Written by: Dr. Mehran Tabrizi, Chiropractor, Cambridge Clinic
When it comes to running, the muscles of the hip provide the power for performance. In order for you to create integrity in the hip joint, you have to have access to the muscles of the posterior chain—those of the glutes and hamstring complex.
But it is not as simple as just strengthening these muscles. If we have back pain, the glutes are functionally inhibited. This is an evolutionary mechanism that is designed to protect us when we are not at our most mobile or agile. If the brain perceives that we have no control of joint stability, it is never going to let you unleash your potential power.
Since back pain is so connected to our hip—and also to the alignment of and load on the knee—it is important to get a handle on what is happening with that. These are the three basic categories that allow you to classify and triage your back pain:
1. Flexion intolerant: This type of back pain will result in spasm with bending forward.
2. Extension intolerant: You guessed it, this type of back pain is aggravated by bending backward as it irritates the facet joints.
3. Sheer intolerant: This is from more complex movements that cause macroglide of the segments.
Like anything in life, though, it is often not as simple as it just being one thing—it can also be a combination. And, minimizing this level of pain is key to function.
In looking at the cause of the pain, checking the symmetry between the mobility of your right and left hip is a key driver to look for. Also, the ratio of quad to hamstring strength will impact the function of the hip and accessibility of power. Those who are more performance-driven tend to be more quad dominant, an imbalance that does not support that posterior chain activation.
It is not only because the quads are stronger, but also because they will then tend to be tighter. Many will work on stretching the hip flexors, which is important, even in the treatment of back pain; however, part of tightness in the anterior chain that is often overlooked is tightness of the quads, specifically the rectus femoris.
The contraction of a muscle is the part that comes easy, but the ability to down-regulate and relax is also important, and is an ability that elite athletes have. That level of awareness is a skillset that requires a different type of exercise.
Often pegged as a contributor to low back pain is a weak core, yet that is an umbrella term that has minimal usage. What we want to know is how reactive is your core—that is, do you have that reactive strength for your core to engage at the right time and in sequence to support your back and your movements.
And, to further complicate the matter, in as much as we talk about the posterior chain muscles of the hip, the calf is also in that chain, as is the thoracolumbar fascia.
With so many variables to consider, we can see how important it is to have personalized care to help sort out the causes of pain and to maximize performance. Join me for an interactive workshop where we can further explore these concepts on April 26, 2022 at 5:30pm.