Runner Therapy: Back Issues and Hip Flexors/Rotators, Finding the Culprit
Part of the complexity of the lower back exists because of its articulation with the pelvis and sacrum (the fused lower vertebrae).
The pelvis and sacrum have multiple large muscle groups originating from them and inserting into them, notably the hip flexors, hip rotators and hamstrings.
Thus, using these muscles will effect the position of the pelvis and, in turn, the lower back.
Its rare to meet someone with lower back issues, (even rarer to meet a runner with lower back issues) that does not have some appreciable degree of hip rotator tightness. Because of our lifestyle and choice of sport, it is difficult to keep the hips mobile. They are used to only swinging in one direction…forward. When we sit, again, they are forward. So rule number one…stretch your hip rotators!
Of the other large muscles, the hip flexors and hamstrings are another secondary problem. The good news? 99 percent of the time it is one group or the other, not both.
To find out what group you are in, stand to the side of a mirror and look at the structure of your lower back. Is there a concavity there or is the back more flattened out?
A decent concave arch suggests your hip flexors are going to be the culprit.
A flatter back, or one that has lost most of its original curve, means the hamstrings are your main issue.
This means, just adding one stretch in addition to the hip rotator stretch will help further boost the mobility of your lower back. And as I always look at it, the less you can do, the better!
Do you have issues with your hips, back and hamstrings? Have you ever tried to identify the issue by looking at the structure of your lower back? What stretching do you do religiously?
(Marisa, a MS PT SCS ATC, is a member of iRunnerBlog’s team and writes the Runner Therapy column, she is a physical therapist in private practice in midtown NYC called Dash Physical Therapy. She one of only a dozen or so physical therapists in the state of NY to be board certified in sports.)