When we think of having a bad back most of us think that this is due to muscles/ligaments/tendons and joints in the back that are causing it. But what if I told you that back pain can be caused from tightness in your hip flexors (the muscles that allow your to bring your knee to your chest). To understand this we need to first look at the anatomy of the hip flexors so that we can figure out ways to combat pain.
One of the main hip flexors is the iliopsoas muscle, which is made up of 2 muscles called the, larger, psoas and smaller, iliacus. The psoas originates at the spine on the transverse process (add photo) and runs diagonally downward towards the hip joint and inserts on the inside of the femur bone at the lesser trochanter. The rectus femoris is a bi-articular muscle meaning it crosses 2 joints and therefore has 2 functions, it extends the knee as part of the quadriceps but originates at the ASIS (see photo) on the pelvis so also crosses the hip joint meaning it causes hip flexion. There are a couple of other muscles that flex the hip however these are the main two that I will be looking at.
The majority of the general population spend over 5 hours a day seated (get evidence), whether that be driving, sitting in front of a computer at work or at home or travelling to and from work. The seated position causes a shortening of iliopsoas and rec fem, this shortening causes a couple of changes.
Firstly weakness, the psoas is a huge postural muscle in the body, keeping the spine and pelvis healthy. It is strong in this shortened position however as soon as we stand up the psoases is unable to lengthen giving its contractile fibres limited ability to withstand tension and therefore loses tone. Tone is essential in our postural muscles as they have to be able constantly adjust length (contract/relax) in relation to movement to keep us upright.
Tightness is another compensation that that the body uses to try and overcome this issue. When we stand up with a weak and shortened psoas the bodies’ immediate response it to tighten the muscle, giving it a reduced range of motion. This tightness causes the anterior (front) of the spine to be pulled downward and compression of the discs in between out vertebra. This increased compression means that over time patients are more likely to injure themselves doing seemingly normal tasks such as cleaning teeth or putting on socks.
This compression significantly reduces the integrity of the articulations between vertebrae due to causing stretching of the smaller ligaments and tendons in the back that are so important for movement.
So what about the rectus femoris?
Due to its functions tightness of the rectus femoris can cause compression of the hip joint, meaning the joint becomes restricted and surrounding musculature including gluteals, piriformis and adductors compensate and further tighten. This causes radiation of pain up towards the lower back and into the gluteal region and further reduction in mobility, meaning that we feel much tighter.
So how can we combat the problem? There are a couple of solutions, firstly making sure that you take plenty of breaks at work if you are pretty sedentary (desk/driver etc), this doesn’t mean walking for 30 mins, just a quick walk around the office. Secondly a lunge stretch has long been the go to stretch for this problem, if you want a video tutorial then please go over to my instagram to see how to properly perform this. Pilates, this is a very underutilized for of physical exercise that has become a recent craze of fanatics. It works through postural realignment to help lengthen/tighten/strengthen muscles that are imbalanced due to altered posture or mechanics.
Lastly is utilizing mobility tools such as foam rollers, therabands and trigger point balls to help with decreasing muscle tightness and improving overall mobility of the lower back and hip joint. In my opinion utilizing a couple of these useful tools can help eradicate the majority of back pain.
If you are struggling with back pain we know how uncomfortable and inconvenient it can be. Our Liverpool Chiropractor can help you with fast, effective pain relief and we will help keep you pain free. Please contact one our friendly team members, who will be happy to make an appointment for you.
