All posts by Cecily Schmidt

Nothing here should be construed as medical advice, but only topics for further discussion with your doctor or physiotherapist. Cecily Schmidt is a physiotherapist who received her Bachelor of Science in Physiotherapy from the University of Cape Town in 1998, just more than 18 years ago. She spent 8 years working and specialising in musculoskeletal injuries in the UK and Australia before returning to South Africa to continue working and specialising in work place health and wellness. She received a research Masters in musculoskeletal injuries and ergonomics from the University of Cape Town in 2015.

Are you an office worker suffering with neck pain? If so, you’re not alone. Office workers are one of the population groups most at risk of developing neck pain, with an incidence of around 55% in some countries.

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If you are an unfortunate office worker suffering from neck pain, is there something that you can do yourself to reduce or prevent your neck pain rather than popping pills or going to see your OMT trained Physiotherapist?

The answer is, yes, of course there is!

The first and simplest things that you need to consider is where your monitor is positioned in relation to yourself on your desk (check our our desktop software designed to help you correct your computer ergonomics). A poor monitor position is one of the most common reasons why office workers suffer from neck pain associated with poor posture. It’s happily also one of the easiest things for to change to help improve poor posture that could be causing your neck pain.

Consider the following 4 monitor position scenarios. Do you see yourself in any of them? All of these poor monitor positions are high risk postures for creating neck pain.

In this scenario, your monitor (laptop or desktop computer screen) is positioned too low on your desk causing you to bend your neck for too long, straining your neck and resulting in neck pain. This is quite common, especially for people working on a laptop or tablet. Mobile computer devices are handy to have, but they all need assistive ergonomic devices to help you work in a safe posture. Read this post on correcting a low monitor position to help you correct this problem.

"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

2. In this second scenario, your screen is positioned too high for you, causing you to raise your chin and compress the joints in the back of your neck causing you both neck pain and headaches. This monitor position will cause neck pain faster than any of the others and is one of the worst postures possible for a computer worker. This posture is common in people who are aware that a computer monitor often needs to be elevated, but are unaware of their own posture and what the correct position for one’s head and neck needs to be to prevent or reduce neck pain. Correct your position asap

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Poor monitor position, poor ergonomics, neck pain, monitor positioned too high — “Starcraft II: Triple Monitors” by Kyle James under Licence CC BY 2.0

3. Here, your screen is positioned too far away from you, causing you to lean forwards away from your backrest and poke your chin out. This posture will cause both headaches and neck pain. Read this post on correcting a monitor positioned too far away to help you correct this problem and reduce your neck pain.

Poking chin posture — “Man uses laptop” by Bill Branson under Public Domain

4. In this last scenario, you are working a lot from notes/papers/files and don’t use a document holder. This means that you are looking down too often during the day and this constant bending of your neck puts you at a very high risk of developing neck pain.

Alternatively, you’re working a lot from notes and have positioned them on your desk between your keyboard and monitor causing you to push your monitor too far away and take a poking chin posture.

Both of these postures will create neck pain and possibly headaches.

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Monitor Positioned too far — Image by US Navy under Public Domain

I will write about how to correct these postures and position your monitor correctly in the near future, make sure you come back to find out how you can help yourself reduce your neck pain.

Uncategorised

Why Your Abs (‘6 Pack’) are Important? Part 1

7th February 2016 Cecily Schmidt Leave a comment

I’m intrigued by the ‘6 Pack’. Not the one that sits in the fridge, but rather the one that joins your rib cage to your pelvis.

From my experience, I have the impression that people focus on their ‘6 Pack’ quite a lot in the gym. As a physio, I have some reservations regarding how much people focus on their rectus abdominus (abs) as well as some of the exercises people engage in to work this muscle, since some of these exercises can actually be detrimental to spinal health (read my post on sit ups and lower back pain).

However, the 6 pack is a part of our body and it is important. The point is, how important? What does do your abs do for you? What happens if you over work your abs, or if your abs are weak or damaged? In my blog I’m going to explore this muscle in more detail in future posts.

6 Pack, Abs, Rectus Abdominus — Image by Pixabay under Public Domain

Our starting point needs to be where your abs (‘6 Pack’/ Rectus Abdominus) are found in your body and what their basic function is.

Let’s start with where your abs are found. If you look at the illustration below, you will see that the ‘6 Pack’ extends from the rib cage to the pelvis and is found in the front of the body, in the area commonly known as the ‘trunk’.

Rectus Abdominus, 6 Pack, Abs, Abdominal Anatomy — “Abdominal Wall” by Henry Gray (1918) Anatomy of the Human Body under Public Domain

What are the basic functions of your abs (‘6 Pack’) ? What does it do for us?

1. Your abs/ ‘6 Pack’ help to form the front boundary of your trunk, keeping your abdominal contents from falling out. Quite an important job I would suggest – nobody wants stomach contents gurgling around their waist as they walk.

2. In addition, when you contract your abs/ ‘6 Pack’, the force of this muscle increases the internal pressure in your abdominal cavity (the area below your diaphragm and lungs and above your pelvis). You use this increased pressure when you cough, laugh, empty your bladder and bowels, vomit (nice) and forcefully exhale. All in all, important activities at specific times in our daily lives .

3. We also use our abs/ ‘6 Pack’ to help us sit up from a reclined position, especially when our hands are not available to help us push up. Mothers are very familiar with this particular function, especially when they’re getting up after lying down with a sleeping baby in their arms.

4. Contracting your abs/ ‘6 pack’ also helps you to perform impressive gymnastic maneuvers such as the headstand ‘pike’ in this video.

Pike Headstand by Carl Paoli. Used with written permission. http://www.nakaathletics.com/

5. Furthermore, on a superficial level, your abs are often used as a tool when looking for a mate. Nothing shouts fit and healthy quite like lean, muscular abs. Don’t believe me? Take a walk along the beach, watch people in the gym, or watch the latest Calvin Klein ad. That should assuage any doubt.

6. Lastly, your abs/ ‘6 Pack’ is involved in your core muscle activation and its affect on producing/reducing lower back pain. Since 80% of us humans are going to suffer from lower back pain in our lives, it might be worthwhile to understand how our stomach strength and exercises are helping or hindering us in this matter. I will look at this more in a future post. Want to read more? Read my post on Why Your Abs are Important Part 2.

Lower Back Pain, The Spine

How to Strengthen Your Abs When You Have Lower Back Pain

4th February 2016 Cecily Schmidt Leave a comment

One of the worst things about lower back pain is that it stops you doing a lot of your normal activities, sports or exercises. From experience, I’ve watched lower back pain reduce some very active people into couch potatoes due to their lower back pain preventing them from following their normal sporting routines. These individuals often struggle to find other ways to keep fit until their lower back pain settles.

A definite exercise no-no for lower back pain is sit ups (read my post on sit ups and lower back pain), or some form of them. Since core exercises are an integral part of any training program, many people must ask how they can exercise their abdominal muscles while they’re suffering from lower back pain and until their lower back pain settles?

Enter: The Plank.

The plank is one of my favourite exercises. It’s easy to perform at home and it will give you a good overall work out. The plank is a lot harder than it looks.

In addition to working your abs, the plank is also a very good exercise for protecting your shoulders against rotator cuff injuries. It accomplishes this by working your shoulder stabilisers while simultaneously working your abs. The plank has another added benefit of strengthening your spinal extensor muscles at the same time as well. It’s an excellent overall core strengthening exercise and should routinely be a part of any training programme.

The Plank exercise, spinal strengthening exercise, abdominal strengthening exercise — Image by Chief Warrant Officer Donnie Brzuska) under Public Domain

When Performing the plank, there are a few things to keep in mind:

Position your feet hip width apart and keep your knees straight and off the floor.
Keep your arms beneath your shoulders and your forearms parallel to each other if you want to work your shoulder stabilisers as well. Ensure that your upper trapezius muscles stay relaxed (in other words, make sure that your shoulders stay away from the ears during your exercise).
Most importantly, keep your spine straight. That means that you mustn’t collapse in the lower back. Your lower back shouldn’t hang like a hammock. In order to keep your lower back straight, you will need to work your core muscles very hard. In order to accomplish this, you will need to contract your stomach muscles in the area just below your belly button. When they contract, they support your spine and prevent too much sagging from occurring in the lower back.
The last part of creating a good plank posture is to ensure that you keep your neck in line with your body. In order make sure that you’re doing this, don’t look up or down and keep your chin in the neutral position.
Now, hold this position for as long as possible, but at a count that you can repeat at least 5 times. A good first goal is to try start holding the plank for 15 seconds. Slowly increase your count over time as you get stronger.
Lastly, it’s important to remember to breathe. Make sure you breathe in and out while you hold the plank. It will make it a bit harder but you will be stronger in the long run.

Reference:

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

Lower Back Pain, Neck Pain, The Spine

How Overdoing Situps Can Cause Lower Back Pain

3rd February 2016 Cecily Schmidt 1 Comment

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

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.

Reference:

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

Lower Back Pain

How Does Lower Back Pain Work? Part I

29th January 2016 Cecily Schmidt Leave a comment

Lower back pain is so common that 8 out of 10 us will experience it at some point in our lives. Any person who has experienced lower back pain can testify to how debilitating lower back pain is and how much it can negatively impact on your daily life, making common gestures like picking up a tissue off the floor, nearly impossible (read my post on how to strengthen your abs when you have lower back pain). Not only that, suffering from lower back pain is likely to make driving extremely difficult, if not even more painful (click here to read more about driving posture to reduce lower back pain). Sitting for long periods at the office or even trying to continue with your normal sport or recreational activities are also negatively impacted when lower back pain comes to call. All in all, one of the least desirable ailments (read my post on how picking up your children badly can cause lower back pain).

How then does lower back pain work? Understanding something is the first step in learning to deal with it better and hopefully to help find a way to reduce it’s impact in our lives.

Broadly speaking, your lower back pain will either be mechanical in nature or inflammatory (read about inflammatory lower back pain), or a combination of these.

When your lower back pain is mechanical in nature, this means that it relates to your biomechanics and to your musculoskeletal function. In other words, it’s how your bones, joints, muscles, nerves, blood vessels and discs are affected by your movements, postures and your rest, to either cause you lower back pain or relieve your lower back pain.

As some of you would know, often when you have lower back pain, some postures and movements are hell and others keep you sane and able to function.

It’s important to take note when this is the case. Some people suffering from lower back pain tend to take no notice of what aggravates or eases their lower back pain and they are missing out on very important information in helping to understand and treat their problem correctly and swiftly.

When your lower back pain is due to a mechanical cause, any movement such as sitting/rising/walking/bending/arching backwards/straightening your knee etc. will either increase, decrease or maintain the intensity of your lower back pain. This is because the mechanical forces created by these movements will have increased, decreased or remained constant on parts of your body tissues such as your spinal discs, facet joints, muscles or nerves.

In addition, you need to understand that different structures in the body are affected by different movements and postures and the forces that they apply. They are also affected by the type of damage that has occurred and how this causes the affected body tissue to respond to different mechanical forces.

Spinal discs for example are generally aggravated by bending and twisting and can be eased by arching backwards (in certain circumstances, in other circumstances the opposite is true – hence it’s important to see your OMT specialised Physio for assistance since they are especially trained to know these differences and much much more). On the other hand, generally speaking, your facet joints are aggravated by arching backwards but eased by bending and twisting. Thus, it’s really important to take note of which movements ease, aggravate or maintain your lower back pain. This information will help your OMT Physio get to the root of your problem faster.

Next time I will discuss chemical causes of lower back pain. Any comments? Please feel free to post them, I would love to hear from you.

Lower Back Pain

How Does Lower Back Pain Work? Part II

29th January 2016 Cecily Schmidt Leave a comment

We’ve said it before, but it bears repeating. Lower back pain is very very common. People who are at risk are office workers and drivers (in other words people who sit for long periods of time) as well as people such as nurses, manual workers in a factory/farm/warehouse setting (since they perform a lot of lifting and bending). In other words, most of us are at risk of developing lower back pain because of sitting for too long in a bad posture or because of lifting and bending poorly day in and day out in our jobs. That is why at least 80% of the world’s population will suffer from lower back pain at some point in their life.

To broadly understand your lower back pain, you need to think of it as mechanical in nature (read my post on mechanical lower back pain), or inflammatory, or a combination of these.

When your lower back pain is mainly as a result of chemicals in your body, this means that hormones and chemicals are circulating in the area of your pain, triggering a pain response from the brain. This can be due to trauma, arthritis, infections, physical pressure on a nerve or other tissue, or chronic pain syndrome (a very complex disorder involving the nervous and chemical systems of the body). Physically increasing the blood’s circulation through movement often aggravates lower back pain of an inflammatory nature. Too much rest (swelling and pressure build up when you rest too much if there is inflammation present) will also aggravate lower back pain in these circumstances.

Sometimes, lower back pain as a result of a mechanical problem can also result in an inflammatory response in the spine. When this occurs, this can really slow down your response to treatment, since the inflammation will need to settle, which normally takes anything between 3-7 days. If you keep aggravating your lower back pain (which many people do), you are liable to keep your inflammatory process active and delay healing further.

At other times, lower back pain of an inflammatory nature can leave scar tissue behind as a result of the inflammation, which in turn can cause mechanical problems for some body tissues such as a nerve impingement that again can result in lower back pain.

Another factor to bear in mind is that when your lower back pain is due to inflammation, anything than causes a change in your circulation will aggravate your lower back pain. This generally means that too much movement can increase your lower back pain because increased movement results in an increase in your circulation, which in turn increases the amount of chemicals causing your lower back pain to be present in the area of your injury. Too much rest also will cause an increase in your lower back pain, since when your circulation slows down, fluid moves out of your blood vessels and into the tissue surrounding it. This causes a pressure build up in your injured tissue which in turn increases your lower back pain. The key when you have lower back pain of an inflammatory nature is to do small amounts of movement often. Not too much movement and not too little. If you listen to your body, it will guide you to get the balance right.

Understanding what type of back problem you have is important to treat it properly. Make sure you have the correct person with enough expertise and medical knowledge to help you. OMT specialised physiotherapists are among the best people to help you resolve your back pain.

Do you have any questions or comments? Please take the time to post it, I would love to hear from you.

Ergonomics, Monitor Ergonomics, Neck Pain, The Spine, Work Place Injuries

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

27th January 2016 Cecily Schmidt Leave a comment

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.

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

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.

Reference:

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.

Musculoskeletal Injuries

How Strong Quadriceps Muscles Help with Anterior Knee

21st January 2016 Cecily Schmidt Leave a comment

Anterior knee pain is a very common cause of knee pain in people across all ages. Some people may also know it as patello-femoral syndrome.

"Image illustrating the areas affected by w:en:Patellofemoral pain syndrome" by BodyParts3D/Anatomography under Licence CC BY 2.1 — “Image illustrating the areas affected by w:en:Patellofemoral pain syndrome” by BodyParts3D/Anatomography under Licence CC BY 2.1

Anterior knee pain (or patello-femoral syndrome) is pain that is found in the front of the knee.

Anterior knee pain will commonly get worse when you use stairs. Going downstairs is generally more painful than going upstairs, or going downhill is also generally more painful than going uphill. This is because going downstairs or going downhill places a greater demand on your quadriceps muscles than going uphill or upstairs. Anterior knee pain is also aggravated by any activity, movement or exercise that places strain on your quadriceps muscle and knee cap. Why is this?

Firstly, you need to understand the parts of the body involved when you get anterior knee pain (or patello-femoral syndrome). If you look at the illustration below, you will see that the knee cap is positioned above the thighbone (femur) and that there is a muscle that is attached to the knee cap via a tendon, that is called the quadriceps muscle. The quadriceps muscle is actually made up of 4 muscle bellies (recently a 5th muscle belly has been discovered).

"Knee Anatomy"Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. with written author permission for use. — “Knee Anatomy”Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. with written author permission for use.

The action of your quadriceps muscle is to straighten the knee when the quadriceps muscle contracts. Because the knee cap is attached to the quadriceps muscle, when you straighten and bend your knee, your knee cap moves up and down along the thigh bone in a groove. This action is controlled by the quadriceps muscle. In fact, your knee cap is there to shorten the lever of your quadriceps muscle and thus improve the contractile strength of your quadriceps muscle when it acts. Thus they work together like hand and glove.

If you have weak quadriceps muscles, however, the knee cap is no longer well controlled in its movement up and down the groove in the thigh bone. What happens is that when your quadriceps muscle contracts in this instance, your knee cap is pushed against the thigh bone and grinds the underside of your knee cap against your thigh bone, causing inflammation and your anterior knee pain/ patello-femoral syndrome.

What causes your quadriceps muscles to weaken and cause your knee cap to grind against your thigh bone creating anterior knee pain? There are various scenarios. A very common one occurs in children and teenagers, where a growth spurt has occurred and the bone is longer, but the quadriceps muscle and tendon haven’t caught up, causing a biomechanical imbalance resulting in anterior knee pain/patello-femoral syndrome. Another scenario is when an injury to the knee has occurred that results in pain and swelling. Any pain or swelling in the knee causes inhibition of your quadriceps muscle, which left untreated, can result in the development of secondary anterior knee pain/patello-femoral syndrome. If you have had a knee injury, make certain that you have been to see your sports or OMT physiotherapist. They are specially trained to help you resolve this problem quickly.

One of the factors that your sports or OMT physiotherapist will attend to is how to avoid anterior knee pain if you’ve had a growth spurt or knee injury or how to undo anterior knee pain caused by weak quadriceps muscles.

Since your weak quadriceps muscles are key to the problem of your anterior knee pain, knowing how to strengthen your quadriceps muscles in a pain free way, until the muscle is strong enough to pull your knee cap away from your thighbone while your knee bends and straightens during your activities, is pivotal in resolving the problem (read my post on strengthening your quadriceps muscles when you have anterior knee pain) and go see your sports or OMT physiotherapist for some treatment.

Lower Back Pain, The Spine

How to Stretch Your Hamstrings Despite Suffering with Lower Back Pain

20th January 2016 Cecily Schmidt Leave a comment

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 (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.

Lower Back Pain, The Spine

How Do Tight Hamstrings Aggravate Lower Back Pain?

18th January 2016 Cecily Schmidt 2 Comments

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.

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

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.

CS Body Health

All posts by Cecily Schmidt

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How to Strengthen Your Abs When You Have Lower Back Pain

How Overdoing Situps Can Cause Lower Back Pain

How Does Lower Back Pain Work? Part I

How Does Lower Back Pain Work? Part II

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

How Strong Quadriceps Muscles Help with Anterior Knee

How to Stretch Your Hamstrings Despite Suffering with Lower Back Pain

How Do Tight Hamstrings Aggravate Lower Back Pain?

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