Another Reason Your Lower Back is Painful
And what you can do about it, Part 2
Last week I discussed two important muscles involved in chronic lower back pain, namely the Erector Spinae group and the Quadratus Lumborum.
You might not think about “non-back” muscles as being the cause of lower back pain, but they can be, especially the Psoas (pronounced SO-az) and the Hamstrings. These two muscle groups are the indirect cause of chronic (and sometimes acute) lower back pain due to sitting.
Sitting can be hazardous to your back from poor posture due to gravity. Gravity causes slouching which strains the lower back when you stay in that position for long periods of time. As we age, our body’s tolerance for poor posture lessens, so “long periods” becomes shorter. Generally speaking, sitting passively shortens the Psoas muscles and Hamstrings. If you aren’t stretching them regularly, they can cause lower back pain over time. You will see how shortly.
The Psoas
The Psoas (pronounced SO-az) is a pair of muscles that flex the hip, meaning they bring the thigh toward the torso. They attach to the sides of the last thoracic vertebra (T12), and first 4 lumbar vertebrae (L1-L4), and run down to the lesser trochanter of the femur (inner edge of the top of the thigh bone).
This muscle runs from the back of the body to the front, crossing through the abdominal cavity. It contracts to flex the hip (move the thigh toward the chest), and it stretches when the hip extends (thigh moves backward).
When you sit for long periods of time, at a desk or driving, the hip stays in a flexed position, passively contracting. Last week I discussed muscles that are strained from being overly stretched with sitting. This week, the problem is chronic shortening of the muscles with passive over contraction.
It is common, as we age, to feel lower back pain after sitting for long periods. When you stand up, the Psoas should lengthen (extend). If the muscle is tight, it will pull at the attachments, potentially causing pain. Usually, because the legs are in a fixed position when we stand up, you feel the pain in the lower back as the torso moves away from the thighs.
Hamstrings
The Hamstring group is a trio of muscles: Semimembranosus, Semitendinosus, and Biceps femoris. They run from the “sit bones,” aka Ischial tuberosities, down the back of the thigh to the back of the Tibia (shin bone). They attach to both the medial and lateral aspects of the Tibia (on both sides) and fibula (bone to the lateral side of the tibia).
Their main job is to bend the knee (knee flexion) but secondarily, they extend the hip (move the thigh backward). When you don’t use the Glutes for hip extension, the Hamstrings take over. This is a common reason for hamstring tightness and lower back pain, which I discuss in the article below.
In this instance, however, I’d like to highlight how the Hamstrings get tight from keeping the knees bent while sitting. When you sit for long periods, your knees are bent (flexed), so the hamstrings are in a constant shortened state. When you stand up and lengthen the muscle group, again, it pulls at the attachments when the muscle is tight.
Because the feet are in a fixed position when you stand, it is the thighs and pelvis that move. When you straighten the legs, you may feel a pull at the sit bones at the base of the pelvis. When the sit bones are unable to move fully away from the Tibia, you compensate by rounding the lower back (lumbar flexion).
As I wrote last week, when you are in lumbar flexion for long periods, it strains the lower back muscles (Erector Spinae group) and they hurt. Ideally the lower back has a slight lordotic curve toward the front of the body. When you lose that curve, the erector muscles strain. Ideally, the natural lumbar curve exists when you stand, but if the hamstrings are tight, this might not be possible.
Simple Yoga Stretches To Relieve Lower Back Pain
I often pair these two stretches together when I teach, as one flexes the hip and the other extends it, creating a nice balance in the pelvis overall. Both of these stretches can alleviate lower back pain due to sitting for long periods, or poor posture in general.
Low Lunge/Anjaneyasana
Starting from Table, step your right foot forward so that the knee is over the ankle and directly in front of your right hip. Your left knee should be directly behind your left hip, with the top of your left foot gently pressing into the floor.
Your hands can either be on the floor or blocks on either side of your right foot, on your right thigh so you are a little more upright, or above your head, palms facing each other. If the arms are up, move the shoulder blades downward and apart (depression and protraction). This will prevent creating tension in the neck and shoulders. Bring the pelvis as vertical as possible in the variation that you choose.
Activate your left inner thigh to direct your left hip forward, as both hips should aim straight ahead. This pose stretches the Psoas and other hip flexors of the back leg. Hold for 3-5 breaths, then switch to the other side.
Half Split/Ardha Hanumanasana
Start in Low Lunge with the right foot forward. Straighten the right leg by pressing your right heel forward and move your sit bones backward, keeping the spine straight. Your ankle should be dorsiflexed (toes pointing to the ceiling, heel reaching forward).
The leg may or may not straighten fully, depending on how tight your hamstrings are. It’s more important to keep the spine straight than it is to fully straighten the leg, as you’ll feel more of a hamstring stretch that way. If the leg is fully straight, engage the Quadriceps (front thigh muscles) so that you don’t hyperextend the knee joint. The knee should never bend backward.
If you find it difficult to reach your hands to the floor, bring them onto yoga blocks or a chair, so that your torso is higher. This pose stretches the Hamstrings of the front leg. Hold 3-5 breaths then repeat to the other side.
Click here to watch a short video guiding you through these poses.
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Lower back pain, it is also swimming can help to relieve it, but swimming should be going slowly.