Athletes Treating Athletes

In the introduction post to this series, we reviewed and answered some common questions regarding stretching, including why, when, how, etc. Click here to review it.

In this post we will be talking about stretches specifically for the low back. This includes the long back extensors (erector spinae), the QL and where the large hip flexor (the psoas) sneaks through to insert on the front of the lumbar spine.

The Rules:

1) Stretching should NEVER hurt. The goal is to only go until you feel a pull in the muscle. It should not be to go until it hurts in one of those “no pain, no gain” efforts. It should be comfortable and repeatable, allowing you to move a little further with each repetition.2) Perform stretches when the muscles are warmed up. This can be following a workout or following work with the foam roller. Click here to review the self massage post for the low back (this includes pictures and video using a foam roller and tennis ball to review 3 self muscle release techniques).

2) Hold for 20-30 seconds and repeat 3-4 times. You can hold longer than the 20 seconds, but the reps are key. You will always get more out of stretching frequently versus one killer session a week.

3) If hurt, make sure you are using a firm surface where the back is fully supported. A saggy bed mattress for example will make these far more difficult than they need to be. Also, start with the easier stretches in the progression and work your way up.

The Progression:

#1. Double knee to chest

This is always a good one to start with as it brings both knees up at the same time to stretch out the lower lumbar muscles. Start laying flat on your back and bring both knees up to waist height. From here let your arms do the rest. Gently pull your knees up until a stretch is felt in the low back. If this is too uncomfortable, start by laying on a pillow and wrap a belt/strap behind your knees. Pull up using your arms versus your legs. Hold 20-30 seconds and repeat 4 times.

#2 Single knee to chest

This is a continuation from the stretch above. Start by bringing both knees to your chest and then drop one back down towards the floor. Just let the leg fall as far as it can comfortably can. It may not go all the way down at first. If you’re looking to increase this stretch, try to use a surface where you can drop the lower leg down further. For example, I have people sit on the edge of the table and then lean back with both knees to their chest. As they let one leg go, the leg can come down into full hip extension and the knee can bend freely. Be careful when trying this one. I can be a big stretch! Start by laying flat on the floor and work from there. Hold 20-30 seconds and repeat 4 times each side.

#3 Lower trunk rotation

Like the stretch above, this stretch allows for a few modifications to make it more challenging as you go. Start by laying flat on the floor with both knees and feet together. From here, drop your knees down to one side. You should feel a stretch in the low back and possibly even wrapping around the hip depending on how tight things are. Hold 20-30 seconds and repeat 4 times to each side.

How to modify this??

1) As you drop both legs to one side, straighten the top knee and keep the bottom one bent. the stretch will also be increased by how high you keep that leg (i.e. waist height and above versus lower).

2) Using the modification above, pull the lower leg back so that your legs are in more of a scissor position. Remember- shoulders must stay flat when you do this. Do what you can to start and work your way up from there.

#4 Quadratus Lumborum Stretch

To target the QL muscle, we need to use both the upper and lower body. for this you’ll need surface where you can literally hang off the side (this means bed, coffee table, etc). Start by laying on your side. Bring the bottom knee up a little and then keep the top leg straight and bring it back. From here let it drop down. The last part is to add the arms in. Twisting your upper body, reach overhead with you top arm. Bottom arm stays relaxed. This should result in a stretch from your hip to your rib cage. Hold 20-30 seconds and repeat 4 times. Go slow setting it up to make sure both the upper and lower portions are set up correctly.

#4 Hip flexor stretch

For this stretch, start in a lunge position kneeling on the side you want to stretch with the other leg out in front. From here you’re going to want to lunge forward onto the front leg (aka push your hips forward with your back STRAIGHT- no leaning forward). Keep the side you are stretching completely relaxed. You should feel a stretch right in the front of your hip and may even feel it in the top of your quad (thigh muscle). Hold for 20-30 seconds and switch legs. Repeat 4 times.

Click here for ways to modify this stretch.