Category Archives: The Spine

How Overdoing Situps Can Cause Lower Back Pain

A ‘6-pack’ – the ultimate fit and healthy look!  One of the most common ways to go about getting your awesome abs is to perform loads of sit ups.  This must be one of the most common exercises performed in the gym, and judging by the photo below, in the armed forces as well (read my post on why your abs are important Part 1).

Image by the United States Navy and under Public Domain
Image by the United States Navy and under Public Domain

Most people are very careful about how they perform their sit ups to avoid straining their neck.  If your abdominal muscles are weak, it’s not uncommon to assist your sit up by using your momentum, which then leads you to pull on your neck which may end up with you experiencing some neck stiffness or even neck pain.  However, neck pain is not the only possible side effect from too many sit ups.  Have sit up enthusiasts considered that too many sit ups may also be placing them at risk of developing lower back pain?

How’s that you ask? Lower back pain?  Well, it’s like this:  Your body is a complex setup of biomechanical levers.  One of the most important levers is your spine.  Sit ups work the front part of your spine, pulling it forwards.  Counteracting this movement are the spinal extensor muscles.  Are you working them as well?  Are the forces acting on your spine balanced? (Read my post on how lower back pain works Part 1)

spinal lever
Image by CS Body Health cc. All Rights Reserved. 2016.










Do you know where your spinal extensor muscles are?  If you refer to the image below, you can see how long these muscles are and how far they extend along the length of the spine.  Are you performing any spinal extensor muscle exercises in the gym?  Do you know how?

"Longissimus muscle" modified by Uwe Gille under Public Domain
“Longissimus muscle” modified by Uwe Gille under Public Domain

If the muscles acting around your spine are unbalanced and your abs/ ‘6 pack’ is over worked in relation to the spinal extensor muscles, this may cause a constant slumping/slouching affect on your spine.  Too much bending of your spine will cause an increase in the compressive and shearing forces through your spine and especially on your spinal discs.  This may lead to premature wear and tear on these spinal discs (spinal cushions), which are in and of themselves weak in resisting bending and turning forces of the spine, too much of which may lead to lower back pain.  Some research puts the incidence of lower back pain due to injuries of the spinal disc at 65% of all incidence of lower back pain.

Furthermore, performing sit ups as a strengthening exercise for the abs/’6 Pack’ shows a lack of understanding for the real function of the rectus abdominus (click here to read more).  Sit ups are therefore not really functional and are also a high risk exercise for developing lower back pain.   What then would be a better exercise to strengthen your abs/ ‘6 Pack’/ Rectus abdominus functionally?  And would there be a way to simultaneously exercise the spinal extensor muscles and ensure balance of your spinal lever?  The answer is a resounding yes.  Read my post on using the plank as an exercise for more information.

Feel free to leave a question or comment.  I would love to hear from you.



McGill S. (2010).  Core Training: Evidence Translating to Better Performance and Injury Prevention.  Strength and Conditioning Journal, 32 (3), 33-46.

How the Position of Your Computer Screen/ Tablet Can Cause Neck Pain

You’re stuck at your desk behind your computer, hour after hour, day after day looking at that darn screen!  “This can’t be good for my health”, you think.  Actually, you are right.  It’s not.

Besides the glare and fatigue, and let’s not mention the stress (all of which add up and contribute to your frequent aches and pains) (read my post on stress and neck pain), there is something else, something mechanical which WILL end up in neck pain.  Simply bending your neck for too long (read my post on 4 computer monitor positions that cause neck pain).

Bending your neck is so common and so ordinary and most of us do it for far too long during the day, which is why at least a 30 -50% of us will experience neck pain.

Why do we bend our necks for too long increasing our risk of developing neck pain? The most common reason that we bend our necks for long periods of time during work hours is because our computer screen is positioned too low on our desk.  Alternatively, if we’reworking with a tablet (or smart phone) in our hand for far too long, these devices with their small screens and integrated keyboards cause us to work in a hunched over position with our heads hanging down.  Prime posture for developing neck pain (read my post on how to correct a low monitor position causing neck pain).

Another reason is because we are working with papers on our desk as well as trying to type on our keyboards, or because we can’t touch type (read my post on touch typing and neck pain).  All these things cause us to bend our necks for too long.

"Catching Up On Email..." by Ed Yourdon under Licence CC BY 2.0
“Catching Up On Email…” by Ed Yourdon under Licence CC BY 2.0

Researchers have discovered that bending your neck for more than 70% of your working day will double your chances of developing neck pain.

So, what position should your neck be in when you work? What posture will help prevent you from suffering from neck pain? Remember that spinal s-curve? (read my post on spinal posture and back pain)

Vertebral Column by Unknown and is licenced in the Public Domain

Vertebral Column by Unknown and is licenced in the Public Domain

Well, that spinal s-curve needs to be maintained when you’re looking at your screen/laptop/tablet/smart phone for extended periods of time.  It also needs to be maintained when you’re typing or working on papers!  (check out our store for assistive devices to help place your monitor/tablet in the correct position).

"IMG_3771" by Joe Loong under Licence CC BY 2.0
“IMG_3771” by Joe Loong under Licence CC BY 2.0

In order to maintain your spinal s-curve and the curve of your neck, you need to raise the screen of your monitor/laptop/tablet to eye level using books, monitor raises, adjustable monitor arms, or a proper laptop raise/ tablet docking station (I’ll discuss this further in another post) to achieve this.  If you’re lucky, some desktop monitors are adaptable, allowing you to elevate them without aids.  Ensure that when they are on their highest setting and that your monitor is in fact at eye level, otherwise you still need some books etc to get it to the correct height.

Need more help with computer ergonomics?  Check out our ergonomic desk exercise software.

All in all, make sure that your neck is in a good position while you work if you’re suffering from neck pain or want to avoid suffering from neck pain.



Ariens G.A.M., B. P. (2001). Are neck flexionk, neck rotation, and sitting at work a risk for neck pain? Results of a prospective cohort study. Occupational and Environmental Medicine, 200-207.

Cagnie B., D. L. (2007, May). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine, 16(5), 679-686.

Guzman J., H. E.-J. (2008). A new conceptual model of neck pain linking onset, course and care: The bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine, 33(4S), S14-S23.

Guzman J., H. S.-J. (2009, February). Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics, 32(2S), S227-S243.

How to Stretch Your Hamstrings Despite Suffering with Lower Back Pain

So, you have lower back pain and are wondering if  your tight hamstrings are an aggravating factor in your lower back pain (read my post on tight hamstrings and lower back pain).  How do you know if your hamstrings are in fact tight?

There are different postures that you can use to test your hamstring length.  One way is to test your hamstring length in standing.  Bend forwards and try and tough your toes.  How far down can you go while you keep your feet together and your knees straight?

Alternatively, you can test your hamstring length in a position we call long sitting.  Again, reach down towards your ankles/feet and see how far down you can reach while you keep your legs together and your knees straight?  It’s important that when you do thee tests, that you do not stretch into pain.  If you are at all concerned about your posture/hamstring length/lower back pain, go see your OMT trained physiotherapist.  They are especially equipped to help you.

touching toes
“Touch Your Toes” by Ben Sutherland under Licence CC BY 2.0

Now that you’ve tested your hamstring length, your next question should be: What is normal hamstring length? Well, actually, that is quite debatable.  What is normal for some people can be very different for others.  For example, some people can easily reach their ankles, whereas others can’t get below mid shin level or even their knees.  So, how do you know if you have tight hamstrings and whether they are contributing to your lower back pain?

Your hamstrings are too tight, when your lower back curve is flattened when you perform your regular activities such as sitting at your desk, driving your car (read my post on driving posture and lower back pain), playing your sport and generally carrying on with your daily life.

The next consideration you need to make is how do you stretch your hamstrings effectively, especially if you have lower back pain?  I am personally not a great fan of passive stretches.  Often people take the stretch too far and hurt the muscle, actually causing more muscle spasm and shortening.  This is counterproductive.

Another consideration when stretching your hamstring is the sciatic nerve.  This nerve runs through the hamstring muscle, and if your sciatic nerve is sensitised or tight for whatever reason, your hamstring muscle will stay tight no matter what you do, in order to protect the nerve.

I also believe that your stretch should be functional, and this is especially important when you are suffering from lower back pain.  Standing places far less loading on the spine than sitting or long sitting (as in the stretch above).  In addition, long sitting is often an aggravating posture for lower back pain for a variety of reasons, hence a posture to avoid.  To assist in a better hamstring stretch, add gentle resistance while stretching, producing an active stretch so to speak.


Active Hamstring Stretch
Active Hamstring Stretch (Taken from our Pain Management Software for Computer Users) Copyright 2015 CS Body Health cc. All Rights Reserved.


Lastly, it’s always prudent to seek professional help when you are suffering from pain.  Your OMT specialised physiotherapist are highly specialised and equipped to quickly and safely help you when you have tight hamstrings, particularly in the presence of lower back pain.  They will help to uncover the real reason that your hamstrings are tight, and assist you in resolving the problem.


How Do Tight Hamstrings Aggravate Lower Back Pain?

Lower back pain is a very common ailment affecting far too many of us.  In fact, the World Health Organisation puts the incidence of lower back pain at 80%.

Lower back pain has many causes for its occurrence.  These causes include disease processes (like rheumatoid arthritis ), infections (sometimes TB can cause lower back pain), injuries (like a fall down the stairs or a car accident), genetic predispositions (like spondylolysis) and then you get mechanical factors (like poor lifting technique and poor exercise habits amongst a whole host of others).

One common mechanical aggravating factor for lower back pain is when a person suffers from tight hamstrings.  To understand more about how your tight hamstrings will contribute to your lower back pain, we need to first understand more about the hamstrings.

Let’s start with where the hamstrings are found in our body.  Where do the hamstrings start and end in the body?  The hamstrings attach to the bottom of your pelvis and end just below your knee.  Because the hamstrings attach to the pelvis and to the tibia (the shin bone), when the hamstring contracts, it will affect both the hip joint and the knee joint.  We call it a 2 joint muscle.  2 joint muscles typically are important in controlling movement in the body.

“Animation of the relaxation and contraction of the hamstrings group of muscles when the leg flexes” by Niwadare under licence CC BY 4.0

Thus, the hamstring muscle is responsible for helping to pull the hip backwards and to bend the knee, and we use these hip and knee movements throughout the day, for example when we walk.  The hamstring also helps to control and stabilise the knee during sport, although this has little to do with your lower back pain and more to do with knee function.  I will discuss this more in a future post.

We now know how the hamstring muscle moves the body when it contracts, but how does your hamstring move the body when it is stretched? What happens when your hamstrings are tight?

Because the hamstring attaches to the bottom of the pelvis, when the hamstring is stretched, or your hamstring is tight, it will result in your pelvis being rotated backwards which has the knock on affect of flattening the important lumbar curve in your lower back (Read more about the important curves in your spine here).  This lumbar curve helps prevent and control lower back pain.

Vertebral Column by Unknown and is licenced in the Public Domain
Vertebral Column by Unknown and is licenced in the Public Domain

Hamstrings that are on stretch and when they are tight, will negatively affect your lower back and predispose you towards lower back pain, particularly when you are in a sitting posture, for example when you are driving (read my post on driving posture and lower back pain) or during any activity that places your hamstring on stretch (for example during sport like running, kicking etc).

How does one end up with tight hamstrings?  Some people are born with them, it’s a genetic predisposition.  Other people have tight hamstrings because of an injury to their muscle and the subsequent scarring that results due to the injury in the hamstring muscle.   Other people have tight hamstrings as a result of pain in their sciatic nerve (which causes the muscle to go into spasm around the nerve to protect the sciatic nerve from being stretched and further irritated).  Tight hamstrings can even be as a result of a mild form of spinae bifidae (a birth defect).  However, a lot of people have tight hamstrings because when they use their hamstrings a lot during their daily life (such as in hiking, cycling, exercises in the gym or even lifting at home/work), they fail to adequately stretch them after their activity, slowly causing their hamstrings to tighten.  And tight hamstrings, thus predispose you to develop lower back pain.

Read my post on how to stretch tight hamstrings if you have lower back pain.

Why the Spinal S-Curve is Important in Back Pain

Lower back pain is extremely common.  It is so common that 8 out of 10 people will experience it at some point in their lives.

Lower back pain can be caused by many factors.  These include factors such as genetics or birth defects (spondylolysis), trauma (falls or car accidents), infections (bacterial infections or even TB of the spine), and poor posture and movement patterns.  Sometimes a combination of causes is to blame for our lower back pain.  Out of all the factors I’ve listed, the one that we have the most control over on a day to day basis, is our posture and our movement patterns.

Back Pain
Personal Injury Back Pain by SanDiego’s PersonalInjury Attorney’s Photostream is licenced under CC by 2.0

The most at risk postures for developing lower back pain are sitting and bending postures.   These two postures when performed badly put our spines at a high risk of developing lower back pain, and people who do a lot of sitting and people who perform a lot bending are often the people who complain of lower back pain.  Think of office workers, drivers, nurses, machine operators, fatory workers, manual workers and more.  These people and others who engage in a lot of sitting and/or bending on a day to day basis are the people who are at risk and who do develop lower back pain.  Does that sound like most of us?  Exactly, hence the high incidence of lower back pain!

Read my post on driving postures and lower back pain.

One of the most important elements of our posture in helping to prevent lower back pain, is the s-curve of our spine and maintaining the s-curve of our spine in different postures and movement patterns.

Read my post on correct lifting posture for picking up children.

The spinal s-curve consists of 3 different curves.  There’s a curve that goes in at the neck (the cervical lordosis), followed by the curve that goes out in the upper back (the thoracic kyphosis) and the curve that goes in again at the lower spine (the lumbar lordosis).  The depths of these curves may vary in different people, but we all have the 3 curves illustrated below and they are very important for our biomechanics and general spinal health.

spinal s-curve
Vertebral Column by Unknown and is licenced in the Public Domain

The importance of these curves in helping to prevent lower back pain, is that these spinal curves throw our centre of gravity between our feet.  With our centre of gravity lying between our feet, the compressive and shearing forces on our spine which may lead to lower back pain are reduced.  Keeping these shearing and compressive forces as low as possible acting on our spine helps to keep the forces acting on our backs within limits that our body tissues can naturally withstand, which then helps to reduce or prevent lower back pain.

centre of gravity
Center of pressure in relation to centers of gravity while walking by Jasper.o.chang under licence CC BY-SA 3.0

When we change these curves through engaging in poor posture while sitting, standing, lifting, driving, picking up children etc., we increase the forces on our spine unnecessarily causing many problems with the complex spinal biomechanics and anatomy that result in injury and lower back pain.


How often do you lose your spinal curve in your activities during your day?  Do you suffer from back pain?  Is your poor posture partly to blame?