free templates joomla
 
 

The development of sports injuries are usually the result of direct trauma or an isolated event, repetitive strain (overuse) or it can be linked to movement dysfunction. It is well documented that tissues can become pathological due to ageing, trauma or overuse. Therapists are no longer just treating the pathological structure which induces the pain, but contributing factors, like movement faults are also identified. If movement faults are corrected, the painful tissues which are constantly being stressed, will be unloaded.
     
 
Anna is a recreational runner. She runs approximately 25 km per week. After running 5 km, her low back starts aching. She can continue running through the pain. When she stops running, the pain goes away. She also experiences the same low back pain after sitting for prolonged periods at her desk. She struggles to stand upright immediately after getting up from her desk. She also goes to gym three times per week. She does not stretch often after training. She enjoys doing squats, lunges and leg press exercises. She also does abdominal crunches.
 

 
On examination Anna has an excessive extension (arch) in her low back. She presents with an anterior tilt in her pelvis as well. Her hip flexors and quadriceps muscles are tight and slightly shortened. Her gluteus (bum) muscles are weak as well as her deep abdominal muscles. Her erector spinae muscles (back muscles) are shortened and in spasm as a result of the excessive extension in the lumber spine. Anna demonstrated her sitting position at her desk: she sits on the edge of the chair with her low back in extension.
 
Anna places excessive strain on her lumbar spine as a result of her habitual sitting posture. The muscles in the front of her pelvis (hip flexors and quadriceps) have shortened and are pulling her lumbar spine into extension. The squads, lunges and leg press exercises in her gym routine are also contributing to the tightness of these muscle groups. Lack of an adequate stretching program also exacerbates the muscle imbalance around the pelvis. Her gluteus muscles (bum) are weak. One of the functions of the gluteus muscles is to maintain a certain degree of posterior tilt in the pelvis to prevent excessive anterior pelvic tilt (which will result in excessive lumbar spine extension). The gluteus muscles should also provide stability to the pelvis. The combination of weak gluteus muscles and tight hip flexor muscles are the reason for the excessive extension in her lumbar spine. Weak deep abdominal muscles also contribute to this muscle imbalance. The weaker the deep abdominals, the harder the hip flexors have to work to stabilize the lumbar spine, therefore they become stiffer and tighter. Anna’s running posture is also in slight anterior pelvic tilt and lumbar spine extension due to the muscle imbalance around her pelvis.
 
 

Unloading the lumbar spine extensor muscles (low back muscles) by correcting the pelvic alignment.
Strengthening of the deep abdominal and gluteus muscles as well as stretching the tight hip flexor and erector spinae muscle groups will correct the excessive anterior pelvic tilt.
Correcting Anna’s habitual sitting posture will prevent the hip flexor muscles from tightening and pulling on her lumbar spine.
 
Due to the muscle imbalance around Anna’s pelvis, she developed an excessive extension in her lumbar spine. The low back muscles were constantly loaded in a shortened position. Running with this posture also placed more strain on her low back. Correcting the movement dysfunction in Anna’s lumbar spine was the solution to her chronic low back pain. She is now running pain free and training to run her first marathon.