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5 Frequently Tight Areas that Play into Your Back Pain

Updated: Jun 27, 2023

How to assess for any of these areas that can cause your back pain

#1 Hamstring Tightness

The patient is lying on the examination table in a supine position. The non-examined lower limb is stabilized on the support surface. The opposite limb is raised, with the hip flexed at 90 degrees and the knees extended to achieve a perpendicular position to the ground. A 20-degree lag from full extension is considered within the normal range, while anything less indicates tightness in the hamstrings. To measure this range, a goniometer is placed at the knee with the fulcrum at the lateral epicondyle. The stationary arm is parallel to the thigh, pointing towards the greater trochanter, and the movable arm is parallel to the leg, pointing towards the lateral malleoli.

#2 Hip Flexor Tightness

The Thomas Test, also known as the Hugh Owen Thomas well leg raising test, is employed to assess the flexibility of the hip flexor muscles. It is particularly useful in evaluating hip flexion contracture and psoas syndrome (Iliopsoas Tightness), which tend to be more prevalent among athletes such as runners, dancers, and gymnasts. Symptoms associated with these conditions include a sense of hip "stiffness" and a clicking sensation when flexing at the waist.

Initially designed to measure the flexibility of the iliopsoas complex, the Thomas Test has undergone modifications and expansions to include the assessment of various other soft tissue structures. Overall, it serves as a valuable tool in identifying hip flexor tightness.

#4 Hip Internal Rotation and #5 Hip External Rotation

Your hip should rotate inward as much as it should rotate outward. Normal range is 45 deg for both. If one motion is lacking it could cause your pelvis or your low back to move more than it should to compensate for the loss. You can check this on your back as shown in the picture and/or on your stomach with your knee bent to 90 degrees.

#5 Thoracic Mobility

Let's just assume your thoracic spine is tight in to extension as shown in the picture. Most of the population is, since we spend so much time sitting and handling items in front of us. Certain individuals have excessive motion throughout their entire body that can have good thoracic extension. These individuals would do better with strengthening the trunk more so than stretching it.

Check and see if you have equal rotation in this position. This position will help lock out your lumbar spine, so the motion can occur in to your thoracic spine. Normal range should be close to having your shoulders perpendicular to the floor.

You should check and see if you have symmetrical motion between left and right. Make sure the motion that you have is occurring in your thoracic(mid back) and not just from the low back and neck or shoulder blades. The thoracic spine should curve to form a C curve. If no motion is occurring here, you will need to work on getting this motion back. This motion will usually coincide with thoracic rotation. Helping one, will help with both.

If you need help making sure you're finding the most safe and optimal way to get back this mobility. Click Here to schedule a DIY Evaluation with a trained Physical Therapist.

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