The Low Back Pain Cycle
The muscles of the body act together as a machine, full of levers and pulleys, each one dependent on another to move the arms and legs, to allow the trunk to twist and bend, and for the head to pivot and nod. If a muscle is dysfunctional for too long, the body begins to adapt to this “new normal state” and recruits other muscles to compensate for the imbalance. Muscles around the hips and buttocks are very busy throughout a normal day. They engage when a person sits, stands, walks or does just about anything that involves moving the hip or the upper leg. Isolating and rejuvenating muscles in this area can have a big impact on low back pain.
The Iliopsoas is a primary hip flexor muscle, so it lifts the leg at the hip up toward our chest. If the leg is fixed (meaning the foot remains on the ground) it helps bend the torso forward, bringing the trunk and leg closer together. People who sit for a long period of time can develop a tight psoas because their hip is constantly flexed. A tight psoas pulls forward on lower back vertebrae, causing an anterior tilt to our pelvis and shortening and weakening the hamstrings attached at the bottom of the pelvis. A contracted psoas will give you pain and difficulty while doing things involving flexing the hip or trunk like trying to get out of bed or while reaching for keys you dropped on the floor.
A tight psoas will also stop your gluteal muscles from firing and activating normally. The glutes are another large stabilizing muscle of the body. So because the two muscles are opposing, if one is out of balance, the other weakens, and vice versa.
The QL muscle, which connects the last rib to the pelvis, is responsible for pelvic stability and structural alignment. The muscle can become irritated when you bend over something or twist and lift at the waist. For example, getting groceries out of a trunk or leaning over a sink while doing dishes. Deep aching low back pain during rest, a sharp, knife-like pain while moving the pelvis, and inability to roll onto either side while laying face up, are all indications of a tight quadratus lumborum. If only one side is tight, that hip will appear to be “hiked” up and can create a leg length discrepancy. Avoid standing with all your weight on one foot or running on uneven pavement.
The gluteal muscles are posterior hip (or buttocks) muscles that help keep the pelvis level when the opposite leg is raised during activities such as walking, running or standing on one leg. These muscles can become irritated when you sit on top of a wallet or with one leg crossed over the other for long periods. Weak and sore glutes fail to support the lumbar spine leading to back pain and an affect on pelvic tilt.
Do you see the cycle?
We sit all day at work (a lot of the time with our legs crossed!) and iliopsoas becomes tight. Then we come home and sit to read or watch tv so iliopsoas remains tight. Without intervention, a chronic problem is created and the pelvis tips forward. Try tipping your pelvis forward. Basically, stick your booty out. Can you feel the tension in your low back as it tries to support you in this position? This postural deviation not only stresses out the quadratus lumborum and other back muscles, but also inflames glute medius as it tries to compensate. However, the tight Iliopsoas psoas has already weakened the opposing glutes. One part of the pulley system always depends on the other.