Low back pain is one of the most common presenting conditions we, as physios, see in our work day. Why? There are many factors that can contribute to ongoing low back pain in the general population, so let’s address a couple. Firstly, we as humans have evolved to sit more and more in our day-to-day lives. This is not a blanket statement, but if you compare our lifestyle to that of the hunter-gatherer populations from thousands of years ago, we DO sit more. A lot of people sit for prolonged periods of time at a desk for work. We sit down to eat. We sit on the couch to watch tv. People are even exercising in a semi-seated position when riding a bike.
When we sit, our hip flexors (the muscles in the front of the hip) are in a SHORTENED position and can become chronically tight from prolonged sitting. Tight hip flexors cause forward tilt of the pelvis, which often jams up the joints of the low back, causing ongoing pain and stiffness. Also, when sitting, our glutes (bottom muscles) are in a LENGTHENED position. When muscles are a lengthened position for prolonged periods of time, they do not work as effectively. We have good research to suggest that addressing the strength of the hip and pelvis is an important factor in the management of low back pain. The hip and pelvic musculature, as well as the deep “core” musculature supports and stabilises the lumbar spine. When these muscles are not working effectively, the lumbar spine is put under increased load.
In our treatment sessions, we address the tightness/weakness of the hip and pelvic muscles and mobilise the joints that have developed stiffness. We provide you with exercises and stretches to support the effects of our manual therapy treatment. We also encourage regular changes of position at work - the use of a sit-stand desk can aid with this. Supportive footwear is also an important part of the management of low back pain – poor arch support in shoes often causes the foot to flatten excessively when walking, which causes a domino effect up the chain at the knees, hips and low back.
These are just a few of the factors that can contribute to low back pain; it is important to speak to your healthcare professional about which management strategies are appropriate for you. Work with your therapist to develop an exercise program that suits you and is targeted at addressing your individual strength deficits and muscle tightness. Strength training is not a quick-fix – it is a long-term process. Your exercise program needs to be progressed in difficulty as you become stronger in order to have ongoing positive effects and prevent future injury.