The prevalence of back pain in our society has reached epidemic proportions. Research shows that 80 percent of people will experience back pain at least once in their lives, impacting their ability to engage in activities they love and enjoy life to its fullest (American Chiropractic Association, 2013). Fitness professionals properly trained in corrective exercise are perfectly positioned to assist these people in getting out of pain. This first part of this article explores some possible lower-body causes of back pain and the second part offers corrective exercise solutions you can integrate easily into your personal training .
A Quick Look at How the Lower Body Should WorkWhen you are walking or running, you must transfer weight forward and from side to side as you step forward with alternating feet. Part of this weight transfer is possible because the feet have the ability to roll inward and toward each other (i.e., pronate). When the foot pronates, the ankle rolls in with it, which in turn helps rotate the lower leg, knee and thigh toward the midline of the body. The femur (i.e., thigh bone), which fits into the pelvis to form the hip socket, should also rotate inward in time with the lower leg, foot and ankle (Kendall et al., 2005).
When you are lunging forward you are also transferring weight into one of your feet. As with walking and running, this transfer of weight forward and in to the foot should be accompanied by ankle, leg, knee and hip motion forward and toward the midline of the body.
How Foot, Ankle and Hip Dysfunction Can Lead to Lower-back Pain
Let’s take a look at how dysfunction in any one of these areas of the lower body can lead to back pain. We’ll start with the feet and ankles. As you now know, pronation of the foot enables the ankle, lower leg and upper leg to roll inward. However, due to a whole host of possible causes like muscle weakness, musculoskeletal imbalances, past injuries, lifestyle activities, choice of footwear and the environment, most people overpronate (i.e., they collapse too much in their foot and ankle), and have done so for most of their lives (American Council on Exercise, 2010). Over time, overpronation leads to wear and tear of the joint structures of this area, which in turn leads to immobility of the feet and ankles. If these structures are unable to move correctly, they cannot transfer weight and/or dissipate impact forces correctly. Hence, other structures in the lower kinetic chain, like the hips, must compensate to get the job done.
However, the hips may not be able to help out effectively. Extended periods of sitting, whether at a computer, driving, eating, playing video games and/or watching TV, place the hip sockets in a constantly flexed position, which can also lead to movement restrictions in the hips. (Overdoing athletic movements that require only one or two ranges of motion for the hips, like bike riding or running, can also lead to myofascial restrictions and subsequent hip immobility.) If all these lower-body structures (i.e., feet, ankles and hips) lack the mobility to turn inward toward the midline of the body, the job of transferring the weight of the body forward when walking, running and/or lunging is displaced further up the kinetic chain to the pelvis and lower back.
The joints of the lower back are less mobile by design than the feet, ankles and hips. The lower part of the back contains a forward curvature, which naturally causes the front of the pelvis to tilt down approximately 10°. When the structures of the lower body are not working correctly and the pelvis and lower back must compensate, it results in a pair of interlinked deviations called an anterior pelvic tilt and excessive lumbar lordosis (Price and Bratcher, 2010). An anterior pelvic tilt is a tipping down and forward of the pelvis and excessive lumbar lordosis is an overarching of the lower back. These common deviations place added stress on the structures of the lower back and surrounding muscles, which causes fatigue over time and eventually leads to pain.
ReferencesAmerican Chiropractic Association (2013). Global Burden of Diseases, Injuries and Risk Factors Study.American Council on Exercise (2010). ACE Personal Trainer Manual (Fourth Edition). San Diego, Calif.: American Council on Exercise.Golding, L.A. and Golding, S.M. (2003). Fitness Professional’s Guide to Musculoskeletal Anatomy and Human Movement. Monterey, Calif.: Healthy Learning.Gray, H. (1995). Gray’s Anatomy. New York: Barnes and Noble Books. Kendall, F.P. et al. (2005). Muscles Testing and Function with Posture and Pain (Researched By : Kátia C. Rowlands – PLETT PILATES ; SPINNING & FITNESS STUDIO – 082 513 4256 )
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