Lower back pain – the sitting disease
Constantly sitting. Everywhere sitting. Sitting for breakfast. Sitting in the car or train to work. Sitting at a desk all day, except when sitting in more meetings. Sitting for dinner. Sitting on the lounge in front of the television. Sitting. Sitting. Sitting.
There’s hardly a time when people are NOT sitting.
So, it’s no surprise that muscles that you use when sit get used to being in that seated position.
Try to stand up ? That’s hard ! Your lower back just doesn’t want you to do that. You may need to use your arms to push you up out of the chair. Probably rub your lower back to try to give it relief. The lower back pain makes it hard to stand for a long time ! Everything is so used to sitting.
Standing for a long time ? Can’t do that ! Slowly but surely you need to lean forward to take the pressure off your lower back.
Sleep on your back ? forget it ! You probably can’t lie flat on your back without something under your knees to take the pressure off your lower back.
Sound familiar ? Chances are, your lower back pain is caused by a muscle imbalance known as “lower crossed syndrome”. With lower crossed syndrome, muscles in the hips and lower back are tight and strong, while muscles in the abdominal area and buttocks are inhibited (or pulled taut and weak).
What does “lower crossed” look like ?
The overall posture problem may not be obvious when you’re seated, much clearer when standing
The first thing you’ll probably notice is an arched lower back (or lumbar lordosis). This is caused by the pelvis being tilted forward (anterior tilt). This tilt means the top of the pelvis is tilted forward, with the upper body naturally wanting to lean forward with it. To stop people from toppling over, it’s not uncommon to also see the upper crossed syndrome too.
This pelvic tilt makes it look like your bottom is sticking out. One of my clients with this posture arrived saying that she had a “duck bum”, because of her lower back pain and arched back.
Despite your bottom sticking out, it’s probably not nice and firm and round. Taking a little more notice, you might see that the bottom is a little bit flat and hanging… not much muscle tone…
To assess whether you may have this posture, try this simple check. Stand with your heels and bottom against a wall. Then try to flatten your back against the wall. If you can’t push you lower back into the wall, then your pelvis is probably tilted forward.
How does it feel ?
Lower back pain is a major clue…
That arched lower back caused by the pelvic tilt, puts strain on joints in the lower back. The lower lumbar spine, sacrum and sacroiliac joint (SIJ) are pulled forward, not where they belong. The soft tissue in the lower back is also usually impacted, with inflammation of soft tissue increasing lower back pain.
This type of lower back pain is often exacerbated by standing for an extended time. It’s also often felt when trying to stand from a seated or bent over position.
This tilted pelvis position can have flow-on effects on the upper body. The shoulders hunch, the head may pull forward, the neck hurts. This is the upper crossed muscle imbalance, that upper crossed version of this lower crossed. [link]
The lower body is often also impacted. Knee joint strain is common, thanks to that position of the pelvis. Knock-knees, flat-footedness, over-pronation, heel pain and plantar fasciitis are felt by many.
In fact, many clients come to see me when the heel pain or plantar fasciitis is giving problems, having accepted a level of lower back pain as part of life.
What’s going on with the muscles ?
Some of the muscles involved are tight and strong. The muscles opposite are pulled taut (like a tightrope) and too weak to counter the strong ones. And other muscles compensate, to do more work where those weak ones cannot
The hip flexor muscles (at the front of the hips) are tight and strong. The main muscle involved (the iliopsoas) runs deep from your lumbar spine, through your pelvis, to your thigh bone. You usually use this muscle to lift your knee (flex your hip) but when this muscle is tight it can pull the lower back and thigh toward each other.
The muscles in the lower back will also be tight, as they counter those hip flexors to keep you upright. The muscles along your spine (the erector spinae) will be working hard, and these may recruit other muscles around the lower back to help.
Together, these muscles make the body want to fold at the hips, making that seated posture comfortable, and making it a little difficult to stand up without feeling stiffness or aches.
With these muscles constantly tight, other muscles are constantly stretched taut, resulting in them becoming weak and elongated. Abdominal muscles are trying to keep the body upright. “Engage your core” is one of the phrases you’ve probably heard, with those abdominal muscles not strong. The muscles in the bottom (gluteus maximus) are also weak.
A number of other muscles further up or down the body are often recruited to compensate. Muscles of the lower-mid back are also become tight. The quadratus lumborum in the fleshy part of the back, and the latissimus dorsi that runs from the sacrum to the arm join the back in becoming tight. Hamstrings are both elongated (as a result of the pelvic tilt) and strong as they try to make up for non-functioning glutes. Calf muscles (gastrocnemius and soleus) become tight and shin muscles (tibialis) weak, as the impact flows down the body.
What to do about it ?
I’d love to say the solution is stretch stretch stretch, but stretching alone is not going to give lasting results.
Those over-tight, strong hip-flexor and back muscles need to be coaxed to let go, so that stretching can have some lasting impact. Also, those weak, taut muscles need a little nudge so that they know it’s safe to start working again, so that some strength work can help them be strong enough to work in unison with their antagonists.
Of course, ensure your desk and chair is set up properly to avoid falling into that posture. (That sounds like another post !) And, regular short breaks out of the chair.
Bowen Therapy is one of the most gentle and effective treatments for helping lower back pain. Encouraging those tight muscles to “let go” and those weak/taut muscles to “spring into life”, bringing balance back to the body.