Back Hurts? Don't forget about the front


When we think about our spine we often overlook the fact that the bodies of the vertebrae - the thick circular parts that actually provide support - are in the middle of our trunk instead of just on the back side. Picture a cylinder with a solid tube running down the middle, and thats the general 3D layout of the bones that make up the vertebral column. 

If you think about it that way, it should be no surprise that there are many muscles that attach to the front of the spine as well as the back (and the sides!). Two of these muscles that become overly tight while sitting are the TFL (Tensor Fascia Lata) and Iliacus.

Both of these muscles leverage the pelvis into an anterior tilt when we stand - they rotate the pelvis forward. This pulls the spine out of efficient alignment and into extension, which forces our abdominal and gluteal muscles out of optimal position, thus decreasing stability. The good news is they aren't too hard to loosen up, you just have to know how. 

To perform these techniques, use a tennis ball if overly sensitive, or a lacrosse ball if you can handle more pressure. Try not to cause pain over a 5/10, which may cause you to tense up, which is counter-productive for this self release. To get to the TFL, lay on your side and place the ball right where your front pocket starts. 

Roll on top of it until you feel a tender spot, and stay there. You should use the arm closer to the ground as a pillow, because you may be here for a while. Try to relax and picture the muscle molding over the ball - NOT the ball digging into your muscle. If it is too painful, rotate backward off of the ball slightly to take off some of the pressure. Maintain this position until the tenderness/pain goes away. For some of us this may take over 5 min, but if you keep trying to relax it will let up. Be patient!

The Iliacus is located on the inside surface of your pelvic bone, so you will need the edge of a massage roller to access it. Anything with a blunt handle will work fine if you don't have a roller. Hold the roller in the opposite hand to apply pressure in a direction across the body, and find the trigger point in this muscle. Again, there is no need to massage or move the point of pressure, just try to relax and breathe until the tenderness starts to dissipate.

It's good to follow these techniques with some glute activation such as glute bridge or standing hip hinging. Both of those exercises will begin to rewire your brain to use those stabilizing muscles in the new position you created by releasing the tension in the front of the spine. If you don't know how to perform those exercises, it may be a good idea to make an appointment with a physical therapist or movement professional!

The tips in this article are for general information purposes only, and are not intended to diagnose, treat, or prescribe therapy for any specific problem. While they will help to temporarily reduce pain, it's always in your best interest to have a movement expert or physical therapist to guide you through a full recovery protocol. 

Pure PT is located in Coral Gables at Old Bull Athletics. We are dedicated to returning active members of the community to the sports and activities they enjoy most.