Common Causes of Low Back Pain

Low back pain is one of the most common conditions we see at Ace Sports Clinic, with up to 80% of adults suffering from lower back pain in their lives. The prevalence rate for children and adolescents is lower than that seen in adults but is rising (World Health Organization).

Often, low back pain, is of gradual onset, creeping in slowly, starting as occasional discomfort and eventually being a consistent uncomfortable or painful niggle. Sometimes it’s a full-blown crisis where we can barely move without intense pain in our back, hips and sometimes radiating into legs.

In all of its forms, low back pain is often multi-faceted in its origins and while it’s rare to identify only one cause, there are common culprits that we see.   When one area is functioning poorly, we often find that the body compensates and shifts the blame elsewhere; meaning the source of the pain and the problem area may not be the same. This is why we can’t just look at the back when it comes to low back pain. 

Below are three of the most common things we see which contribute to low back pain and some gentle exercises you can perform to try to help settle down the pain.  

Be mindful that each case of low back pain is different, and we recommend coming into the clinic to get an accurate diagnosis and assessment so we can tailor an Ace Client Care plan to your individual needs.

1. Tight hip flexors / Too much sitting

Your hip flexor, or your iliopsoas, is an incredible and powerful muscle. Made of two muscles which share a common insertion, the psoas major originates in a spinal attachment in your mid-low back. Psoas major makes its way forwards through your abdomen where it picks up the iliacus muscle at the front of your pelvis and together, they descend into a shared attachment on your femur (top of thigh). This muscle also impacts the way we breathe, having insertion into our Diaphraghm (main breathing muscle).

The massive iliopsoas has many attachments, including those at the lumbar spine, the hip and pelvis.

Since we spend so much of our time sitting, the hip flexor is often in a contracted or shortened position, which means it can become tight without you even realizing. Due to its attachments, when your hip flexor is tight, it can have ramifications not just at the hip, but also in your lower back. Tight hip flexors often manifest in an excessively arched lower back, or flexion through the hips.  Over time, these postures put stress on the joints and muscles of your lower back and result in pain.

This can be common for those who participate in exercises or sports which cause us to lean forward such as hockey, cycling, tennis or squash as these activities tend to shorten our hip flexors.

Hip Flexor Stretch

We often find that a correctly performed hip flexor stretch, is one of the most effective ways to settle low back pain contributed to by a tight hip flexor.

Begin by comfortably kneeling on one leg on the floor – place a towel/mat under your knee

Ensure you are straight and not twisted through your hips. Tuck your tailbone under to flatten your low back

The purpose of this stretch is to lengthen your hip flexor.  If you have any excessive arching in your low back, you are effectively shortening your hip flexor because of its attachments to your spine.

Hold for 30 seconds. The sensation you feel should be a gentle stretch and not discomfort.

2. Lazy glutes 

Your gluteal muscles are collectively one of the most powerful muscle groups in your body… when they work. A common finding in low back pain is overactive and tight quads, hip flexors and/or hamstrings and poorly functioning gluteal (buttock) muscles. This can put strain on the joints and muscles of your lower back and alter your mechanics resulting in pain. If your quads are on fire after a leg workout and you feel nothing in your buttocks, this one is probably for you!

Why are the glutes lazy?  As with all questions regarding the body, it can be for various reasons. Sitting is a huge contributor because it shortens the structures at the front, which re-positions your pelvis and inhibits the proper functioning of your glutes. Over time, this results in the glutes becoming lazy and turning off.

Often, poor workout technique or imbalance in your workout routine can be to blame. You should ensure that you balance exercises which target the front of your body with those which target the back 1:1. 

In terms of technique, if you are finding exercises that are supposed to target your glutes aren’t making you ‘feel the burn’, come and speak to one of our exercise specialists and get some advice on how to make your exercises more targeted. 

Some general advice is to avoid over-arching your back and to make sure your weight is in your heels rather than your toes.

Hip Bridge

The hip bridge is an excellent exercise to both open up your hips and also target your glutes and hamstrings. This is one of the most commonly prescribed exercises for low back pain where the gluteal muscles are one of the culprits

Start by lying on your back with your knees bent up and feet hip distance apart.

Breathing in to prepare, on your exhale, press through your heels to evenly lift your buttocks off the ground to make a straight line with your body.

Ensure that you do not over-arch your lower back to lift your buttocks higher. 

Slowly lower your body and repeat.  

Start with 2 sets of 10 repetitions.

3. Poor Mobility

Mobility is an essential component of any healthy spine. When one area of your back is tight, it will impact other areas. It’s very common for anyone who spends a lot of time sitting to have poor mobility in their upper and mid-back, which can put excess pressure on the muscles and joints of your lower back, causing pain.

Poor seated posture is a huge contributor to poor spinal mobility. We recommend that desk workers or anyone who spends a lot of time in their car, have an ergonomic assessment done every 12 months at a minimum and a ‘body check up’ every 3 months to identify and prevent any problems like tightness that can later lead to pain. 

A major predictor of poor spinal mobility is previous low back injury. If you have a history of low back pain, you may be habitually protecting your low back by avoiding movement in that region, which could in fact be contributing to your pain. A lack of movement may be causing over-activity in the muscles of your back (and elsewhere), which can cause them to be tight and sore. It can also cause compensation patterns which can result in problems elsewhere.

Mobility is one of the most important things for a healthy body and we should all be including it as a regular part of our exercise routine. Including a weekly Pilates or Yoga session as a regular part of your routine is a wonderful way to get some movement in your body. We can also tailor mobility exercises for your specific body type and individual tight spots.

Low Spine Twist & Arm Openers

Below are two gentle, easy mobility exercises which target your upper and lower back respectively. They can both be done in bed or on the floor and are an excellent way to start or end your day. We often encourage people to use these as a warmup exercise for sport as a way to gently get your body moving before launching into higher energy movements.

Low Spine Twist

Lying on your back, cross one knee over the other.

Take a deep breath in and as you exhale, drop your knees towards the side which is crossed over i.e. if you have crossed your left knee over your right, drop to the left-hand side.

Keep your head, neck and upper body and hands flat to the floor to feel a stretch through your lower back and side.

As you inhale, bring your knees back to the starting position. 

Repeat for 10 repetitions before swapping your legs over and performing 10 on the other side.

Arm Openers

Begin by lying on your side with your head supported by a pillow. Your knees are bent and your hands are stretched out at shoulder height with hands stacked one on top of the other.

Ensure your shoulders are relaxed

Take a deep breath and as you exhale, float your top arm up and keeping the elbow straight, rotate through your ribcage to reach out to the opposite side.

Allow your eyes to follow your hand to feel a gentle stretch through your ribcage and upper-mid back.

Remain in the stretch for a breath, before returning on the following inhalation. Repeat for 10 repetitions before swapping sides and starting again.

Conclusion

Any back pain is often a multi-faceted and complicated issue. Rarely is there one single cause and every person will have a different cause and different needs, however, we do know that mobility in your spine and equality in your movements are two of the things which reduce the reoccurrence and incidence of low back pain. 

* If you feel any pain while performing these exercises, you should stop immediately and seek the opinion of a health professional.

At Ace Sports Clinic, we employ a holistic, hands-on approach to healthcare which addresses your whole body’s needs to aid in pain, injury management and prevention. We recognise the important link between the structure of your body and the way in which it functions. We will collaborate as a team to positively impact your health and wellness. 

Your Ace Certified Practitioner will utilise a variety of hands-on techniques, alongside exercise prescription and education to work with you to achieve your health goals.