Nick D’Amelio Exercise Physiologist
And some quick and easy things to try at home to help settle it down
Low back pain is one of the most common injuries we see at Beyond. Often it’s an insidious onset, creeping in slowly, starting as occasional discomfort and eventually being a consistent uncomfortable or painful niggle. Sometimes it’s a full-blown crisis where patients can barely move without intense pain.
In all of its forms, low back pain is often multifaceted in its origins and while it’s rare to identify only one cause, there are common culprits that we see over and over again. That being said, your body is capable of incredible compensations and so often when one area is functioning poorly, we find that your body shifts the blame elsewhere, meaning the source of the pain and the problem area may not be the same.
This is a common story in low back pain, which is why you will see below that we can’t just look at the back itself in isolation. Below are three of the most common things we see which contribute to low back pain and some gentle exercises you can perform to try to help to settle down the pain.
- Tight hip flexors / Too much sitting
Your hip flexor, or your iliopsoas, is an incredible and powerful muscle. Made of two muscles which share a common insertion, the psoas major originates in a spinal attachment in your mid-low back. Psoas major makes its way forwards through your abdomen where it picks up the iliacus muscle at the front of your pelvis and together they descend into a shared attachment on your femur.
The massive iliopsoas has many attachments, including those at the lumbar spine, the hip and pelvis.
Since we spend so much of our time sitting, the hip flexor is often in a contracted or shortened position, which means, it can become tight without you even realizing. Due to its attachments, when your hip flexor is tight, it can have ramifications not just at the hip, but also in your lower back. Tight hip flexors often manifest in an excessively arched lower back, or flexion through the hips. Over time these postures put stress on the joints and muscles of your lower back and result in pain.
This can be common for those who play or participate in exercises or sports which cause you to lean forward such as hockey, cycling, tennis or squash as these activities tend to shorten your hip flexors
Hip Flexor Stretch + Quad stretch
We often find that a correctly performed hip flexor stretch, in conjunction with a quad stretch is one of the most effective ways to offset settle low back pain contributed to by a tight hip flexor.
Try the below stretches and remember that the key to this one is in the tilt of your pelvis. Because of the attachment of your hip flexor, the position of your pelvis can change the length of the muscle and so it’s important for maximum stretch to keep that correct pelvic tilt.
You can also play around with the position of your hand, sending it slightly further back or forward and trying to find the best stretch for your hip flexor.
Hip flexor stretch
Hold for 30 seconds per position, per side
Hold for 30 seconds per side
- Poorly activating gluteal muscles
Your gluteal muscles are collectively one of the most powerful muscle groups in your body… when they work appropriately! A common finding in low back pain is overactive and tight quads, hip flexors and/or hamstrings and poorly functioning gluteal muscles. As we saw above, this can put strain on the joints and muscles of your lower back and alter your mechanics resulting in pain. If your quads are on fire after a leg workout and you feel nothing in your buttocks, this one is probably for you!
Why are the glutes activating poorly? As with all questions regarding the body, it can be for a multitude of reasons. Again, sitting is a huge contributor because it shortens the structures at the front, which re-positions your pelvis and inhibits the proper functioning of your gluteals. Over time this results in the gluteals being poorly positioned to work effectively and since your body is great at compensation, it asks for more work in other areas instead.
Often poor workout technique or imbalance in your work out routine can also be to blame. You should ensure that you balance exercises which target the front of your body with those which target the back 1:1. Also try to pay attention to where you feel your body working in your workout. Are you doing a muscle for your hamstrings or back of your legs but feel your quad or low back working instead?
In terms of technique, if you are finding exercises that are supposed to target your glutes aren’t making you feel the burn, ensure you speak to an exercise professional to get some pointers on how to make that exercise more targeted. Some general advice is to avoid over-arching your back and to make sure your weight is in your heels rather than your toes.
The hip bridge is an excellent exercise to both open up your hips and also target your glutes and hamstrings. This is one of the most commonly prescribed exercises for low back pain where the gluteal muscles are one of the culprits. The roll of the pelvis also means you get some movement in your low back.
Perform 2 sets of 10
- Poor Mobility
Mobility is an essential component of any healthy spine. When one area of your back is tight, it will have impacts along the chain. It’s very common for anyone who spends a lot of time sitting to have poor mobility in their upper and mid-back, which can in turn put excess pressure on the muscles and joints of your lower back, causing pain.
Poor seated posture is a huge contributor to poor spinal mobility. We often recommend that desk workers or anyone who spends a lot of time in their car, have an ergonomic assessment done every 12 months at a minimum. If you are interested in the correct way to set up your desk, you can view our blog on this topic here: https://www.movebeyond.com.au/workplace-injury/lets-talk-about-desks-sitting/
A major predictor of poor spinal mobility is previous low back injury. If you have a history of low back pain, you may be habitually protecting your low back by avoiding movement in that region, which could in fact be contributing to your pain. A lack of movement may be causing over-activity in the muscles of your back (and elsewhere), which can cause them to be tight and sore. It can also cause compensation patterns which can result in problems elsewhere.
Mobility is one of the most important things for a healthy body and we should all be including it as a regular part of our exercise. Including something such as a weekly pilates or yoga session as a regular part of your routine is a wonderful way to get some movement in your body.
Low Spine Twist & Book Openers
Below are two gentle, easy mobility exercises which target your upper and lower back respectively. They can both be done in bed or on the floor and are an excellent way to start or end your day. I often encourage people to use these as warm up exercises for sport as a way to gently get your body moving before launching into higher energy movements.
Perform 10 per side daily
Perform 10 per side daily
Any back pain is often a multi-faceted and complicated issue. Rarely is there one single cause and every person will have a different cause and different needs, however, we do know that mobility in your spine and equality in your movements are two of the things which reduce the re-occurrence and incidence of low back pain. If you have any questions regarding your back pain, or are wondering if you’re having the start of some niggles, call one of our clinics or talk to your healthcare professional and let us help you MOVE THROUGH LIFE!