[Lower Back Pain Care by Type ②] Common in those who stand for work! Hip stretches to improve 'swayback'

In the previous article, we introduced "sitting-too-much lower back pain," which is common among desk workers, and pelvic tilt stretches. This time, we are focusing on the "swayback type," which is common among those who stand for work, walk for long periods, or have weak abdominal muscles. Do you recognize any of these symptoms? It hurts more when standing, it feels better when sitting, when lying on your back, your lower back arches and doesn't touch the floor, you stand for long periods or often wear heels. These are signs that the lumbar spine is excessively arched, concentrating stress on the facet joints and the base of the spine.

First, check: How to distinguish it from the sitting type. A major characteristic is that even with the same lower back pain, the postures that cause pain are completely opposite.
Sitting Type Swayback Type
When sitting 😣 Painful 😌 Comfortable
When standing 😌 Comfortable 😣 Painful
Lying on back Relatively comfortable Lower back arches and hurts

It is not uncommon for both of these to apply to some people. In that case, prioritize the type based on the posture you spend the most time in during the day, and once you get used to it, try incorporating both every other day.

The "real cause" of swayback is in the hip joints
It may come as a surprise, but for many, swayback is triggered not by the lower back itself, but by a decrease in flexibility in the front of the hip joints (iliopsoas muscles). When the iliopsoas muscles become stiff, the pelvis is pulled forward, causing the lumbar spine to naturally arch too much. This pattern is very common for those who find no improvement no matter how much they massage their lower back. A case often seen in clinical practice: I often receive consultations from people who stand for long periods saying, "Even if I go for massages, it goes back to how it was in a few days." What they have in common is that the front of the hip joints is significantly stiff, and pressing on the lower back only provides temporary relief, while the hip joints themselves are not being cared for. I have the impression that more people are feeling that they are "gradually getting better" by incorporating care for the front of the hip joints.

Effective stretch: Hip joint front stretch. How to do it: Get into a half-kneeling position (front knee at 90 degrees). Push your pelvis forward so that the front of the hip joint on the back leg side stretches. Keep it for 20-30 seconds while lightly engaging your core, and do both sides.
💡 Point: The point is to keep your abdomen thin and tightened so that you do not arch your lower back too much.
Variation if half-kneeling is difficult
You can also substitute by sitting shallowly on a chair, pulling one leg far back with the top of your foot on the floor, and stretching the front of the hip joint. Please use this in situations where space is limited, such as at the office or while waiting for a train.

Common mistakes and habits to avoid
❌ Mistake ①: Thinking swayback = lack of abdominal muscles, and suddenly working hard on abdominal exercises.
Abdominal exercises in a state where the lumbar spine is hyperextended can increase the burden on the lower back. Loosening the hip joints should come first.
❌ Mistake ②: Continuing to massage or stretch only the lower back.
Since the cause is often in the hip joints, caring only for the lower back may not lead to fundamental improvement.
❌ Mistake ③: Continuing habits that stiffen the iliopsoas muscles.
Long hours of driving, slouching on the sofa, or sleeping on your stomach increase the time the hip joints are fixed in a bent position, reducing the flexibility of the iliopsoas muscles. Let's try to reduce these as much as possible.

Mindset for "using abdominal muscles correctly"
Intense muscle training is not necessary. First, start with a "draw-in" by lying on your back with your knees bent, exhaling while pulling in your abdomen, and holding for 5 seconds to lightly fill the gap between your lower back and the floor. Once you get used to it, try to be conscious of pulling your navel toward your spine for 10 seconds x 3 times while standing or walking. Prioritize getting the feeling that your abdomen is engaged without your lower back arching over the number of repetitions.

Frequently Asked Questions
Q. Should I stop wearing heels?
You don't necessarily have to stop, but wearing them for long periods tends to increase tension in the iliopsoas muscles. I recommend using flat shoes as much as possible.

Conclusion
Swayback is not just a visual problem of "bad posture," but a major cause of lower back pain. By loosening the front of the hip joints, let's reduce the burden on the lower back from the root. If there is no improvement even after continuing, or if it is accompanied by numbness or fever, please prioritize seeing a medical institution over self-care.

Next time: ③ Start-of-movement type | Stretches for those who feel pain with the first step in the morning

👤 Author Profile
Physical therapist. Works at a general hospital. Currently posting exercise guidance tailored to each individual on note.

#LowerBackPain #PhysicalTherapist #SelfCare #DeskWork #HealthNote