7 Tips in helping your Lumbar Facet Syndrome

Danh NgoLow Back PainLeave a Comment

golf and lower back pain

When you are having lower back pain, the unknown of what you are dealing with can be frustrating. The list of diagnosis in what it can be is long and google does not help you feel reassured. As the only Physical Therapist in Long Beach with a triple specialization in Sports Medicine, Spine, and Functional Medicine, we have seen 1000’s of people with lower back pain. Today we will highlight one common diagnosis called Lumbar Facet Syndrome.

Before we dive into the tips, it is important to understand the pattern that confirms that you have lumbar facet syndrome, and what does that mean to you.

We have a saying that we preach. If you treat your body the way it was designed, you will age well and have little to worry.

Your facet joints, also known as your zygapophyseal joint, are designed to guide a specific movement, help offload compression stress to your spine, and limit rotational stress.

If you look at the picture of the lumbar spine and follow-up by placing your palms together into a praying position, you are demonstrating the exact positions that your lumbar facet joints are oriented. The praying hand posture allows you to slide them up and down like you are warming up your hands. The same hand posture compresses into each other when you attempt to move your hands’ side to side.

The quick exercise you just did help you to see how your lumbar facet joints help with movements such as flexion (bending forward) and extension (bending backward). This is called moving within the sagittal plane.

You can feel the compression and resistance when you twist your spine. Your lumbar facet joints move side to side with lateral tilting and twisting. Due to this factor, your lumbar facet joints help to support and offload the stress that goes to your lumbar disc.

It is rare to find someone with a lumbar disc bulge, prolapse, or herniation without any wear and tear to the lumbar facet joint. A common finding that you may read in your radiologic finding includes osteophytes or facet joint hypertrophy.

There are research studies that have looked at how your lumbar facets anatomy can give you a higher chance of having lower back pain. There are three common findings. Your facet can be shaped like a “C”, “L”, or “I” shape.

If you play along and shape your palms in this letter shape, you can see how they alter the function to your lower back. You have less support with “L” shape facet joints.

Regardless of this, the human body has survived this long because it does not rely on one structure to do one job. There are numerous structures and tissues that help and support.

1. Improve your abdominal strength.

If your lumbar facets are designed to take on work and posture load when you extend your lower back, the antidote to this movement is to strengthen the muscles that resist extension. This is where building up your abdominal strength is valuable in offloading the load to your lumbar facet.

There are numerous abdominal muscles that are positioned in different directions or vectors. There are your Rectus Abdominus, Transverse Abdominus, External Abdominal Obliques, and your Internal Abdominal Obliques muscle. You can add non-abdominal muscles to this list, but they provide an indirect counterforce: Iliopsoas, Diaphragm, and Superficial front fascial line.

TIP: Planks: Lay on your stomach and prop your body up while you are on your elbows and toes. Your spine and body should be straight as a line.

It is suggested to use a mirror to check form. You should only feel your abdominals region working and not your lower back, groin or Quadriceps muscle region.

HOLD 20-60 seconds. Repeat for 3-5 times.

2. Implement an anti-rotational stabilization program.

Your abdominals help to offload the direct posterior vertical stress load to your facets, but it does not directly assist your lumbar facet in its functionality. If you help that tissue or structure at play, then it does not have to work hard.

Your lumbar facet role is to resist rotation. The anatomical orientation of the lumbar facet makes it a structure that collides into each other when you rotate through your lumbar spine. This happens when you are not using your body’s inherent rotators to help you move 3-dimensionally.

Your hip muscles, thoracic spine joints, and ankle/feet muscles help to sense, initiate, and produce a counter-rotational force.

If you notice the thoracic facet joints are in the opposite plane of motion and hence the joint that can take the brunt of this force. Your hips are designed as a ball-and-socket joint, and hence are more mobile and the region that allows us to move in a true 3-dimension fashion.

Your ankles are highly unique as it is two joints into one. Your talocrural and subtalar joints are the two joints. If you have been following us, your hips and feet feed off each other to help you to move.

TIP: Pallof Press Exercise. You need a sofa cushion or a yoga 1-2 inch foam pad and a theraband or cable cord system.

Grab a sofa cushion and place one knee down. Place your other leg in front. You are in a half-kneeling position.

The band or cable cord should be to your side.

Grab the theraband or cable cord handle and pull the band from your sides towards your front. The cord or band is pulling you sideways into a twisting motion and you are working to resist this force.

HOLD 20 seconds or short of lower back pain. Repeat 5 times. Make sure your trunk or hips are not shifted and located firmly over each other.


3. Improve on your Superficial Fascia Back Line.

As our body is not reliant on one specific structure, we have to train and treat it in a holistic manner. Here is where the fascial system comes into the picture.

Our fascia system functions to spread the workload throughout the body. It is the system that makes the theory of kinetic movement energy system happen. The kinetic energy system is where Bruce Lee is using every single muscle and joint in his body to produce a 1-inch punch. It is the system that separates a pitcher from throwing 100 mph and another at 80 mph.

Your Superficial fascia back line helps to connect most of the musculoskeletal system located on the backside of your body to each other. It is the system that connects your hamstring muscles to the scalp in your head or Epicranial aponeurosis.

Your fascial system works best when it is supple and pliable. The ideal movement pattern that demonstrates an optimal Superficial Back Line is toe touching. If you cannot stand and touch your toes, keep working on this movement pattern to help your Lumbar Facet Syndrome.

TIP: Supine Alternating Straight Leg Raise (SLR). Lay on your back and steadily raise your legs up towards 70-90 degrees. Your knees must be straight and under good control.

Perform 30 repetitions daily. You should feel your abdominals muscles working more than your hamstring muscles stretching.

4. Understand the nuance of your lifestyle and sports and its impact on your lumbar facet joints.

The difference between a Physical Therapist and a Sports Medicine Physical Therapist is the understanding of how rehabilitation needs to connect to a client’s goals.

As you only exercise for 20-60 minutes a day, an athlete or your lifestyle tends to put you in more repetitive work stress that overrides your exercise benefit.

Here are three examples that highlight the nuance of every sport.

A pitcher who does not have good hip or leg awareness, core neuromuscular control, poor technique, or physical compensation somewhere will overextend their spine back and to one side. This is the classic pattern with overloading your lumbar facet. A pitcher will do this for 1000’s of times.

A golfer with a lack of hip awareness or control, improper golf swing technique, or possible golf club fitting will overextend and dip their shoulders back and down. This is called a Reverse Spine Angle and a classic number one reason for having back pain during a backswing sequence.

An offensive lineman’s job is to protect the quarterback. If he has weak arm power, poor leg control, football technique, or insufficient core strength, he will overarch his back without knowing this. This places huge stress on both of his lumbar facet joints.

As you can see how knowing the sport can help piece a problem when a client does not get better with exercise alone. Technique and empowering the client with physical and sports awareness will ensure the lumbar facet joints gets a break from the huge sports workload.

TIP: Seek out a professional sports coach with a Sports Medicine Physical Therapist.

5. Be obsessed with getting your 7-9 hours of sleep.

The best way of explaining this is on two premise.  You cannot tap into your hard earn strength if you are walking around like a zombie.  If control is more important than strength, your brain needs to be on point to provide precise and timely strength.  This is the true definition of stabilization. 

You can practice all of your core stabilization exercises daily but if your body is moving a step behind your mind, then you will be in trouble.

Lastly, your body recovers at night.  PERIOD.  You can only put in as much good as you take out the bad.  Your body’s tissue regenerates and restores.

TIP: Use night brightness filter to ensure the blue light from your phone or desktop does not alter your circadian rhythm.  You can buy blue light blocker glasses and this will help with all lights and devices.

6. Be observant and avoid eating foods that are known to cause inflammation.

This tip is in the same idea as sleep.

Your body is only as strong as your energy source. If you have a low level of inflammation, you will have to work harder. This is fine but there are times when it is best to work smart.

Why would you want to live with a mild cold every day? It sucks. Imagine playing golf or your favorite sport with a headache daily.

Do you know that there are numerous studies looking at how food inflames our muscles, nerves, and joint tissues?

If your goal is to live without pain, why would you add more inflammation for your body to handle?

TIP: Eat more than 30+ types of fruits and vegetables. No matter what diet you are on, eating 30+ plants has been shown to give you the best odds of recovering.

7. Practice Tip 1-6 with grace and self-kindness, but vigilant on putting yourself first.

This tip is more about not consuming into this modern society’s appearance that you need to be perfect to survive.  Social media and society’s ideals are implying you are either good or not.  

The pressure to move at 100+mph is real and if you are not, then you are left behind.  This is where we recommend moving with grace.  

If you have good days, good job!

If you have aweful days, pick yourself back up and try again.  Try to do something different if your plan A is not working.  Modify.  Adapt.  Try again.  This is the definition of a good practioner.  

Consistency is the key and this article has given you a foundational plan to overcome Lumbar Facet Syndrome.  It is courageous to seek out a medical professional for help.  

If you live in the neighborhood of Los Angeles or Long Beach, CA, and you prefer a Spine Specialist to help you to get to the next level, click on the button below for your FREE consulation with a Spine and Sports Medicine Specialist.

Looking forward to hearing your success story, ONE LOVE,

Dr Danh Ngo

Board Certified Orthopedic and Sports Medicine Specialist

Doctor of Physical Therapy

ReVITALize Rehab Club

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