Lower back pain is one of the global health issues and affecting more than 25% of the U.S. adults and becoming more common among teenagers. There are 2 reasons why we are continuously having lower back issue.
First reason is we are sitting too long. More you sit hip flexors gets tight and cause irritation as we stand up. Tighter the hip flexors, more stress you will cause in lower back region main adding more stress to the disc and nerves surrounding which often cause stiffness, tingling or numbness down the leg.
Second reason is because we stand upright with two legs and not on fours like other animals do. This is ironic but our spine must work against gravity constantly because we are consistently upright. It’s been said that over 60% of brain function is to work against the gravity. Therefore, depending on your posture and activity habits your lower back can be rounded dominant or arched dominant.
Lower Back Load Difference Between Sitting and Standing
There is a study compared lower back compression load between sitting and standing after 2 hours. Standing had lower back compression load of 242lb whereas sitting had lower back compression load of 381lb (1). Of course, way you sit and how much a person weigh does impact the amount of load, however, you can see the compression load difference between sitting and standing.
As we sit longer hours, we know that hip flexor muscles get shortened and tight. One of the hip flexor muscles called psoas muscle originate from T12-L4 in your vertebrae and insert to ball joint area of your femur or thigh bone. When this muscle gets tight and trying to stand up will pull on to your lower back causing irritation due to compression to the discs in those T12-L4 region. Another hip flexor example is rectus femoris, one of the quadriceps or thigh muscles. It is originated in front portion of iliac spine or hip bone, then insert at top of patella or knee cap. The primary movement for rectus femoris is lifting your knees up and straightening your knees. While sitting, top portion of rectus femoris get shortened and tight, therefore, causing difficult of standing tall after sitting for too long and can cause discomfort in the knee.
Sitting itself is not culprit to lower back pain but sitting long duration is. Every 2 hours, it is best practice to stand up and walk around so that muscles will be lengthened and loosened.
Rounding and Arching of the Lower Back
Let’s talk about the spine. Spinal structure is never straight. It has wave like curvature from cervical to coccyx. This is to distribute load. Between each vertebra, there is jell-like object called disc sandwiched by body of vertebrae and nerves comes out from rear portion of vertebrae and extend downwards like root of the plants.
The spine is mobile and can flex or extend as needed. Natural curvature of lumbar is arched, however, majority of time, the lumbar spine is round dominant where spine is created curvature in front. When this posture is maintained too long the muscles surrounding the spine also get shortened and tight.
Reason why our lumbar spine is round dominant rather than arched dominant is because of the nature of are activity. Whether you are driving, cooking, eating, working, exercising, most of the movements happen in front of us. This front movement does lead our spine to round. Often times, we are told not to arch back when lifting object but it is a big mistake. You do want to maintain natural curvature, which in lower back or lumbar region, in its natural form, is arched. Overarching is not good either because of the disc, however, it is important to maintain natural arch in the lower back.
Biggest issue is how the disc is compressed while the lumbar spine is rounded. Imagine you are eating hamburger. When you eat your burger from one side only, there is a chance that the patty may slide off from the other side of the sandwich or ketchup may drip off. Same thing will happen to our disc. When stress or load is more in front portion of vertebrae, disc will be pushed towards the back and may irritate the nerves by disc compressing on it, which is a condition known as pinched nerve. When the rounded lumbar spine becomes chronic, there will be a chance for the disc to be in the condition called herniated or bulged disc, which will also add pressure to the nerves. This is also a reason why nerve irritation occurs when arching the back after the back injury because of the disc irritation is in the rear side of vertebrae.
For people who has weaker arching muscles (such as erector spinae and quadratus lumborum) will have more challenge restoring the spinal curvature balance. This is also a reason why some people need to rely on wearing belt when lifting an object. Imagine you are lifting 2-300lb object and all of the load including your body weight is all on front portion of disc only. Sounds painful right?
The disc itself actually is very strong when load is even throughout the disc instead of portion of the disc. Therefore, all we need to do to solve this issue is by exercising the tight and weaker muscles.
Strengthening Lumbar Spine
Along with muscles you can also train your disc to handle more load and stress. However, if you are currently experiencing lower back problem, I suggest to check with your physician before trying out the exercise.
Couch Stretch - Stretch
Tight hip flexor will interfere with training your lumber spine so it needs to be stretched prior to mobility and strength program. You can do this stretch pretty much anywhere. At gym, at home, during vacation, anywhere. This will help stretch out your hip flexor muscles in the back leg. Reason why it is called couch stretch is because it can be performed using the couch. However, not everybody can get their leg up on the couch as you see in the video. What I suggest you to do is use couch cushion instead of couch itself. This will elevate your foot in the back but not as high as couch. You can gradually work your way up by adding cushions. Spend about 60 seconds on each side. Like in the video it is good to have proper padding under the knee for comfort.
Cat and Camel-mobility
If you do have tight muscle surrounding your spine, you may want to start with this exercise to mobilize your spine. Take your time along with your breathing and perform 15-20 reps for 2-3 sets. Focus is not so much in increasing the range so do not force the movement. If there is a pain, minimize the movement.
Modified Pancake - mobility/strength
Modified pancake can allow you to mobilize your hip and conditioning the lumbar spine to arch and strengthening the muscles surrounding. Key points to this exercise is not to look down and focus on maintaining the arch rather than hinging lower. When we look down, spine has tendency to round and make it really difficult for the lumbar spine to arch. Later point is just a matter of focus of the exercise. Perform 15-20 reps for 2-3 sets.
RDL (Romanian Deadlift) - strength
Rather than regular deadlift, RDL can start from arched back position. You can perform this with barbell, dumbbells or kettlebell. Once you grab the weight, stand tall to create the natural arch curvature in your lower back. If you are not sure if you are doing it right, then lift your chest up as high as you can with looking straight forward. With maintaining this posture, hinge over from your hip. You can keep the knees soft but not flexing too much. Once you've reached maximum distance while maintaining the arch in lumbar spine, then stand right back up. Perform 8-10 repetitions for 3-4 sets. Don't rush and take time with each repetition.
Both rounding and arching are the function of our spine and both are equally important. However, we do more rounding because of how we do things according to how we are structured. Because of that, we do need to work on other function to balance out the imbalances.
Kota Shimada
Reference
1. Low back joint loading and kinematics during standing and unsupported sitting. Taylor & Francis. (n.d.). Retrieved September 30, 2021, from https://www.tandfonline.com/doi/abs/10.1080/00140130118276.
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