WHEN THE LOWER BACK MAY BE ABSORBING THE PUNCH A JANMI Postural Pain Pattern

Dear Reader,

A man in his early 30s, working in finance and competing in boxing, came to JANMI after developing severe right-sided lumbar pain during a match. The pain radiated into the right gluteal region.

There had been no major accident or obvious traumatic event. The interesting part of the case was not only where the pain was felt, but how the whole body was managing rotational force.

During assessment, I found a wider asymmetrical pattern including posterior pelvic tilt, guarded gluteal tissues, tension through the piriformis and quadratus lumborum, medial hamstrings and adductors, iliopsoas guarding, and possible restrictions through the foot, hip and trunk.

This raised a more useful clinical question:

Was the lower back the problem, or was it the area absorbing movement and force that should have been shared elsewhere?

Boxing is highly asymmetrical. During punching, force should travel from the foot and ankle through the hip and pelvis, into the trunk and shoulder.

If hip rotation, hip extension, thoracic rotation or foot mechanics are restricted, the lumbar region may have to contribute more movement and stabilisation.

That does not prove that one restricted area caused the pain. It simply means the wider movement chain is worth exploring.

The posterior oblique sling may also be relevant. Latissimus dorsi connects through the thoracolumbar fascia with the contralateral gluteus maximus, helping transfer rotational force across the body.

This cross-body connection becomes especially interesting in sports such as boxing, where force is repeatedly generated and transferred through asymmetrical stance, pivot and rotation.

The JANMI approach was to assess the painful area, observe the full rotational chain, reduce overload in guarded tissues, restore hip rotation and extension, improve pelvic and split-stance control, and gradually reintroduce trunk rotation.

The key principle was simple:

The painful area is not always the whole story.

Sometimes it is the part of the body doing more work because another link in the chain is not contributing efficiently.

Treat locally. Reason globally. See the person.

JANMI Soft Tissue Therapy Clinic

Marylebone, London

Inspired by a real clinical presentation. Identifying details have been adapted for privacy. Clinical observations do not establish causation. Educational content only, not medical advice.

Until next time,

Paulius