I’ve worked with many people who have come to me via the Physio & the doctor in the last 12 months with differing levels of back pain. There seems to be a constant diagnosis of weak core, weak glutes & tight hamstrings! Ok, so as far as some of that may be relevant, the most commonly overlooked factor is tight hip flexors.
From my work as a T.P.I Golf Fitness Pro, I have learn’t that with any injury, you must first diagnose whether it is Joint mobility dysfunction or Tissue extensibility dysfunction and once you have done that, you can set about trying to heal yourself.
If your injury is skeletal, i.e a joint issue then of course you will need to seek assistance via the Medical Team, Doctors, Physios & Chiropractors etc However if the condition is a Tissue issue then a good PT should be able to take the shackles off.
Unlocking the Hips:
As you can see in the image, there are a lot of area’s where pain caused by hip issues can manifest itself, in time, leading to severe referred back pain. I’d have to say that 9/10 people that I have dealt with have not had hip joint issues but tissue issues around the joint, that prevents the hips range of motion. I have found that the key to good hip health is a combination of foam rolling combined with mobility & flexibility exercises. The hip is a ball & socket joint and it is has multi directional planes of movement and therefore should be trained in that way. Leg swings across 3 planes (Front to back, Left to Right and diagonal) are fantastic mobility exercises for the hip, moving the hip in a circular motion also. Multi directional lunges are preferred to same plane weighted lunges and an overhead lunge will help to break down the fascia in the front hip & quad area. Internal & External rotation of the hip is of a massive importance to Golfers as they turn in & out of each hip simultaneously during their Golf swing and exercises focussing on that motion are vital. The hip flexor, or Iliopsoas is the only muscle that links the upper body to the lower body and the welfare of this muscle is a major player in allieviating back pain. If this muscle is weak or tight, the motion of the hips can be compromised thus affecting the knees and/or the back. Oftentimes people mistake a lack of mobility in the hip as a strength issue, it is massively important to point out that strength is reduced with a lack of mobility in the joint so focus more on mobility first rather than strength! The hip flexor can become shortened with increased periods of sitting or driving etc so it is wise to stretch & mobilise following these periods. Certainly if you’ve been sitting at a desk all day and then head off to the gym for a stint on the bike or treadmill or a squat session, you’re going to feel that the next day!
Releasing the Hams & Strengthening the Glutes:
Ok so another problem with sitting a lot is the shortened position that you take the hamstrings into and whenever the hamstrings become tight the poor old back often gets lumbered with the pain. Stretching the hamstrings is easy enough to do with a resistance band as shown below:
The Glutes can also be stretched off to ease tension with pigeon stretch:
The glutes can often lose strength and exercises to assist their performance such as Bridges 1 & 2 leg, Hip Presses & single leg deadlifts will really hit the spot. The Glutes are the largest muscle in the body and when they are strong they massively assist the body’s performance both in Sport and daily activity.
Loosening the Erector Spinae & strengthening the core:
For loosening the back I prefer to see the use of rollers, this helps the individual to locate the area’s of tension for themselves and teaches them how to deal with it. However lengthening the spine is also worthwhile with total body extensions either standing or prone. Curving and arching the spine is a worthwhile daily movement as are rotary motions and sidebends. These are all motions that the spine should undertake when mobile and if you struggle with these movements 9/10 times it will be because of the restrictions that tight, matted down muscles are placing on the spine rather than the spine itself. Obviously another reason why the back may be overloaded could be due to a weak or disengaging core, again this is simple enough to work on once muscular tension has been released with the use of core exercises that keep the spine in extension such as mountain climbers. Although this seems to be a simple motion, full concentration is required to engage the core rather than to simply pump the legs forward with a rounded back. You can progress to doing this in plank on a stability ball. Crunches need not be frowned upon as a poor selection of core exercise, they just need to be performed correctly.
Remember, the easiest way to deal with back pain is with the correct diagnosis, once you’ve discovered whether you have a tissue or joint issue you can set about a healing pathway, if its joint then bring in the medics, if not set to work on regaining mobility with a few simple 30 minutes of mobility, flexibility & strength exercises.
For any assistance with aggravating or persistent injuries, get in touch, I’ll be happy to help.