Nearly all cases of lower back pain involve a degree of stiffness developing in the lower back when you have an injury. Back pain is often made much worse with these tight muscles. The hamstrings for example play a role in many cases of lower lumbar spine injuries. Stretching can help you alleviate the stiffness accompanying your back pain, but there are important considerations that you must make.
Next we consider the stretching of the lower back itself. Often a feeling of pressure, seizing and stiffness in the lower back musculature is the first manifestation of a back injury. This is thought to be the problem, as opposed to part of the problem, or more accurately, a symptom of the problem.
If you’re to have success in fixing your low back pain, you must understand when to use stretching, when to avoid it, as well as what the realistic effect of stretching is going to be at various stages of back pain. Our hope is today that we can help you have a better grasp on the utility of stretching for your lower back pain relief and that you are able to employ this strategy to help and not hinder your back pain rehabilitation.
A brief comment on the cause of lower back pain
We will not labor the point as there are many articles and videos on our website, youtube channel & podcast explicitly going into detail on this. That being said, back pain is caused by compression to the lumbar spine to a degree that the tissues that maintain normal structure and function become injured, the spinal ligaments and discs. This could either be a one off and severe traumatic event, or a repetitive barrage of strain over a long period of time.
Accompanying this injury is the inevitable reactionary muscle spasm and tension. This is often the first awareness an individual has of the back problem. The muscular stiffness and aching, is the first symptom that the consciousness picks up on.
The first principle with stretching for low back pain
Understanding what you are feeling is an important first step. For example, If you have been sitting for a long period of the day, your back muscles will invariably become stiff. This is not the same as tight contracted muscles that need to be stretched.
Fortunately, a very rudimentary, primary school level of anatomy will suffice here and carry you forwards for the long term. If your back is rounded, the muscles are elongated. Therefore, if you are feeling stiffness and tightness after being sat at the desk for a long period of time, or prolonged sitting has been a factor in your back pain, you do not need to stretch your lower back more.
Your back in the above example, is fed up with the muscles being pulled apart, what the muscles want is a change in length, often relaxation, or a return to neutral, not more rounding of your back in an attempt to stretch them more!
Here we are not even considering the back injury, doing so only adds additional impetus for us to avoid knee hug or child’s pose-like stretches that round the back further in a futile & misguided attempt to alleviate lumbar spine tension.
Conversely your hamstrings during this aforementioned prolonged sitting have likely been held in a shortened position with your knees bent and your back slouched. This means that the stiffness and tightness that is present will be a result of shortened contracted muscles that again have been held like this for a long period of time.
Both of these opposing cases have similarities, the muscles have been held for a long time in a set position. Our muscles, joints and body in general, do not like to be still for long periods, we are built to move!
Hopefully now you can start to see the literally opposite circumstances, lead to the same feeling and that the “feeling of tension” is not helpful. We need to understand the cause of that tension, back pain aside.
The role of stretching for back pain
Now that we’ve covered the essentials, we must acknowledge that within the Back In Shape Program, we have stretching. Within many recommendations from clinicians around the world, stretching is recommended for back pain. However it is the information discussed above as well as additional insight that helps us understand the role of stretching in your back pain recovery.
When we have an active back injury, especially in the early days when pain fluctuates daily and the back is vulnerable, stretching is of limited benefit. The simple fact of the matter, as we discussed at the outset, is that the signals from the injured segments will send signals right back down to those muscles to tell them to tighten back up again.
Let us suppose you’ve just done some great stretching, your hips are feeling nice and free, you walk into the kitchen and knock a glass off the counter, you suddenly reach down to catch it, in doing so you tweak your back again.
What happens now?
Those muscles you just stretched go back into spasm – you’re pretty much no better off than before you did your stretching.
So many have stretching as their primary mode of back pain relief and this is why they find themselves going round in circles over months or years because it’s not got a cumulative protective effect and is missing the vital strengthening work that fundamentally is what helps reduce relapses and decrease back vulnerability.
There is a place for you to do stretching, but understanding that the effect, as helpful as it is loosening the hips off, is a temporary one. You cannot have success unless you are devoting an at least equal amount of time and focus on strengthening the lower body and trunk region.
Some stretches just make back pain worse
We used the example earlier of the lower back stretching, and hopefully you are already seeing this sort of stretch for what it is – unhelpful!
The reason these stretches are recommended is because people often do not have a sufficient understanding of the lumbar spine and consider the lower back to be a “back” instead of the complex structure it is. They also fail to make the distinction earlier between elongated muscles that need movement and shortened contracted muscles that could benefit from elongation and movement.
On top of this, those who recommend these exercises often do not have a good understanding of the spinal mechanics or the implications of injury to the structure of the spine and its integrity in the short and medium term. These are not insurmountable challenges but they are ignored at your peril.
Avoid stretches that round your lower back more, especially in the throws of a flare up, where there has likely been a little tissue damage. If you have a scab on your elbow or knee, it’s obvious that bending the joint fully, when you wake up, is going to open the wound and slow the healing process. Do not do it for your lower back!
How is stretching helping your lower back pain
So with all this out the way, we can help you now understand the role of stretching in your lower back pain recovery. In the Back In Shape Program we teach two types of stretching, both of which will help you with improved back and hip health for the long term.
The first type of stretching is the unloading of your spine, we won’t go into detail here, but this is the towel exercise, this has the effect of gently stretching the discs and spinal joints in general in a neutral, lordotic position. It is also a very gentle and balanced stretch. It helps you unload from the daily strain of gravity, something that can be particularly painful in the very severe case of back pain. It also helps provide a little unloading as you progress on with your rehab and healthy working out for the long term. It’s free, easy, takes 2-5 minutes and only needs a rolled up towel to complete.
The second stretching category is the hip muscle stretching. This is your standard muscular stretching, but we focus primarily on the main hip muscles, the glutes, hamstrings and hip flexors. Powerful muscles which exert their influence directly onto the spine via the hip. Many of us, myself included, could have better hip mobility at the best of times. When we have a lower back injury, your hip rigidity will mean that your low back is more involved in daily movements. This is where those common tweaks and flare ups happen as your back is challenged unnecessarily. By regularly working to keep your hips as mobile as possible, knowing full well the effect will be temporary at first, you can help give your back an easier time.
It’s not all a waste of time though, as you start to get momentum with your strengthening exercises, you will start to gain momentum and your lower back injury will begin to stabilize and start going through a more effective healing process. This is the point at which your stretching will start to have cumulative benefit and further complement your hard work strengthening. The two will now help one another as you continue to heal your lower back.
This now allows positive reinforcement to work in your favor, the more progress you make the more healing takes place without relapse, the less inappropriate signalling your muscles will be getting, the more progress you can make with your strengthening and flexibility work, and so on.
Now you have this better understanding of the role of stretching in your back pain recovery, you should start to have more success going forwards implementing what we’ve discussed today.
Comment of the week – Lindy
“After following (still) BIS advice, this is me finishing the Bournemouth 10k last Sunday, in a time only 2 minutes slower than my PB 10 years ago! BIS, you have given me my life back!! “
3 tips to help your stretching for your back pain
3 tips to help your stretching for your back pain
These stretches serve no benefit and in fact create more trouble than they’re worth. Focus instead on targeted stretching to the hip muscles and stop the movement before you feel your lower back becoming involved.
Practice engaging your core and supporting a neutral spine
This will help you increase your awareness when stretches of the hips are beginning to influence the lumbar spine, if you’re holding your core well you’ll feel the “bite point” just like the point the clutch engages in a manual car.
Stretching will become more effective when your strengthening is progressing
Unlike stretching, strengthening can make real cumulative progress right from day 1, in spite of setbacks, focus on making progress here and you’ll find the more you do, the better your stretching will work.