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Kicking Lower Back Pain’s BUTT

Kicking Lower Back Pain’s BUTT
By: Dr. John Rusin, PT, DPT, CSCS
Water and Sports Physical Therapy, Inc.

Is your lower back pain and stiffness limiting your gains in the gym? One of the most common and debilitating injuries to athletes and weekend warriors alike is lower back pain. In 2011, nearly one hundred million American’s presented with some type of spinal pain.
The lumbar spine is an integral region of the body because of its intermediate location (halfway between the upper and lower body), and its many muscular and ligamentous attachment points. Controlling predominantly flexion and extension movements of the spine, the structures of the lumbar region, including the intervertebral discs and segmental stabilizing muscles, are prone to injuries with combination movements of twisting, bending and turning. Practicing correct movement strategies and posturing of the spine may not be enough to protect your lower back. The answer to reducing your back pain and avoiding future flare-ups can be as simple as assessing and improving your hip mobility, mechanics and posturing.

The hip joint is an extremely mobile ball and socket type joint consisting of the head of the femur and the acetabulum of the pelvis. Motions controlled by the hip include flexion, extension, internal and external rotation, abduction (away from midline), and adduction (towards midline) movements.

The most common hip range of motion limitation in the active population is internal rotation. With limited internal rotation, the external rotating musculature of the hip become short and tight. The primary external rotators of the hip consist of the gluteus maximus, gluteus minimus and piriformis muscles. Increasing length, and decreasing tightness of these muscles will allow more mobility of the hip, and enhance movement mechanics of the lower body.

Add these 5 simple stretches to your workout regimen to decrease lower back pain, and increase range of motion of the hips:

1. Gluteus Maximus Stretch

a. Supine- While laying on your back, extend you left leg out straight and keep contact with the floor. Bring your right leg up into flexion at the hip and knee, and use your hands to pull your right knee towards your chest. Repeat for the left leg. (Picture: top left)

2. Piriformis Stretch

a. Seated- While seated in a chair or bench with your ankles, hips and knees all bent to 90 degrees, place the outside of the lower right leg onto the left knee. This position should generate a stretch through the backside of your right glute. For a more intense stretch, use your hands to pull your right leg up and across your body and hold. Repeat for the left leg (Picture: not shown)
b. Supine- While laying on your back, bend your knees to 90 degrees and hips to 45 degrees. Place your right leg over your left knee. This modified position can be used for more spinal stabilization. Repeat for the left leg. (Picture: bottom right)
c. Prone- While laying on your stomach, flex your right hip underneath your body while also moving your right knee to the left. Use your body weight to bring your chest to your right knee. Place your arms out in front of your right knee, and walk out your hands. Your left leg should remain in contact with the ground. Repeat for the left leg. (Picture: top right)

3. Gluteus Minimus/Medius Stretch
a. Supine- While lying on your back, keep your left leg extended straight in contact with the ground. Flex your right leg at the knee and hip to a 90 degree position in both joints. Rotate your right knee over your body coming in contact with the ground to your left side. Your left arm will be placed on your right knee and provide an overpressure bringing your right knee towards the ground. Your right arm will be extended to anchor your position. (Picture: bottom left)
*all stretches will be completed for hold times of 30 seconds, and repeated for 3 sets per leg.

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