?> PaulsethPT | Physical Therapy Tip: Prevention of Low Back Injuries

By: Alexander Abzug, PT DPT

With the double-digit mileage training piling up we also have the start of the holiday season. At this juncture, it is critical to maintain optimal health in order to continue training without any roadblocks. Because work is in full swing with long days at the office, the pairing of more sedentary work days with intense physical training tests the limits of our low back. This combination places high amounts of force through the individual joints in the spine.

This week’s physical therapy tip will highlight the low back area which tends to be overlooked during our training. Specifically, we will discuss how the hip flexor muscles affect your low back and what you can do to minimize back pain during your training.

ANATOMY 101: The iliacus and psoas muscles (short hip flexors), together forming the iliopsoas tendon, start at your low back and pelvis and attach to the front of your femur (thigh bone). The rectus femoris muscle (long hip flexor) starts at your hip bone and runs down below the front of your knee. These muscles flex our hips (ie. bringing our knees up to our chest) and limit hip extension (ie. kicking our leg back behind us).

WHY IS THIS IMPORTANT?: Since the psoas muscle attaches directly to your spine and the rectus femoris and iliacus attach to your pelvis they can have a significant effect on how your spine and pelvis move. Tightness of these muscles can often lead to back pain, especially in runners who use these muscles often. These muscles become tight for two reasons. One, when we spend the majority of our day sitting, these muscles adapt to being in a shortened position. Two, they can tighten up when we exercise and run without stretching properly. Over time this can become a more chronic issue.

HOW DOES THIS AFFECT RUNNING?: The situation described above can result in decreased stride length (smaller steps) as your hip is unable to extend to the desired amount while you run. Hip extension is vital when you are running in order to increase your stride length and improve your efficiency. If your hip flexors are tight, every time that you take a stride these muscles will be pulling on your low back and pelvis which will end up involuntarily arching your back. If you think about the fact that a mile long run consists of approximately 2,000 steps that means that you may be arching your back 2,000 times during a single mile’s run! That is a lot of stress that your back is not designed to handle.

WHAT SHOULD I DO ABOUT IT?: This can be addressed through proper stretching and strengthening. To start, below are two stretches that target those previously mentioned hip flexors.

1: Rectus femoris stretch: standing on one leg, place other foot onto chair or table, keep knee below hip; keep a pelvic tilt to avoid arching of low back and slowly bend knee of standing leg until stretch is felt in front of other thigh. Hold 30 seconds. Repeat 3 times.

2: Standing or Half Kneel Short Hip Flexor Stretch: (a) standing with one foot on step/chair & other foot on floor; pelvic tilt, tighten abdominals & keep back straight; move hips/trunk forward toward foot on step until you feel a stretch in front of hip on standing leg or (b) kneeling with one leg forward repeat above. Hold 30 seconds. Repeat 3 times.

By incorporating these stretches into your training program you will see increased flexibility and ease with maintaining an adequate stride length. But do not forget that as you increase your flexibility it is even more vital that you develop your core (abdominal and hip) strength to keep your back upright and to avoid overuse of your low back muscles (lumbar paraspinals).

FURTHER CONSIDERATIONS: After any type of physical activity, especially after long training runs, it is very important to maintain good postural awareness. Your posture is important because the muscles and joints around the spine are “warmed up” and more prone to injury upon sitting in a slumped posture after activity. A good habit to get into upon completion of a long run is while sitting down, utilize a folded towel behind your lower back. To do this make sure you sit with your backside to the very back support of the chair. Then place the folded towel just above your backside, which will help support and maintain the natural lumbar spine curve or lordosis, and therefore, make you less prone to placing increased stress on the muscles and joints of the low back.

We wish you well with your training and make sure to look for further tips from Paulseth & Associates Physical Therapy in future newsletters. If you have any additional questions regarding this topic please contact our clinic at info@paulsethpt.com.

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