What’s Your Thoracolumbar Fascia?

by | Jul 17, 2023 | Other | 0 comments

Introducing the Thoracolumbar Fascia (TLF)

It’s a bit of a tongue twister and you might not have even heard of it before but it’s an important structure in your body and it’s intimately involved in chronic lower back pain.

Breaking it down:

Thoraco – of the thorax

Lumbar – lower back region

Fascia – main connective tissue in the body

It is a strong sheet of fascia, a bit like a large flat tendon, that covers the lower back region. It acts as an attachment point for the major muscles in your upper body, the trapezius and latissimus dorsi, which between them extend from the back of your head, your neck, your shoulders and all the way down your back. It is also an attachment point for your gluteals and your hamstrings. Around your middle it attaches to your abdominal muscles and creates a strong girdle around your body to protect and stabilise the whole area. It plays an important part in maintaining posture and in breathing.

What’s so special about the TLF?

There has been much research in recent years about the properties of this important sheet of fascial tissue. Not only is it an attachment point for muscles, but recent studies have shown there is a continuity between the thoracolumbar fascia and the deep fascia of the upper and lower limbs.

This means that it plays an important role in movement and in particular in the diagonal transmission of force from lower to upper body as we move. The thoracolumbar fascia is that connection which creates the contralateral (diagonal) pendulum-like movements of the arms and legs as we walk, run and swim, for example.

What happens when it goes wrong?

However sometimes this pattern of force transmission can go wrong, perhaps due to overuse, injury or poor posture. This can result in a tightening or restriction of the thoracolumbar fascia which reduces its normal ability to slide and glide freely as we move. As this is an area where there is a particularly high concentration of sensory nerve endings, any restrictions in the fascia irritate these nerve endings which are interpreted by the brain as pain.

From a fascial perspective, the connections throughout the body mean that the original injury or event that caused this change can as easily have happened in the shoulder, for example, as in the lower back.

How this relates to lower back pain

All of this helps to explain why some lower back pain is apparently unexplainable or idiopathic for a medical perspective. That injury to your left shoulder 2 years ago may not have fully healed and instead it changed the way you swing your arm as you run, which in turn changed the way your torso rotates as you run, which in turn created a different pull on your thoracolumbar fascia gradually thickening and irritating the tissue.

This also helps to explain why a myofascial therapist will look at your whole body posture and assess where there may be imbalance that is contributing to your lower back pain. Their treatment may be equally wide ranging to release the restrictions causing your imbalance.

How can you help yourself?

When you are doing your own self-help myofascial exercises it is always good to keep this information in mind. In our Fascial Fix video for Back Pain we share exercises to release some of the most obvious problem areas for lower back pain. You may also find that stretching or using a ball on your other ‘problem’ areas may help you to discover your own fascial connections that you may not have even realised were there, until now!





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