’s training heaps, he’s one a heap of fly work – he’s just sore and over working/ fatigued.

This worked for a short while and he could continue to swim, but the pain would keep coming back, and so I had to look deeper. Why was this happening as I can obviously ‘fix it’ — but I wasn’t addressing the ‘why’.



The problem was actually a weak left glute…if you look at the picture above you can see his ‘glute fills his shorts, you can see the left side does not – there’s ripples in his pants from a deficient glute.

On testing what was actually happening was he couldn’t lift his leg fully from the glute area so was pulling into his lower back – hence the over activity in QL, erector spinae and also the ‘hinge’ at the lumbar joints.

We added in glute work with clams and low and behold the pain hasn’t returned.

Being his mum makes it easy – I know how he moves, I see him all the time, the down side for my kids is that I never actually really “assess’ them properly – they ask and complain about aches and pains 5 minutes before bed.

They don’t want to have that ‘thorough’ assessment because i should just know.

They don’t get that I need to actually fully test things and are reluctant to drag their eyes from the telly to get ‘looked at’.

His whole episode of pain and restricted training was over a two week period.

My management could get him pain free but he couldn’t fully train as he would then feed back into poor muscle recruitment.

This is where the issue lies when people say I keep getting treatment but it’s of no use – it keeps coming back. Physio doesn’t work.

It does work – we are just off the mark.

Sending my child to someone else – I would hazard a guess he would have been told to rest for two weeks and go back. With my management we just modified training and removed fly and he could do everything else and was back pain free after two weeks – not going for a review and check up.

Experience and knowledge and looking beyond the obvious reaps benefits.

Will I ever send my kids to another physio – Yes – if i think they are better than me, and if my child needs to hear what needs to be said from some one else.

Would I let them touch them without knowing what they are doing or agreeing to it – absolutely no way!


If your management is not giving lasting results – you need to change it.


About Saree Hewlett (149 Articles)
Saree has 20 + years as a physio, training in the UK and completing her Masters in Manual Therapy in Perth, UWA. She has integrated Pilates into her practise having trained in the Polestar method and currently owns and runs two Studios in Perth's Northern Suburbs. A previous international Artistic Skater she understands the needs of sports people and also those suffering from chronic pain and reduced function - we all want the same thing - to be the best we can be! She is married with two active young boys!

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