Low back pain is one of the most common causes for work related absences in the United States. It is estimated that about 50 billion dollars per year are spent on treating this particular ailment.1 Although there are many contributors in the development of low back pain, this blog will discuss the relationship between the group of muscles known as the hamstrings and their contribution to low back pain.
The hamstrings are a group of 3 muscles located on the back of femur or thigh. The muscles connect from the buttocks area of the pelvis to the backsides of the lower leg. This allows the hamstring muscle group to bend the knee as well as extend the hip (bringing the thigh behind you). Normally the spine is set in such a way that there is a small curve in the low back. This is because the backside of the pelvis is slightly higher than the front. When the muscles in the back of the thigh are too tight they can pull the back side of the pelvis downward. This can be demonstrated by tightening the buttocks or pushing the hips forward. This downward pull of the pelvis can cause a flattening of the back which puts the spine at a disadvantage when it comes to the ability to hold your body upright against gravity. The constant pulling of the shortened muscles increases pressure on the bones of the spine as well as adds strain to muscles because they have to work harder to hold the body up against gravity. When this happens for a prolonged time, the muscles in the low back become weak and start to fatigue or get tired sooner. The muscular imbalances can cause pain in the low back because of these reasons. An example of a situation in which this can occur can be seen in an individual who sits at a desk for prolonged periods of time without proper back support and/or posture.
How to help prevent tight hamstrings?
Stretch, stretch, stretch! A simple stretching routine can help limit the amount of tightness especially if you are sitting all day. Remember though, that it is not just tightness in the hamstrings that can cause low back pain. If pain is does not go away within 1-2 weeks, it is best to seek a consultation with a licensed physical therapist to help to diagnose and treat the issue. Here are some examples of stretches that may be part of a physical therapy routine for a diagnosis of tight hamstrings:
Figure 4 Stretch
1. Sitting on a flat surface (i.e. the ground) one foot is fully straightened.
2. The opposite leg is bent and the foot of the bent leg touching the inside of the straightened knee or thigh.
3. Keeping the back straight, facing forward with the buttocks slightly sticking out, slowly lower the trunk towards the straight leg.
4. Hold for 30 sec when minor discomfort is felt, never to pain.
5. Rinse and repeat. 4 repetitions can be done or a total stretching time of 2 min.
1. Lie on your back with both legs straight.
2. Bend one knee to roughly 90o so that it is perpendicular to your body.
3. Hold your bent thigh behind the knee.
4. Slowly straighten the bent knee keeping the thigh straight with the opposite leg straight on the ground.
5. Hold for 30 sec when you feel a small amount of discomfort or when the opposite leg starts to lift off of the ground or bend at the knee.
Because the pelvis is the part of the body that connects the legs to the upper half, any changes in the orientation of the pelvis can create problems at other joints above and below such as the knees, ankles, and even neck. A licensed physical therapist is trained to help diagnose, treat, and prevent situations such as this. If you ever feel discomfort or pain that lasts greater than 2 weeks, again it is recommended that you consult with a physical therapist. Physical therapy treatment has been shown in studies to help reduce the amount of pain and discomfort and improve the quality of life of individuals who are afflicted with low back pain and can be a pivotal step in your recovery process.
What Can I Expect?
Some things you can expect when being treated for low back pain:
● Physical therapists will use treatment tools such as heat or cold therapy, whirlpools, ultrasound, and/or electrical stimulation to help reduce symptoms such as pain, swelling, and tightness in muscles and help improve blood flow to tissues.
● Exercise Prescriptions will be utilized to help improve muscle strength and endurance.
● Stretching programs will be prescribed to help decrease pain and muscle tightness.
● Education on proper body mechanics and posture, as well as instruction on the use of ergonomic equipment that aids in maintaining proper posture can also be expected.
● Physical Therapists are trained in the application of hands on manual therapy techniques such as manual stretching techniques, joint mobilizations, deep tissue massage/trigger point release, and myofascial release. When implemented by a trained/licensed physical therapist, these techniques can help increase range of motion, improve muscular and joint function, and decrease pain in individuals suffering from musculoskeletal injuries including low back pain.
It is a good thing to know that physical therapy is not just for people with severe injury. It is wise to visit with a physical therapist on a routine basis to help maintain general fitness levels, prevent injuries that may produce debilitating symptoms such as low back pain, and help maintain/improve quality of life.