Low back pain? Blame the core muscles. People who have low back pain often think that either their core muscles are weak or that they don’t exercise enough. If that’s the case, why do professional athletes and people who exercise regularly are not immune to low back pain? While it is important to have strong core muscles as they provide stability to the low back, it should not be the only one that you focus on. There are other more profound causes of low back pain. Lumbopelvic-hip dysfunction and muscle imbalance are among the most common causes of low back pain. Unfortunately, they are also most often neglected during assessment and treatment of low back pain.
The lumbopelvic-hip region consists of the entire pelvis, the attaching hip joints on either side of the pelvis and the lumbar spine resting above on the pelvis. Have you ever been told or noticed that one of your legs is longer or shorter than the other? Unless you were born with one anatomical shorterleg or that the shortened leg was due to a fractured ankle or tibia, chances are that your unequal leg length is due to a functional leg length inequality rather than a true, anatomic leg length inequality. Lumbopelvic-hip dysfunction causes functional leg length inequality.
The pelvis consists of two hip bones, a sacrum and a tailbone. When there is no restriction and dysfunction between the two hip bones and the sacrum, everything is rosy. You have good range of motion in your hips and low back. You can bend over without the fear of putting your back out. Your legs and pelvis feel even. There is no stress and strain to the muscles, pelvis and low back. However, hip and low back pain may become more frequent when there is lumbopelvic-hip dysfunction.
This is what happens when you have a lumbopelvic-hip dysfunction. One hip bone will rotate backward and down while the other hip bone will rotate forward and up. When this happens, one leg will feel longer and the other leg will feel shorter with standing and walking. Lumbopelvic-hip dysfunction also affects the sacrum and the lumbar spine. The sacrum will tilt forward and down on one side and backward and up on the other side. With its sacral foundation tilted forward and down to one side, the lumbar spine resting on top of the sacrum will also rotate and tilt toward the low side of the sacrum. People with lumbopelvic-hip dysfunctions will often be told that their pelvis is tilted or that they feel the pelvis is twisted.
Think of the sacrum as the foundation of your house. If the foundation of the house sinks to one side, the house will be tilted. What will happen to the walls, plumbing, electrical wires and frame of the house if this continues for many months and years?
There are many important muscles that attach to the lumbopelvic-hip region. These muscles include low back muscles like the psoas and quadratus lumborum, gluteal muscles like the gluteal maximus and medius and hip and thigh muscles like the tensor fascia latae, iliopsoas, quadriceps and hamstrings.
Similar to the effects of a sunken house foundation on its supportive frame, wall, plumbing, etc., lumbopelvic-hip dysfunction can cause muscle imbalance to the low back, gluteal, hip and thigh muscles. Some muscles will become tight and overactive while other muscles will compensate and become weak.
One simple assessment that you can do to reveal lumbopelvic-hip dysfunction and muscle imbalance is with the “Y” pattern squat. Stand with feet shoulder-width apart with hands overhead in a “Y” pattern. Now slowly squat down as deep and low as you can. While doing the “Y” pattern squat, you have lumbopelvic-hip dysfunction and muscle imbalance that may cause low back and hip pain if you:
- tuck your tights into the hips and bring your belly toward the thighs
- have tightness and stiffness in the low back, hips and pelvis
- have difficulty squatting down
Proper treatments for low back and hip pain from lumbopelvic-hip dysfunction and muscle imbalance require soft tissue treatments, stretching tight and overactive muscles, strengthening the weak muscles and manual chiropractic adjustments to correct any restriction and dysfunction involving the low back and pelvis.
Thanks for reading. 🙂