**Disclaimer – if you have symptoms of numbness/tingling or weakness in your leg(s), see a doctor or physiotherapist to rule out more serious problems **
You bent over to pick up a sock and – bam! – your lower back has seized up on you again. You say, “I’ll just walk around like a robot for the next several days and it will get better”. Or you’re someone whose lower back, hips and/or hamstrings always feel tight. “I’ll just stretch and do some foam rolling and it will feel better”, you say. But then you find yourself doing it again day after day, never truly getting better.
Recurrent lower back pain and tight hips/hamstrings are common issues. But that which is common, is not always normal. These are usually signs of an underlying mechanical problem in your lower back. What does this mean? As you habitually sit slouched at your desk/on the couch, or repeatedly bend to pick things up off the ground, there is strain that is put on particular structures in your lower back. The longer you sustain a position or the more repetitive bending you do, the longer it takes for these tissues to bounce back. Unfortunately, this ratio is not 1 to 1. In other words, if you spent an hour slouching at your desk, it will take much longer than an hour for things to return to normal. Chances are you’ll spend another hour slouching before your tissues have recovered. As you repeat this process week after week, things slowly build up to the point where those tissues have had enough and they will let you know via symptoms of pain, stiffness and or loss of range of motion.
- insert photo of sitting slouched at desk and bending forward to pick something up
You can break this cycle with a very simple approach. The majority of mechanical spine problems have a direction of preference. This is a direction that you can move your back that will gradually return those tissues back to balance, freeing up your range of motion and decreasing your pain/tightness. This direction is typically the opposite to the direction that got you in trouble in the first place. For the majority of people in today’s workforce, the direction that has created this issue is anterior (forwards) and the direction of preference is posterior (backwards).
The fix will involve two simple steps
- Decrease the amount of anterior directed forces on your lower back
- Do your direction of preference exercise regularly (posterior directed forces)
Anterior Directed Forces
- insert pictures of sitting slouched, bending at waist
With these two positions, there is significant compressive load being placed on the structures of the anterior (front) of your lower back and tensile (stretching) load placed on the posterior (back) structures. These are positions that need to be avoided as much as possible so that your direction of preference exercise (see below) can work its magic. For some additional tips on how to better set up your workstation, see my article on improving your posture.
– insert link for posture article
Posterior Directed Forces: Repeated Lumbar Extension
- insert video of REIL and REIS
In these two videos, there is an inverse of the above loading pattern – compressive force of the posterior structures and tensile force on the anterior structures. The idea with these movements is to move as far as you can with each individual repetition. The lying down version is generally far more effective than the standing version. Not everyone can lie down at the office, so the standing version is a fair alternative in this situation.
This may initially be sore/stiff, but should loosen up as you repeat them either within an individual set or after several sessions through the day. If this exercise worsens your pain or makes your lower back stiffer, stop immediately and book an assessment with your friendly neighbourhood physiotherapist!
How much is needed?
The general guideline for these exercises is to do 10-15 repetitions every 2-3 hours throughout the day.
You will likely need to continue with this regularly for anywhere from 2-4 weeks to return things to balance. Once things are feeling good, then it is a good idea to continue with these exercises 1-2 times per day indefinitely in order to keep your lower back happy moving forwards.
If this approach does not resolve your back pain, you likely have a different direction of preference or your back might need a little help to get moving via some manual therapy. In these scenarios, seek out a physiotherapist for further evaluation.