“My lower back hurts.”
This is the reigning champion of chronic pain. Between 60 and 80% of gym-goers complain about low back pain - more than any other ailment.
We’ve all been there. Sitting at your desk for 8 hours, dialed in to work. As you stand up you feel the tension above your tailbone. Sometimes it even radiates down your leg. It takes several short, awkward steps to get the normal feeling back in your lower body. I bet you can feel it right now.
The tension, and resulting pain, in your lumbar spine can be reversed with a clear understanding of what that part of your spine is for, how to keep it mobile, and how to make it strong.
The lumbar spine gets a lot of attention due to the high number of folks reporting pain and discomfort in that area. From the bottom of your rib cage down to your sacrum (tailbone) are your 5 lumbar vertebrae. You also have 2 vertebrae in your tailbone, but these are not part of your lumbar spine.
The network of muscles and connective tissue in this area is, to put it mildly, extensive. The entirety of your core musculature, insertion and origin points for back and hip muscles, and a seemingly endless web of fascia, tendons, and ligaments work cohesively to support and stabilize your lumbar spine.
The major muscles that can add to tension in the low back are the spinal erectors, quadratus lumborum, piriformis, gluteus medius, psoas, and rectus femoris. These muscles end up chronically shortened and weak due to long periods of sitting, made worse by poor posture.
It’s important to note that the lumbar spine doesn’t work in isolation. The entire Lumbopelvic Hip Complex (LPHC) has to be taken into consideration to put the static and dynamic patterns of the hips/pelvis into context.
The lumbar spine can rotate, flex in multiple planes, and extend. Without adequate mobility you’re almost guaranteed to feel stiffness and discomfort.
That being said, you need to be able to stabilize your lumbar spine. Your spine is pretty much a flexible rod standing on end. Without adequate strength and stability you are prone to injury.
At a surface level, all tension, discomfort and pain can be deduced through a handful of issues. Some have to do with static posture, others with dynamic movement. At the end of the day you have one of three problems.
All three of these issues can be dealt with through targeted corrective exercise in 10 minutes a day. In many cases, these problems stem from tension on the anterior (front) side of the hips in the form of tight hip flexors and quad muscles.
Tension in the front of the LPHC causes an anterior pelvic tilt, shifting your pelvis forward and pulling your tailbone up. Imagine your pelvis is a bucket and you’re tipping the bucket so water pours out in front of you - that’s anterior pelvic tilt.
This tilt leads to compression and extension in your lumbar spine. Pain, inflammation, discomfort, and even pressure on the sciatic nerve are common with an anterior pelvic tilt. Your hamstrings also are lengthened and tightened in this position. It’s common to misunderstand this hamstring tension, thinking that poor hamstring flexibility is the cause of low back pain when that’s not the case.
We are going to walk you through the most common corrective procedures for low back pain. If these don’t help after 2-4 weeks, it’s time to go see a corrective exercises specialist, doctor, or physical therapist.
Grab your foam roller and hold on tight. We are going to roll you rectus femoris, the middle quad muscle on the front of your upper leg. The rectus femoris is the only quad muscle that goes through the hip and knee joints rather than between them. Cyclists and runners especially build up excessive tension and knots in the muscle.
Roll slowly from your hip to your knee cap. You may have to work through a few extremely painful knots, so pause on especially tender spots and breathe deeply. 30 second per knot should help.
It can be helpful to do one leg at a time, using your other leg on the ground to control the amount of pressure placed on the rolling leg.
Stretching the psoas (deep hip flexors) is crucial to alleviating pressure in the lumbar spine. To do this effectively you need to create tension around the psoas. This takes a little concentration and is very worth the effort.
Kneel tall with your right knee directly below your right hip. Flex your right glute hard so the hip is fully extended. Pull your belly button toward your spine, engaging your deep core. Reach your right hand to the ceiling. You should feel a stretch in the front of your right hip from mid-tight all the way up into your lower abdomen.
Strengthening the low back is multifaceted. When low back pain is present there is usually weakness in the glutes and anterior (front) core.
The two best exercises to begin correcting this strength imbalance are deadbugs (for your abs and deep core), and glute bridges.
2-4 sets of 10-20 reps should be enough to get the ball rolling. Focus on feeling the appropriate muscles contract.
If any of these stretches or exercises hurt, stop them immediately and see your doctor. Acute pain changes this from a movement issue to a medical issue. It's sad I actually have to say this, but you should only trust doctors and physical therapists with a medical issue. YouTube and Instagram “trainers” are not licensed medical professionals.
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