We have all experienced some sort of back pain. Some of us are fortunate enough to return to a pain free or almost pain free state after sleeping funny, sitting in a weird position for a little too long, or after a slight shift or breakdown in form during weightlifting/powerlifting movements. The other side of the story is when you have ongoing back pain from a chronic condition or acute injury and it just won’t let up. Here is where we dive in to the mechanics of the back and why you have pain somewhere down the kinetic chain. Where does this pain come from and is it here to stay? The answer to this question highly varies, but we may be able to get down to fixing some of the root causes that could solve or decrease your pain. This stems further down the body than the middle or upper back. Hip pain, knee pain, and even ankle pain can be occurring from their (inverse) relationship with the back.

Let’s get into some of the most common problematic areas of the back:

Quadratus Lumborum – two muscles of the spine that attach to the back of the hip as well as the spinal column just below the ribs. The Quadratus Lumborum (or QL) is one of the most common reasons people have non-specific lower back pain. This pair of muscles assists in stabilizing the spine during side bending as well as extension (bending backwards) of the spine. Non-specific lower back pain is typically caused by extended periods of sitting but can also stem from normal wear and tear during weightlifting. Due to these reasons, people always want to stretch the QL. This is great if what they are looking for is temporary pain relief. Here is why. When sitting all day, the QL are over stretched for many hours. When someone stands up and feels tight, it is due to the prolonged stretch to “normal” state of these muscles.

Instead, foam rolling the QL will massage the muscles to encourage relaxation and recalibration to their original state. When foam rolling the QL, start by laying on your back and bridging the hips up to get the foam roller under your lower back. Once in this position, let the lower back curve by attempting to relax and drop the hips to the ground. Once you are relaxed as possible, cross one leg over the other and drop your knee down toward the ground until you feel a slightly discomforting feeling deep to the surface of the back just outside the spine. Rolling back and forth is one method to help the QL return to a calibrated state but a static hold may do the trick as well. Athletes with bulging discs should avoid this method. (Download PDF to see Fisgur 1)

Psoas – two muscles that also attach to the spine but originate from the front of the hips. They are accessible deep to the abdominal muscles, specifically the Rectus Abdominus. Think of these muscles as two more anchors to hold the spinal column upright. This area of the body is highly overlooked by professionals in the health and fitness fields as the Psoas are stabilizers of the Lumbar spine (lower back). This pair of muscles tend to pull the spine forward and cause too much of a concave curve in the lower back. In addition to the hip flexors (discussed below), the Psoas will cause an anterior tilt. Think of your hip bones as a bucket of water. If your hips are neutral, no water will spill out of the bucket. If they are tilted back (posterior pelvic tilt), water will spill backwards from the bucket. An anterior pelvic tilt is where water is spilling forwards out of the “bucket” of the hip bones. This last example is where most people derive their non-specific lower back pain. You can assess yourself by taking pictures from a lateral (side) view and see if water is spilling from the front of your body. Regardless of whether or not you can see theoretical water spilling from the front, you should take care of the Psoas muscles with foam rolling as you would any other muscle. Warning: foam rolling the Psoas is always uncomfortable, and may even be painful. Consistent releases of these muscles will lead to better movement and stability from surrounding joints (i.e. hips, lumbar spine) but is always a blast to work on. Have fun! (Download PDF to see Fisgurs 2 and 3)

Hip Flexors – The hip flexors are responsible for pulling your knees to your chest. These muscles are particularly tight from prolonged sitting and even squatting movements. As mentioned above in conjunction with the Psoas, the hip flexors will cause an anterior tilt of the hip bones which will put the lumbar spine into a concave position beyond its normal curve, also known as lordosis. Due to the positioning of the hips from overactive (tight) hip flexors and Psoas muscles, the spinal column will feel pressure within the vertebrae and/or tightness of the QL and Spinal Erectors (muscles traveling up either side of the spine). Roll these muscles after hitting the Psoas and you are bound to feel some relief from lower back pain. (Download PDF to see Fisgur 4)

Adductors – The adductors one of the most overlooked pieces of the back pain puzzle. These muscles consist of the Sartorius, Gracilis, Adductor Magnus, Adductor Minimus, Adductor Longus, Adductor Brevis, and Pectineus. Quite the group! They all attach within the base of the pelvis and tend to pull the hips left and right causing a diagonal tilt so the base is no longer parallel to the ground. During movement, or even during prolonged sitting, a tilt of the hips can cause a lateral shift in the spinal column. Due to this tilting, unnecessary pressure is placed on the discs of the spinal column between the vertebrae. Use the following foam rolling positioning to hit the entire adductor group. See Figure 5 for positioning. (Download PDF to see Fisgur 5)

From all of the aforementioned muscle groups, everyone can benefit from a little self-love pre and post workout. When you wake up, during a long day at work, and before bed isn’t a bad idea either. Foam roll each of these areas for a minimum of one minute to really feel the benefits of releasing these overactive muscles. In order to see long term, lasting results, a minimum of five weeks is recommended to feel noticeable pain relief on a day-to-day basis. Every body is different and we all have our own ailments, but regardless of the level of pain or initial reason for the pain to have occurred, foam rolling these muscles will allow for better movement on training days, decreased pain during normal activities, and increase your quality of life. Put yourself in a better mood and take care of the muscles that take care of you, no matter how overactive they are. Additional injuries from the lower back down may stem from these muscle groups. Fix these areas and notice the trickle effect down to each joint all the way to the big toe.