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Back is out but it hurts in the front

Your Pain Pattern,
What Aggravates It,

The Underlying Anatomy
How to Get Relief,
and more…


How People Describe This Pain Pattern

People complain of a stiff and/or painful back but it is most painful near the fold of the hip in the front. They move stiffly and tend to have other back problems. The low back has flattened and become stiff. It may or may not have pain that feels like they are fragile and may move in a way that makes their back “go out.”

Many of the cases that I’ve seen have already been to a doctor for an ultra-sound or cat scan without notable problems in the radiology report.

The cases that I’ve seen fall into one extreme or the other. They are either young and very athletic or older and notably overweight. Both of these postures create an imbalance between the deep abdominals and the superficial abdominals. One study showed this as being most common in teenage female soccer players with very tight abdominals. I have also seen this in overweight people with a tight, bloated abdomen.



How You Activate and Intensify This Pain Pattern

soccer kick from rockytopsportsworld.com

This is usually one of those problems that stems from a chronic imbalance that is bumped into an acute condition. The client usually has very tight, flat abdomen or very extended abdominal muscles from bloating.

If they can associate an activity that started the problem, it is something that pulls the pelvis forward on one side. Clients have reported that this started after activities like kicking a ball, sex, and slipping on ice.


The Musculoskeletal Anatomy Behind Your Pain

Start by Understanding the Anatomy.
About the coloring of the illustrations…

This muscle is highly variable based on race, gender and even varies from side to side in the same person. You can learn more in this post on the anatomy of psoas minor.



Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.


Treatment Notes for Massage and Bodywork

Better Bodywork
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.



This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.


Weekly Featured Post

This post is about the watershed moment that changed the direction of my bodywork. People would say that it is about treating at the source. I’d say that it is about understanding the governors and accessories in a pattern. This gives the therapist and client choices on how to plan on treating for relief or treating to create a body that is self-correcting.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

Question? Comment? Typo?
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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.

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