Low back pain question

[gman]

Mark,

Had a question regarding chronic low back pain that I have been having intermittently for the last few years. I injured my back wrestling in college 20 years ago, and while it initially only bothered me once or twice a year, as I get older it has been fairly constant over the last 2 years. I have had 2 episodes in the last 2-3 years that left me unable to walk for several days, and in pain for 3 weeks afterwards.

The pain is in my right SI area, almost like someone is applying pressure with their thumb. This is worse with valsalva. I also have been told by a physical therapist that my hip flexors are very tight, and I have been working on this through some stretching exercises. Some days it feels like all this is helping, and other days I really cannot tell a difference. Overall, it feels like squats have helped, but there is a "fear factor" with squatting because I have had 2 episodes of my low back catching, mainly due to poor form early on, and I am hesitant to try deadlifts because of this. I know you addressed an earlier post about back pain and recommended reverse hypers and back extensions, and I am currently working on building a wooden attachment for my squat rack for the reverse hypers. Any other suggestions for exercises that may help?
Thanks,

[Mark Rippetoe]

I sympathize, because I have had similar back pain over the past 20 years. The thing that has made the most difference for me is that about 4 years ago I began diligently stretching my hamstrings every time I train. I have used back extensions, reverse hypers, and deadlifts all successfully to rehab this problem, but since I have been stretching my hamstrings I can get my back in the correct position to lift with much greater reliability, and have had FAR less trouble than I used to have with my back. Hip flexors are NOT the trouble -- if your hamstrings are tight you cannot get into proper lumbar extension. Give it a try, and you'll know in a couple of weeks.

[buster]

Sorry to jump on this thread, but i was wondering what stretches you think are best for stretching the hamstrings out.

Cheers

BUSTER

[Dan F.]

I sympathize, because I have had similar back pain over the past 20 years. The thing that has made the most difference for me is that about 4 years ago I began diligently stretching my hamstrings every time I train. I have used back extensions, reverse hypers, and deadlifts all successfully to rehab this problem, but since I have been stretching my hamstrings I can get my back in the correct position to lift with much greater reliability, and have had FAR less trouble than I used to have with my back. Hip flexors are NOT the trouble -- if your hamstrings are tight you cannot get into proper lumbar extension. Give it a try, and you'll know in a couple of weeks.

Reading posts in forum and for personal experience it seems that hamstring tightness is the most common problem in males new or relatively new in training - and also in males who are doing some sport at an amateur level. (Women seem to have less problems, perhaps for genetics). Why so? And why in particular that muscular group?

Maybe caused by the lot of hours sitting on chairs at school or work (also in guys practicing sports and training some hours at week)?

Have you any thoughts about this?

[Mark Rippetoe]

I think you're right. Hamstring tightness is extremely common, it is probably due to a seated society, and since males are tighter in general (prolly due to muscle mass and more physical injuries) we have this problem more frequently. We probably also account for more of the reported back problems too, although I'm just guessing about that.

As for stretches, I like to hold my fingers under my toes and shove my butt up in the air, although many others dislike this due to the tendency to round the low back during.

[Colm OReilly]

Kelly Starrett (of the injury rehab protocol stickied to this forum) has a good article on hamstring flexibility in the July CrossFit Journal, which you can pick up for $5.(Also includes a Rip article - "Silly Bullshit")

He recommends, amongst other things, a stretch similar to this.

[Mark Rippetoe]

Kelly's actually the guy who doesn't like my stretch. It works for me because my low back is so tight that I can't hurt it this way, and tight enough that it stretches my hamstrings preferentially.