If back pain is causing you to shorten or skip your workouts, you're not alone. According to the National Institute of Neurological Disorders and Stroke, Americans spend an annual $50 billion each year on low-back pain diagnosis and treatment. While a number of factors contribute to back pain, muscle imbalance between the gluteal and hip muscles may be to blame, especially if pain occurs during walking or running. By understanding the causes of muscle imbalance, you will be better able to develop a well-rounded exercise program that alleviates your back pain.
Understanding Muscle Function
Muscles work in pairs, and each paired muscle is designed to oppose its counterpart’s action. When one muscle in the pair becomes weaker or stronger than the other, muscle imbalance occurs. If you’re experiencing pain in your lower back or hip during walking or running, a muscle imbalance in your hip joint could be the culprit. The gluteus maximus and hip flexors form one muscle pair often responsible for muscle imbalances in the hip joint. Muscle imbalances can also occur in muscles that work together to perform the same function. This can be seen in the hip joint when the posterior gluteus medius muscle is weaker than the tensor fascia lata muscle.
Gluteus Maximus and Hip Flexors
The gluteus maximus muscle is designed to extend and rotate the hip, which allows the leg to move backward and away from the body. The hip flexors, comprised of the iliacus and psoas major muscles, are involved in hip flexion, which occurs when you bring your thigh toward your upper body. The hip flexors are also essential in helping rotate the hips when individuals change directions. When you spend too much time sitting, your gluteus maximus muscle weakens, which forces your hip flexors to carry out both their assigned function and the function of the gluteus maximus. This causes the hip flexor muscles to become tight and places abnormal stress on the vertebrae in the lumbar spine, resulting in low-back pain. To counter this form of muscle imbalance, focus on strengthening the gluteus maximus by performing targeted exercises, such as front squats using dumbbells and forward lunges, and stretch the hip flexors.
Posterior Gluteus Medius and Tensor Fascia Lata
The posterior gluteus medius and tensor fascia lata muscles are both involved in hip abduction, which occurs when you move your leg to the side. When your posterior gluteus medius muscle weakens through lack of exercise or becomes injured, you are forced to rely heavily on the tensor fascia lata muscle to perform hip abduction movements, which causes it to shorten and tighten. This type of muscle imbalance is often mistaken for sciatica because it causes pain in the lower back and buttocks that often radiates down one leg. Pregnancy, weight gain, sitting for prolonged periods of time and poor posture all contribute to this type of muscle imbalance, which can be remedied by strengthening the gluteus medius through exercises, including forward and side lunges.
Back Pain Considerations
Even if you suspect your back pain is caused by a muscular imbalance, you should see your physician to rule out other conditions, including bulging discs, sciatica and spinal degeneration, which may require different treatments depending on the diagnosis. While back pain is rarely an indication of serious illness, you should seek immediate medical attention if low-back pain is accompanied by fever, incontinence and leg weakness, as these symptoms are all indicative of cauda equina syndrome, which can cause permanent neurological damage if left untreated. To prevent back pain, engage in regular cardiovascular exercise to maintain your weight -- walking, using an elliptical machine and water aerobics are all good choices if you already have back pain -- and try to avoid sitting in one position for long periods of time.
- BBC Science: Muscles – Work in Pairs
- All-Access Fitness Academy: Glute Strengthening and its Importance in Hip and Back Health
- The Iowa Orthopaedic Journal: Rationale for Treatment of Hip Abductor Pain Syndrome
- Moore Mind, Muscle, Movement: Are Your Hip Flexors a Pain in the Butt?
- National Institute of Neurological Disorders and Stroke: Low Back Pain Fact Sheet
- New York Times: Exercising That Back Pain Away
- Comstock/Comstock/Getty Images