Low Back Pain: A Potential Culprit

Originally Posted on the Fit 2 Excel Blog on December 4, 2017


Nearly all of us have been there. You wake up feeling great, the sun is shining and the beautiful December weather is in the air. You notice that one of your pillows fell off the bed while you were sleeping. Naturally, you casually reach down to pick it up (probably with a rounded back), and… ugh. You tweak your low back. You may know this story all too well. And if you’re feeling tight in your lower back, you are surely not alone. A 2009 study in Archives of Internal Medicine estimated that nearly 80% of Americans will experience low back pain at some point in their lives.

Lower Cross Syndrome

The most common postural fault that I witness every day in athletes of varying endeavors is known as Lower Cross Syndrome. Lower cross syndrome is where our hip flexors and low back extensors become increasingly tight, and glutes, hamstrings, and abdominals become increasingly weak. To compensate for these imbalances, your pelvis tilts anteriorly, which creates excessive spinal curvature, also known as hyperlordosis. This syndrome is less formally known as “Donald Duck butt,” due to the appearance of the person’s butt sticking out like Donald Duck. If you think about the lifestyles we lead, this makes perfect sense. We sit at a desk all day, drive our car with our hips in a flexed position, and then go play sports and do exercises that are predominantly performed with our hips in flexion. It is no wonder then, that we are unable to get out of this hip-flexed position when we exercise. Today’s post will focus on strengthening the hip extensors, but it is important to remember that they are just one piece of the puzzle in correcting this fault.

Due to excessive hip flexion, many people do not have the ability properly extend their hips at all. Their bodies are not able to distinguish between extension in the low back (lumbar extension), and extension through the hips. For example, one exercise that we commonly perform here is the stability ball hamstring curl. The goal with this exercise is to get the hamstrings, which are typically weak, to properly extend the hips. What do we mean by this? Well, the hamstrings, comprising of 3 muscles, (biceps femoris, semitendinosus, and semimembranosus) have 2 major functions:

  1. Flex the knee (knee flexion) – this one is most commonly seen in traditional hamstring training.
  2. Extend the hips (hip extension)- this is the key that is often overlooked. If we can simultaneously get into maximal knee flexion AND maximal hip extension, the hamstring will be in its fully shortened position.

    At the top of a hamstring curl, knees are flexed AND hips are extended.

However, when many people perform this exercise the extension does not come from the glutes and hamstrings. It comes from low back muscles that are already strong, particularly the quadratus lumborum (QL), which extends the lumbar spine, NOT the hips. In other words, the lumbar extensors are working in place of the hip extensors. Hamstring curls are a good example of this, but it is also very common at the top of deadlifts and squats, and essentially any exercise where hip extension is a part of the movement.

Donnie Thompson, the first person to hit a powerlifting total of 3,000 lbs, has called the QL, “an angry troll on your back.” Couldn’t have said it better myself. Our QL’s are, to be blunt, way too strong for our own good. Our QL works hard all day, performing actions that should be done by our glutes and hamstrings. Over countless reps day after day it should be a no surprise that this muscle becomes inflamed, causing low back pain.

Quadratus Lumborum – a.k.a. angry troll

If you’ve ever taken a class here at Fit 2 Excel, you’re probably sick of us telling you to get into a pelvic tilt. What this means is to literally posteriorly tilt your pelvis and remove the curvature in your lumbar spine. When you can posteriorly tilt your pelvis, you put your QL into a position where it is very weak, so that the extension has to come from the hips, which will be primarily performed by the glutes and hamstrings. In nearly every exercise, from core exercises, to deadlifts, to push-ups, the pelvic tilt is where you should start every movement. In fact, I will take this one step further and propose that we should try to walk around in a pelvic tilt as much as you possibly can. If you can work out with good spinal mechanics for 1 hour, that’s great, but what about the other 23 hours? If you’re still sitting most of the day and moving around with your pelvis tilted anteriorly and thus your low back excessively arched, then long term change will likely not occur.

So, your call to action, is to, starting today, spend 5 extra minutes in that pelvic tilt. Turn off the lumbar extensors and turn on the hip extensors. As time goes by, gradually increase the amount of time. Ultimately, long term change only occurs with long term lifestyle and behavior change.

We’re always open to questions, comments, feedback, and suggestions. Reach out on social media, or if you would like to personally reach me you can email me at dwrosalesvt@gmail.com.

Works Cited

Boyle, Michael. New Functional Training for Sports. Human Kinetics, 2016.

“Donald Duck.” Disney Clips, Walt Disney.

Ferriss, Timothy. “Gymnast Strong.” Tools of Titans: the Tactics, Routines, and Habits of Billionaires, Icons, and World-Class Performers, Houghton Mifflin Harcourt, 2017.

Freburger, J K, and T S Carey. “The Rising Prevalence of Chronic Low Back Pain.” Archives of Internal Medicine, vol. 169, no. 3, 9 Feb. 2009.

Human Kinetics. “Lower Cross Syndrome.” Muscleimbalancesyndromes.com, Muscle Imbalance Syndromes, 2010.

“Quadratus Lumborum.” Ken Hub, Ken Hub.

 

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