Back Pain with Backward Bending Part 2

In Part 1 of our series on extension-based lower back pain, we explored how inadequate spinal extension control can contribute to lower back discomfort. In this second installment, we’ll focus on a critical factor in managing and preventing extension-based lower back pain: improving hip extension range of motion and hip flexor mobility.

The Crucial Role of Hip Extension and Flexor Mobility

The relationship between hip extension, hip flexor mobility, and lower back health is often underestimated. When hip extension is limited, the lower back tends to compensate with excessive lumbar extension. This compensatory mechanism places additional stress on the facet joints of the spine and can lead to discomfort and pain.

Hip Extension and Lower Back Pain

A restricted hip extension range forces the lower back to overcompensate during activities that require a full range of motion, such as lunging, running, or even walking. This compensatory overuse can strain the lower back, aggravating existing issues and leading to persistent pain.

Importance of Hip Flexor Mobility

The hip flexors, particularly the iliopsoas, are pivotal in maintaining proper posture and alignment. Tight hip flexors often contribute to a forward-tilted pelvis, which can push the lower back into more extension, exacerbating pain. Improving hip flexor mobility can help restore proper pelvic alignment, reduce lower back strain, and enhance movement efficiency.

Strategies to Improve Hip Extension and Flexor Mobility

1. Couch Stretch with a Contract/Relax Strategy

The couch stretch, when combined with a "contract/relax" strategy, is an effective method for improving hip extension and hip flexor mobility. This technique involves contracting the target muscles before relaxing them, which can enhance flexibility and range of motion.

• Start Position: Kneel in front of a couch or wall, placing one foot on the couch or wall behind you while keeping the other leg bent with the foot flat on the ground in front of you.

• Contract: Gently contract the hip flexor muscles by actively pushing your foot into the couch or wall for 5-10 seconds, while maintaining a neutral pelvis.

• Relax: After the contraction, slowly ease into the stretch, allowing the hip flexor to relax and lengthen. Hold the stretch for 20-30 seconds.

• Repeat: Perform this stretch 2-3 times on each side, ensuring proper alignment throughout.

2. Diaphragmatic Breathing During Stretching

Incorporating diaphragmatic breathing into your stretching routine can significantly enhance the effectiveness of your hip flexor stretches. Diaphragmatic breathing helps relax the body and reduces muscle tension, allowing for a deeper stretch.

• Technique: While in the stretch position, inhale deeply through your nose, allowing your abdomen to expand, and exhale slowly through your nose. Ensure you fully exhale and pause for a full 5 seconds before taking the next breath. Keeping your tongue on the roof of your mouth during this process can further optimize nasal breathing and promote better alignment.

3. Proper Pelvis and Ribcage Alignment

Maintaining proper alignment of the pelvis and ribcage is essential for effective stretching and overall lower back health. An anterior pelvic tilt, which involves a forward tilt of the pelvis, can exacerbate lower back discomfort. Ensuring a neutral pelvic position during stretches helps target the hip flexors more effectively.

• Alignment Tip: As you perform stretches, imagine gently pulling your pelvis under you and engaging your abdominal muscles to support a neutral spine.

The Connection Between the Psoas and the Diaphragm

The psoas muscle, a major hip flexor, and the diaphragm, the primary muscle involved in breathing, are closely linked. This connection means that proper breathing is crucial when working to mobilize the psoas. Inefficient breathing patterns, such as shallow or rapid upper chest breathing, can lead to reduced effectiveness of the psoas and exacerbate lower back stress. By promoting proper diaphragmatic breathing and engaging in effective stretching techniques, you can better support both the psoas and diaphragm, reducing overall strain on the lower back.

This Breathing Exercise is a great one to relieve tension in the lower back in those who have pain with extension or backward bending. 

Conclusion

Addressing hip extension and flexor mobility is crucial for managing and preventing extension-based lower back pain. By incorporating targeted stretches, mindful breathing practices, and maintaining proper alignment, you can improve hip mobility, reduce lower back strain, and enhance overall well-being. Consistency and proper technique are key to achieving lasting improvements and relieving discomfort. Stay tuned for the next installment in our series, where we’ll continue to explore strategies for optimizing lower back health.

"Before implementing any exercise or rehabilitation program, it’s important to consult with a healthcare professional, especially if you are dealing with a nagging injury. They can help you tailor these principles to your unique needs and ensure you progress safely."