- Diseases, Disorders & Conditions
How Sitting All Day Causes Low Back Pain
How Does Sitting Hurt Your Back?
We all do it. Whether we are in class, at the office, or lounging at home in front of the TV, we are sitting. It might not seem like a big deal, but when we sit, we simultaneously shorten and weaken muscles that normally keep our spine in a neutral position — the position that allows our body to function optimally. The longer we sit, the more this becomes an issue. Our bodies adapt to this position and when we stand up, we feel a great deal of tension in the lower back but lack the ability to cope correctly. If not fixed, this imbalance can also lead to pain in other areas of the body, such as the knees, shoulders, and neck.
Stretching or massaging the lower back might bring temporary pain relief, but it doesn't get to the root of the problem, and the pain will return. The problem isn't actually in the lower back itself but in the hip flexors and the glutes that stabilize the lower back. Understanding how sitting affects these muscle groups will help you figure out how to correct the problem permanently and prevent it from reoccurring.
How Does Sitting Tighten the Hip Flexors?
These Are the Major Hip Flexors
- Psoas: This major postural muscle originates in the lumbar vertebrae (L1-L5) and inserts at the lesser trochanter of the femur (inside top of the thigh bone).
- Rectus femoris: It is largest of the 4 quadriceps and the only one that attaches to the pelvis. It originates in anterior inferior iliac spine (middle front of the pelvis) and inserts into the patellar tendon.
- Tensor fasciae latae (TFL): This small muscle sits where the coin pocket of your pants are located. It originates at the anterior superior iliac spine (the bony protrusion you can feel and see at the top of the hip) and inserts at the top of the tibia via the iliotibial tract (IT band).
How They Become Tight
These hip flexors function as their name implies; they flex, or bend, the hips. When we sit, the hips are in this flexed position, but the muscles aren't actually doing the work. They are actually shortened and relaxed, and the body begins to think this is how long the muscles should be when in a resting state. After half an hour or more of sitting, the body adapts to this new structure.
When you stand up, you might feel tightness at the front of your hips because the flexors, though weak from disuse, want to remain in their new, shorter relaxed position and pull the hips into a slightly flexed position. In an effort to remain upright, the body overarches the back rather than contracts the glutes — the antagonist muscle group to the hip flexors. The combination of overactive lower back muscles, tight hip flexors, and weak glutes pull your lower back into hyperlordosis.
Hyperlordosis of the Spine
How Does Sitting Weaken the Glutes?
The Glutes Are Important Postural Muscles
The glutes might be known for aesthetic appeal, but that is not all they're good for. They actually play an important role in maintaining good posture, yet they are often overlooked. Working opposite to the hip flexors, the glutes extend the hips to balance the position of the pelvis and lower back. We will focus on the gluteus maximus, one of the three glute muscles, which does the majority of the hip extension.
The gluteus maximus originates in the gluteal surface of the ilium (top back of of the pelvis) and sacrum (tailbone). It inserts into the gluteal tuberosity of the femur (inside top of the thigh bone).
How They Become Weak
You usually aren't contracting the glutes when you are sitting because it isn't necessary. In fact, you may find it difficult to get a good contraction when seated. Go ahead, try it! This is because the glutes are out of their optimal functional range and in a slightly stretched position.
Like with the hip flexors, the body adapts to this new lengthened and weak position. When you stand up, the glutes aren't able to counteract the pull of the hip flexors, so they allow the back to overarch. With weak glutes and tight hip flexors, you'll find that walking can be a bit awkward as well because you aren't able to fully extend your hips at the end of a stride. Overtime, this pattern will reinforce the imbalances caused by sitting.
How to Stop the Pain
We want to reeducate the body so that it knows what correct posture is. We also want to get the hips to function in its normal range. Both of these things will stop your low back pain and allow you to move freely again. The best way to accomplish this is by stretching the hip flexors and strengthening the glutes.
The Kneeling Hip Flexor Stretch
This stretch is fantastic because it stretches all the hip flexors and requires you to activate the glutes.
- Kneel down on one knee with legs at 90 degrees. (If you're really tight you may already feel a stretch at the hip)
- Tuck your pelvis by squeezing your glutes. (You may feel a bit more of the stretch down the thigh)
- Keeping your chest up and back straight, drive the hips forward.
- Hold for 1-5 minutes. Do not rock back and forth.
- Repeat for the other side
Note: The most important thing to remember during this stretch is to squeeze the glutes and keep the chest up.
To intensify the stretch, bring your arms up overhead and lean to the side with the leg up (away from the side you're stretching).
If you want an even deeper stretch, put the back foot against a wall so that the heel and glute are almost touching. This will bring more of the rectus femoris into the stretch. Again, squeeze the glutes!
Glute Strengthening Exercises
With the hip flexors stretches you should feel the tension in the lower back decrease and the correct posture restored at least 90%. The extra 10% comes from strengthening the glutes. This will help the body learn the proper range of motion in the hips as well as balance the actions of the hip flexors more effectively.
- Lie on the ground on your back with knees bent at 90 degrees.
- Squeeze the glutes and drive the heels into the ground to extend the hips.
- Hold for at least 30 seconds and repeat for 15 repetitions. (As you get stronger, you can hold for longer and/or do more repetitions)
Note: It is important to drive through the heels and not the balls of the feet. Driving through the heels engages the glutes while driving through the balls of the feet engages the hamstrings.
Want to up the difficulty? Do the same thing but lift one leg up in the air.
- Start with the legs about shoulder width apart.
- Keeping the chest up and back straight, take a big step forward and lower the hips. (The knees should be at 90 degrees)
- Drive through the heel of the forward foot to pick yourself up again.
- Repeat for 15 reps on each side.
Note: If you've never done this before, you may find it hard to balance during the movement. Just pick a point in front of you and focus on it. Another tip is to take a deep breath and tighten the abs as you go down. Breath out as you push yourself back up.
How to Prevent the Pain
The best way to avoid low back pain from sitting is to do whatever you normally do but standing up. Eat your lunch standing up. Study standing up. Watch TV standing up. By doing this, you are constantly engaging your postural muscles and avoiding the tendency to slouch.
Some of us can't avoid sitting for long periods of time; we might have a desk job or have classes all day. However, we can still prevent the negative effects of sitting too long with these two tips:
- Get up every 15-30 minutes. Walk around. Get a drink of water. Just a couple fo minutes is enough.
- If the space allows it, you can stretch while you do your work. For example, you can drop down in front of your chair to stretch your hip flexors.