The not-so quick fix for tight hips and low back pain
This blog post was inspired by a job interview question I recently heard that asked if the interviewee had any competencies that could be explained in depth, yet concise. It got me thinking about what I would say. Take a stab at quantam physics and try to show off? Marketing principles – or is that too similar to the job? I decided on a movement based approach to curing low back pain; one of my passions and a modality that could would help most of the population immensely.
Majority of modern human beings live in a workplace or academic setting that demands of us to sit down. At the end of the day we eat, watch TV, commute or drive elsewhere – all seated, These contemporary lifestyles are the main reason we develop tight hips and nagging low back pain. Now, understand that it is our human adaptive ability that allows us to survive or thrive almost anywhere, and that is a wonderful thing. It means you can smoke cigarettes, have no nutritional awareness, watch television all day, and still be a relatively high functioning individual. However, it also means that our body can adapt in ways we do not want it to. One example, and the focus of this blog post, is how the neuromuscular systems adopt the positions we spend the most time in. And when the bulk of life time (literally) is spent sitting down, sleeping wrong, and driving then that becomes a major posture issue.
*Side Note: Posture derives from a word meaning position. The colloquial understanding of posture is usually limited to sitting and standing, but that is wrong, Posture should be looked at as maintaining positional integrity in any movement. For example, picking up a pencil off the ground is as much an expression of posture than sitting in a chair with your joints stacked properly.
How does our lifestyle actually lead to back pain?
First, I would like to limit the scope of this blog post to the pelvic and lumbar positioning, in addition to the immediate surrounding musculature, as to allow more granular explanation of the topic at hand. The proceeding information will not be given its due explanation or reasoning, but should suffice for this conversation. As always, for more further conversation you can check out the various social media links on the home page.
Back to the topic at hand – your pelvis positioning is maintained mainly, but not exclusively, through three mechanisms: torsion and articulation from your feet, activation and awareness of the lateral hip and glutes, and lastly your abdominal muscles. When you sit down two of those three stabilizing mechanisms become irrelevant and you’re left with just core strength and a small supporting cast. The body will compromise and sacrifice your pelvic positioning in attempts to maintain a neutral spine postioning and expend less energy. So, instead of using your glutes, hamstrings, core, etc. to maintain posture throughout the day the body learns to tighten other muscles. The most common offenders: the Quadratus Lumborum, Piriformis, Hip flexors, Psoas, and Hip Flexors, will become very tight and overtime your body adapts to these compromised positions. Then we up the ante on these issues by improper gait, poor breathing patterns, and bad sleeping posture. A daily 5,000 steps and 20,000 breathes are 25,000 events per day that your body is forced into inadequate being.
How is this lifestyle fixed?
Well, the remedy is as self explanatory as it may seem – you need a lifestyle change. The big question is HOW. Before being prescriptive in stretches and movements I would like to substantiate the lifestyle point once more. If all you do is stretch to ameliorate your muscle tightness or weakness issues then nothing changes in the long term. A relevant analogy thrown around the fitness industry is as follows: stretching is like putting out a fire. You may get a temporary resolution, but if the stove is still too hot then you only get more fire. If you stretch to fix the muscle tightness then you may feel relief, but if nothing changes with your lifestyle or kinesthetic awareness then you will always just be putting out fires.
Stretching, as previously mentioned, will not be the cure-all for tight hips and low back pain. However, it is a fantastic place to start, and any daily efforts in the right direction is what we are really after. Below are a handful of stretching ideas or jumping off points for you to look into. Because every person has such varying degrees of posture, and may have different deficits for reasons other than general sedentary lifestyle (such as a genetic lordosis or sport training with bad form) then it is difficult to prescribe stretches applicable to the masses.
- lacrosse ball on feet, calves, ql, piriformis, pecs, traps
- lunge hip flexor stretch
- frog yoga pose
- pigeon yoga pose
- twisted cross stretch
- upward dog yoga pose
Movement pattern implements will be very productive work, particularly before working out. You can look up some of the movements up online to see tutorials (please do). In general the idea is to train your body to pattern movement correctly – activate the correct muscles and joints in the correct sequence. In general these ideas are founded mainly on increasing lateral/posterior hip activation, scapular stability, and general proprioception.
- supine psoas march / leg drop
- inlcine bench YTW’s
- hard exhale glute bridges
- Wall slides
- Laying internal/external shoulder rotations
- clam shell
This is where the rubber hits the road. Will you actually learn how to change your lifestyle to a movement rich environment for your body. Perhaps future blog posts will cover some of these things in depth, but regardless I recommend learning how to do the following:
- walk: do this more; learn the musculature of the feet and ankles; learn a proper gait; find a shoe (or none) that suits you.
- sleep: breathing through the nose; using a mattress/ pillow and a position that stacks your spine and other joints in proper position.
- breathe: learn the various types or breathing, how it is supposed to be executed, and the musculature used.
- sit: learn how to sit less and how to sit when you have to.
- stand: which muscles to engage, cues to think about, and where joints stack
You alone have responsibility over your posture and integrity, and for most of us it requires a lifestyle change – but those do not happen over night. Start by doing something – anything – in the right direction and keep moving (literally) towards the light. Stay mobile friends, and I wish everyone who made it this far the best. Thanks.
Matthew David Watson , MD(W)