Category: Back pain

Got a Bendy Back and Tight Hip Flexors? Try this Short Workout

Five years ago I wrote a blog post titled The Curse of the Bendy Lower Back that laid out many of the difficulties facing people with a naturally bendy lumbar spine. One of the most unpleasant consequences is shortened, weak, painful hip flexor muscles.

This phenomenon has been well documented. In 1979 Dr Vladimir Janda coined the term “Lower Crossed Syndrome” to describe the postural condition where the back arches and the pelvis tilts forward. This results from and further contributes to tight muscles in the lower back and the front of the hips, and lengthened muscles in the abdominals and glutes/hamstrings.

At the root of the problem is inefficiency. Our bodies are designed to move from a stacked spine where the S-curve rests directly on top of a vertical pelvis and very little muscle is required to hold us up. When our spine is not neatly stacked the muscles and connective tissue have to work much harder to hold us up, resulting in angry, resentful, tight muscles.

In the case of the bendy lower back, the spine pulls the pelvis into a forward tilt (and sometimes the pelvis pulls the spine). This makes the back muscles have to work very hard to hold up our upper bodies, and compresses our illiopsoas, the largest and deepest set of hip flexor muscles. It also aligns us in a way that makes it our quadriceps muscles over work and makes it harder to use our abdominal muscles and glutes. Left unchecked over time this creates chronic postural problems, tightness, and pain.

I’ve had a pretty severe case of Lower Crossed Syndrome for most of my life. I do exercises every day to counter its effects and it has decreased my back and hip pain and increased my hip mobility. I’ve also seen these exercises help other people with the same issues, so if you’re in the same boat, perhaps they will prove useful for you too!

The video below contains specific exercises that I find useful, but here are some guiding principals that can help you design your own workouts and adapt your current workouts to make sure that you aren’t reinforcing your imbalances.

1. Know Your Dominant Muscles and Try to De-emphasize Them

For many folks with bendy back issue, the quadriceps muscles are bossy as hell. When designing your exercises, find ways to reduce input from the quads in favor of the illiopsoas, glutes, hamstrings, and core muscles. Basically, anyone but the quads. It may mean going lighter with your effort in order to find those quieter, shyer muscles.

2. Just Because a Muscles is Tight Doesn’t Mean it’s Strong

The back and hip flexors do not want to lengthen. They may feel tight as a bridge cable, but that doesn’t mean those muscles are good at contracting either. Often those muscles are just stuck at one length, not getting shorter or longer. When that happens, I recommend working on contracting the muscles first, before trying to stretch them. It is easier to make a muscle contract than relax, and once you get them to contract they gain some confidence and are more amenable to relaxing and stretching.

3. Just Because a Muscle is Long Doesn’t Mean it’s Weak

Those glutes and abs may be stuck in a long position, but that doesn’t mean they aren’t strong in a long position. When I was doing backbends all day my abs were very strong, they just didn’t want to get shorter. The key to making sustainable change was to get away from the crunches that I was used to and find exercises that forced me to use my abs when they were in a shortened position, with my spine in forward flexion. This resulted in lots of shaking, and some sustainable improvement in my bendy back issue. Putting a squishy ball or pillow under the hips for ab work is a great way to start.

4. Changing Posture is a Daily Practice

Posture doesn’t change overnight. It’s likely you’ve had this posture imbalance for much of your life so doing exercises once in a while isn’t going to make a noticeable difference. Changing posture and maintaining that change means doing exercises to address the imbalance almost every day, possibly for the rest of your life. But hey, at least you’ll always have something to do.

For my fellow hyperlordotic (bendy lower back) friends, I hope that some of these tips and exercises are useful for you. I know many of you may be dealing with back and hip pain, and all I can say is that there is hope for relief with consistent dedication to this small, undramatic, exercises.

Happy Bendings!

 

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Spinal Anatomy for Back Benders

Back bending is one of the most challenging areas of the flexibility arts. The spine is an extremely complex structure consisting of bones, cartilage, connective tissue, and tons of nerves. You are essentially bending your brain’s tail.

Back bending is also special because most of the flexibility gains come from shortening the muscles of your back. Most flexibility training focuses on lengthening muscles. That is why back bending feels so different than other types of stretching and why it requires a specialized, primarily active (strength-based) approach. For ideas on strength-based spinal mobility check out the Video Club series.

Back bending is intense! Moving those bones and nerves around can create all sorts of unexpected responses. Dizzyness, euphoria, nausea, headaches, intense emotion, muscle spasms, and exhaustion are all common responses to back bends. My coach used to say that one hour of backbending taxes the nervous system like eight hours of normal exercises.

And of course back bending can be dangerous. Overtraining risks the possibility of fractured vertebrae, herniated discs, pinched nerves, and chronic pain.

Lest I sound like a total downer, I still love to teach and practice back bending. I just have strong feelings about the need for education and safety around the pursuit of the back bend. So let’s start with understanding the basics of how the spine is constructed.

 

The Three Segments of the Spine

Outline of the Spinal Anatomy

The spine is made up of 24 boney chunks (vertebrae) that are hollow in the middle to allow the spinal cord to pass through. In between each vertebrae is a squishy disc to allow for movement and protection, and there are tough cords of ligaments that keep everything held together. To nerd out more deeply on the anatomy of the spine check out this good introductory article from the University of Maryland Medical Center.

Vertebrae change shape as they go up the spine. Based on that shape the spine can be divided into three different sections. Each section has a different kind of movement function.

Lumbar Spine

The Lumbar SpineThe lumbar spine starts at the sacrum, a flat shield-shaped bone that attaches to the pelvis. The five lumbar vertebrae (some people have six) are the largest of the three sections and naturally curve into a back bend shape. Some people have a lot of natural curve, some people have less.

The primary muscles supporting the lumbar spine are the illiopsoas, transverse abdominus, obliques, and the pelvic floor muscles. The muscles in the back that need to shorten for backbends are the multifidi, quadratus laborum, and the large muscles on either side of the spine that connect the spine and the ribs.

The shape of the lumbar vertebrae makes them more mobile going forwards and backwards although they also allow for twisting and side bending. Your lower back is part of the support system for your entire upper body, so it is important to keep it strong and mobile even if backbends aren’t your passion.

If back bends are your passion, beware over-using your lumbar spine. Because it has a natural back bend curve it’s easy to dump into your lower back, especially if you have a lot of natural curve and/or tight hips and upper back.

 

Thoracic Spine

The Thoracic SpineThe thoracic spine is the longest section of the spine, starting in the mid back and extending up to the base of the neck. The shape of the vertebrae differs considerably from the lumbar spine allowing for less mobility. The thoracic vertebrae are also the anchors for the ribcage, further limiting movement potential.

The muscles that support the thoracic spine in backbends are primarily upper back muscles including the lower and mid trapezius, the serratus anterior, and the rhomboids. The diaphragm is also involved in upper back bending and a tight diaphragm can limit upper back mobility.

The thoracic spine has a natural forward bend that is often exaggerated by modern posture. This is why learning how to find a backbend in the thoracic area is valuable even if you aren’t a back bender. And if you are a back bender it is extremely important to develop the muscles that reverse the natural curve of the thoracic spine to avoid over-using the lower back and neck.

The thoracic spine is very good at twisting, so one entry point it to work on twisting motions.

Cervical Spine

The cervical spine is in the neck, providing the bridge between the skull and torso. There are seven cervical vertebrae designed for maximal movement in all

Cervical Spine Illustration

directions: forward, back, tilting, and twisting. This is necessary for us to have the mobility we need but it does mean that back benders (and everyone else) need to take very good care of our necks.

Like the lumbar spine, the cervical spine also has a natural backbend shape. That makes the neck another vulnerable place for back benders. I often teach backbending without including the neck at all until some amount of thoracic bend is present to lessen the pressure on the cervical vertebrae. Strengthening the neck muscles is also essential, especially for those planning to practice chest stands (locust pose) or shoulder stands.

 

It is important to strengthen all of the neck muscles evenly because it is so mobile. Don’t just work the back bending range, work forward, tilt and twist with resistance. That head weighs about 11 lbs. It’s heavy!

 

 

Know Your Bend

Understanding the sections of the spine and how they work will aid you in improving the beauty and ease of your backbend and making sure that your back stays healthy and pain-free.

Pro Tip:
Take some photos of your backbend. Notice where you are bending: which areas of your spine are doing the work? If you notice that you are only bending in a few spots and other areas of the spine are not bending at all, or eve bending forwards, this is a good indication that you should focus your training on evening out that bend before going deeper into your flexibility.

Please watch the video below for you visual learners, and check out our video workouts and workshops for ideas on how to safely approach back bending.

Happy Bendings!

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Improve Middle/Straddle Splits and Hip Stability: How to Do a Highly Effective Clamshell Exercise

 

I’ve often said that if I were stuck on a desert island and I could only bring one exercise, the humble clamshell would be a strong contender. This exercise is gold for targeting one of the most important and under-utilized muscle groups in our lower body: the deep butt.

The deep butt are six little muscles that run horizontally under the gluteus maximus, connecting the head of the femur to the pelvis at various points and angles. These muscles (the obdurator internus and externus, the gemellus superior and inferior, the quadratus femoris, and the famous piriformis) are external rotators and are vital to stabilizing your pelvis for positions like middle splits and straddles, as well as for life.

But the gold in clamshells is very much in the details. It’s so easy to swish through a set of clams utilizing non-targeted muscle groups like the obliques, the hip flexors, opposite butt muscles, and even the spinal extensors. The gluteal muscles (gluteus maximus, minimus, and medius) are working but not the primary targets here. The first time I figured out how to get all those other helpers to pipe down and really focus on the deep butt muscles I was shocked to find a tiny range of motion and shaking like I was hefting an olympic barbell. But it was just my thigh bone. So exciting!

How to Set Up for Success

Even Out Your Hip Bones: If you have a difference in the diameter of your waist and hips, which most people do, when you lie on your side your top hip will tip up towards your rib cage making your hips uneven. Use your waist muscles to lengthen that top hip out towards your heels until the top hip bone is directly above the bottom hip bone. This will make it harder for your obliques and back muscles to “help out”.

Slight Lean Forward: Very slightly rotate your pelvis forward as if you were considering rolling forward onto your belly. Lengthen your top knee out just past your bottom knee. Feel like that top leg is lengthening out of the hip socket. You are going to maintain this lengthened feeling and forward tilt throughout the exercise to minimize the participation of the gluteus minimus and medius and hip flexors.

Stack the Insteps of your Feet: Make sure that the feet are stacked one directly on top of the other with the insteps lined up and pressed together. That slight press down with the top foot is going to encourage the external rotators to be more enthusiastic.

Tips for Optimal Execution

Nothing Moves but the Knee: Try putting your top hand on your top hip. Don’t let that hip bone move at all. The only movement is the lifting and lowering of the thigh bone.

Bottom Leg Stays Relaxed: It is so tempting to push that bottom leg down to lift the top leg up, and some amount is inevitable. But really try to keep it as relaxed as possible.

Keep it Small: Most of us don’t have a huge range in our external rotation. If you are doing a giant movement where your knee points towards the ceiling every time you are likely bringing pelvic and spinal rotation into it and no longer isolating those deep butt muscles. Keep it small, keep it honest.

Feel the Burn: For most people this is not an isolation we do every day. Those deep butt muscles should be singing! You probably wont need more than 10-20 reps to get to shaky, crampy, maximum. Feel free to do multiple sets but when you get too tired to isolate, take a break.

For you visual learners check out the YouTube video below!

Pro Tip: The standard way to do this exercise is with the hips at about a 45 degree angle and the feet lined up with the hips but that isn’t the only way to do it. You can emphasize different muscles but doing the same set up with the knees tucked up towards the chest or in full extension with the feet back behind me like you were hanging upside down from a trapeze. These exercises are great for improving hip stability at every angle.

 

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The Tensor Fasciae Latae (TFL) Can Cause Hip and Back Pain: Here are Some Ways to Help

WTFL???? What is the Tensor Fasciae Latae (TFL)

The Tensor Fasciae Latae, or TFL to its friends, is a small muscle in the outside front of the hips that works very, very hard. The TFL is a multi-tasker. It does hip flexion, hip abduction, internal rotation, and it even internally rotates the lower leg through its attachment to the IT band.

The TFL is an important hip flexor muscle

 

Moving the leg out to the side in parallel inspires the TFL to work in hip abduction with the gluteal muscles

 

The TFL is also one of the primary muscles working in internal rotation

 

Because the TFL has so many abilities, it is often overworked. It’s just so easy for other muscles to lay back and let the TFL take over. The TFL is also not one of those sexy muscles that we pay a lot of attention to when we go to work out, so it may not be strong enough to do everything we need it to do.

As a result it is not uncommon for the TFL to get sore and/or tight, contributing to problems in the lower back, hips, and knees. The TFL is also one of the common culprits in what is often interpreted to be a tight IT band. Because the IT band is fascia, and doesn’t stretch, it can’t be tight. For more on “tight” IT bands and my rant about the futility of foam rolling check out this blog post (link).

 

How do I Find my TFL?

Sitting on the floor with both knees bent and the feet more than hip width apart, let both knees fall to one side. If your hips are very tight you may want to sit on a block to start. Focus on the leg that is internally rotated (the back leg). Place your thumb on your hip bone then move it around to the outside of your hip about 2 inches, then down about 2 inches. Poke around for a lumpy muscle.

As you are poking, begin to sink your right hip back down towards the floor, rotating towards your back leg. You will be able to feel the TFL contracting and shortening under your thumb. If this is unpleasant, then you probably have a cranky TFL.

Poke around the front outside of your hip feeling for the TFL. You should feel it compress and shorten as you sit your butt down and rotate towards the back leg

 

How do I Release a Tight TFL?

When a muscle is very tight and angry, its usually because it is stressed out. It feels overworked and unappreciated. Sometimes when you start with rolling out or stretching a muscle like this it just gets more stressed out and, while there may be momentary relief, it will just get tighter again when you start to move.

Beginning with a very gentle TFL contraction will help the muscle feel more confident, loved, and appreciated. Here are three very kind TFL exercises to get you started.

 

Strengthening a Weak TFL

TFL Internal Rotation Exercise

Laying on your back, bend both knees with both feet more than hip width apart. The wider the feet the more difficult the exercise. Put your hands on your hip bones to remind you that the hips will not move at all. One leg at a time, gently internally rotate your femur, dropping the knee in towards the floor. Feel that little TFL gently contract at the end range of motion to push your knee down towards the floor. Remember, keep this gentle or you will start to feel other muscles (glutes, inner thighs, back) and you want just the TFL. Do 10-15 soft, sweet pulses in this position on each leg.

    This exercise directly targets the TFL by internally rotating the legs.
TFL Flexion Exercise

Still lying on your back move both legs to parallel, just at hip width apart. Pick up both legs to table top (knee at a 90 degree angle), internally rotate the leg slightly keeping the knee still and moving the foot out, then begin to pulse the knee in towards your chest. It is very important not to let the pelvis move. You may notice that the pelvis wants to tuck under as you pulse. Don’t do it. You are in charge. Do 5-10 pulses on each side.

    Combining slight internal rotation with hip flexion really gets that TFL fired up
TFL Abduction Exercise

Lay on your back with your legs together. Your abdominal muscles will be working a bit here to keep your body still so only your legs will be moving. Externally rotate both legs, turning the feet out but keeping the knees straight. Without bending the knees, start to slide the legs apart as far as you can go without twisting the hips or arching your back. You will feel your TFL work as a team with your side butt. Teamwork! Do 10-20 pulses apart in this position. Don’t arch your back, even though that feels very tempting.

External rotation biases the TFL when doing hip abduction (moving the legs away from the center of the body). Don’t worry if you don’t go as far as Natalie when you first start, she’s a pro.

 

How to Stretch your TFL

Its really easy to miss the TFL when you are stretching your hips. Its in a weird spot on the front outside of the hips and its often so tight and grumpy that your body would just rather skip it. Hopefully giving it a little strength will help it feel more relaxed, but the form on your lunge will still have to be impeccable to get into the right spot.

  1. Start in an upright lunge, back knee down and hips perfectly square and slightly tucked under.
  2. Slightly externally rotate the back leg. It doesn’t have to be much for most people to feel it. Just move that back foot across the body a few inches and that should be enough.
  3. Make sure that when you rotate the back leg you don’t rotate the pelvis, those two hip bones are still in one line.
  4. Gently push the hips forward and slightly out to the side, extending the hip of the back leg. If you don’t start to feel a stretch in that TFL keep checking on your form. Hips must be tucked, square, and the back leg externally rotated to get the right stretch.
  5. Lift the arm up over your head and lean sideways away from the back leg, sticking your hip out to the side a little bit. That’s just a bonus bit of juicy goodness to get a little deeper into the stretch.
  6. Be sure to do both sides and if one side feels tighter, do it again. It’s best to hold the stretch about 30 seconds or so but less if it is very painful. You can do some gentle, soft pulses into the stretch if the muscle needs some movement to help it relax. No momentum.

This delicious TFL stretch is a variation on the square lunge. Be sure to keep your hips square!

 

What Else Can I do to Relax my TFL?

As mentioned above, the TFL can become overworked because it is compensating for sleepy muscles in other places. Two of the most common muscle groups that could be slacking off are the illiopsoas, and the gluteal muscles.

Check your Psoas

The illiopsoas is also a hip flexor and an internal rotator so a sleepy psoas can heavily overburden that TFL. To test out your psoas strength do the hip flexion movement listed above but with the leg slightly turned out. This should move the work in the inner hip. If that feels difficult, work to strengthen that psoas.

Are the Gluteus Medius and Gluteus Minimus Working?

The gluteal muscles are right up next to the TFL and also attach to the IT band. If you have a sleepy butt then your TFL has to work very hard as a hip stabilizer, and that might make it resentful. To find your glutes do the leg sliding apart exercise mentioned above but with the legs internally rotated. See if you can find that side-butt work. If that feels week the more side butt strengthening should help support your pelvis without so much contribution from the TFL.

Doing the same leg slides into abduction with the legs internally rotated will bias the glute muscles. If this feels weaker than the TFL exercise you may need to strengthen your side butt!

Remember that our muscles are tight for a reason. They are tight because they are trying their best to hold our bodies together and do the work we ask of them. Treating them with kindness and figuring out how to support them is the best way to get them to relax and stop screaming at us so we can be stronger, more flexible, and have less pain.

 

Happy Bendings!

Kristina

 

 

 

 

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