Do Sit-ups hurt you or does your core feel benign to their performance? Did you hurt your lower back even though you were doing something that seemed so innocuous at the time? Is everyone’s core just too weak?
These questions have no doubt gone through your mind at some stage in your life. Is it the case that we need to find the right answers to these questions or is it more the case that we need to start with the right questions? The common denominator in all these problems tends to be the 21st century westerner more than any other factor. So what is it about the modern day humans or what they do that makes them so susceptible to such dilemmas? Let’s start with how humans are made and how their anatomy is influenced.
The hips are the body’s focal point of movement, force production and stability. Understanding the hips and their profound influence on almost every facet of our physical activities will go a long way to understanding a lot of the muscular imbalances that can occur throughout one’s body. Let’s look at a specific muscle group of the hip that is the source of many of our aforementioned problems – the hip flexors.
The Hip Flexors:
The hip flexor muscle group is often overused by most people in modern western society. This muscle group connects from the pelvis/lower back to the femur and has the role of pulling these two areas together. Perpetual sitting overworks these muscles (particularly Psoas Major and the Iliacus muscles) due to the hip being in a constantly flexed positon.
Of the hip flexor muscle group, Psoas Major and Iliacus (collectively known as the Iliopsoas) usually cause the most grief and are the main source of most people’s lower back issues. The Iliopsoas originate inside the vertebral column of the lower back, pass over the front of the pelvis and attach to the femur (upper leg bone). Analogously, the iliopsoas can be somewhat like the tight strings of a cello (see figure 5.7). When this muscle group shortens, it pulls the lower back forward and down, leading to a swayed back and increases the pressure on the vertebral column.
This often creates a sub-optimal hip position where the pelvis is rotated forward (anterior pelvic tilt) causing pinching and restriction of the nerves around the lower back and tightening of this area. This in turn causes the muscles surrounding the hip to tighten and compensate for this altered anatomical position. For many, this is a workplace ergonomic subjection and leads not only to tightness in the front of the hip and lower back but also weak abs and weak glutes (AKA your butt!).
The treatment of the swayed back and anterior pelvic tilt involves an integrated approach of stretching/loosening of the hip flexors, aswell as the strengthening of the abs and glutes in order to bring the pelvis and lower back into proper alignment.
Understanding the Abdominals:
Working in contrast to the action of the iliopsoas are the glutes and the abdominals – particularly Rectus Abdominis (shown below). The Rectus Abdominis originates in the lower ribs and attaches to the base of the pelvis (pubis) and is responsible for flexing the lumbar spine and drawing the ribcage and pelvis together. Its action can involve bringing the rib cage towards the pelvis when the pelvis is fixed (such as when performing a “crunch”), or bringing the pelvis towards the rib cage (posterior pelvic tilt) when the rib cage is fixed, such as in a leg or hip raise. The two can also be brought together simultaneously when neither is fixed in space. This muscle works predominantly through the first 30 degrees of range of motion.
Gluteus maximus along with gluteus medius and minimus are collectively known as the glutes. The glutes make up a large portion of the hips and have a big influence on the appearance and shape of the area as a whole. This muscle group is responsible for externally rotating and extending the hips. To see the importance of this muscle group, stand with your feet shoulder width apart and look down at your knees. Now squeeze your butt really hard and watch how your knees turn outwards externally and stabilise. To really illustrate what happens when the glutes are not functioning well and the hip flexors and hip internal rotators are dominating, stand in the same position and let your knees buckle in. Notice that your pelvis tipped forward when you did this and the arch in your lower back increased.
Restoring the problem areas:
Abdominal exercise: The McGill Crunch
Most Sit-up exercise variations use an element of abdominal activation and a significant contribution of the hip flexors in order to execute the movement. In a conventional sit-up, the abdominals work from the start of the movement to about 30 degrees elevation before the hip flexors take over for the rest of the movement. Most people with lower back pain are advised to avoid Sit-ups due to the element of hip flexor work that would impose greater tension to an already over-used muscle group. The McGill Crunch is a great exercise for isolating and solely working the abdominals whilst nullifying the contribution of the hip flexors. Invented by the world’s foremost authority in the treatment of low back disorders Dr Stuart McGill, the McGill Crunch is a great exercise for targeting the abs without applying excess force or stress to the lower back region. To perform the exercise, lay on your back with one leg bent and one leg straight on the floor. With hands behind head and elbows back, proceed to crunch up by curling through the upper spine whilst keeping the lower back supported and still on the floor. Squeeze the abs tight and pause at the top of the movement before lowering the spine back down to the starting position under control. This technique will recruit the abdominals more, reduce hip flexor activation, and reduce the strain on the lower back region. Aim to advance to 3 sets of 20 reps for this exercise before considering more advanced progressions
Stretching the hip flexors:
This is a preferable hip flexor stretch over most others as it stretches all the hip flexor muscles and in particular the Rectus Femoris which is a large quadriceps muscle that not only straightens the knee like other quadriceps muscles but it also plays a significant role as a hip flexor. Due to the large amount of time most people sit each day, usually longer and very frequent bouts of this stretch are best. Start with 2 mins per side in a mildly stretched position repeated twice in the morning and twice in the evening. If one side is tighter than the other, stretch the tighter side first and give this side priority. Generally, more is better when it comes to stretching.
Recruiting the Hip Stabilizers:
Most people with overly tight hip flexors, sore lower backs and weak glutes will tend to have a preference for recruiting the hip flexors aswell as the hip internal rotators (namely the hip adductor muscle groups which tie into the groin area). This imbalance will contribute to anterior rotation of the pelvis and the consequences that result from this (as explained earlier). To overcome this imbalance, the hip external rotators and stabiliser muscles (namely Gluteus Medius) need to be engaged, recruited and properly strengthened in order to take the load off the lower back and other areas of the body that are unnecessarily taking over hip stabilisation work. An exercise in which to accomplish this is the Glute Stability Step and its variations. For starters, the most basic variation of this exercise is the performed by doing the following:
To execute the movement correctly, bend at the hips and push the butt back until you are in a quarter squat position with your weight in your heels. From this position, stabilise one leg for balance while the non-stabilising leg will be moved back and forth without any movement in the hip or knee of the stabilising leg. The stabilizing leg will have the tendency to want to buckle in – you need to work against this. Place your finger tips on the front of your hips (namely the hip flexors) and your thumb on the top of gluteus medius – which is opposite the hip flexors and at the top of the rear portion of the same side hip. This is done to get kinaesthetic feedback from the muscular contractions. You are aiming to not feel the muscles under the finger tips contract (i.e. the hip flexors) but rather the hip stabilisers instead (under the thumbs). Aim to do 20 reps each side with this exercise whilst keeping the hips balanced throughout the whole time. Once you have reached 20 reps each side for 2+ sets, aim for the following more advanced variations of this exercise:
Glute Stability Step Progressions:
Backwards + Sideways:
Backwards + Sideways + Forwards:
Once you are doing the last variation for this exercise fluidly and with no imbalance issues for 20-25 reps in each direction, you should have adequate kinaesthetic awareness and hip stability to recruit these muscles during most lower body exercises when they are required.
Activating and strengthening the glutes:
A great exercise for targeting the glutes (specifically the larger gluteus maximus) is the Hip Thruster exercise and its variations. See below for the most basic variation:
To perform Hip Thrusters correctly, lie on your back with your knees bent and feet separated shoulder-width apart. Press your heels hard into the floor, squeeze your butt hard, and bridge up until your body forms a straight line between your knees and shoulders. Imagine grasping a pencil between your butt cheeks as you squeeze hard at the top position of the movement. Lower yourself down under control and repeat for 10-12 repetitions. If you can do this for 3 sets of 10-12 reps, then advance to the Single Leg Bridgeback exercise:
To perform Single Leg Bridgebacks correctly, lie on your back with one of your knees bent and with the other leg out straight. Press the heel of the bent leg hard into the floor.squeeze your butt hard, and bridge up until your body forms a straight line, then lyourself down under control and repeat. Be sure to maintain a straight line from your non-planted foot to your shoulders throughout the entire exercise and do not ‘swing’ the non-planted leg – it should remain in alignment with the torso the whole time. If one side is weaker than the other, prioritise the weaker side and do not do more reps on the stronger side than what you can perform on the weaker side.
Aim to build up your reps to 20-25 per side for 2 sets – when you get to this level of strength you will not need to do this exercise daily but rather you can drop back to a frequency of performing these every 2-3 days – this is because intensity (how hard an exercise is), volume (how many times you repeat the exercise i.e. sets x reps), and frequency (how often the exercise is repeated) are inversely related. Therefore, as one increases (in this case; volume), you will need to decrease the exercise frequency in order to facilitate recovery and enhance performance.
Due to the nature of most people’s sedentary work and lifestyles in the modern era, it is highly likely that you will need attention to some or all of the aforementioned areas of the body. If you diligently apply yourself to the exercises and guidelines listed, you should notice a substantial improvement in how you feel, perform and even look. Aim for the target numbers on each exercise and you should start to look and function like a normal human being again.