If you’re suffering from low back pain, you’re in good company. Studies suggest that the prevalence of low back pain in adults is on the rise, with over 80% of the population expected to experience an episode in their lifetime. According to the Journal of American Medical Association, low back pain (coupled with neck pain), represented the highest healthcare-related spend in 2016, topping out at an astronomical $134.5 billion in doctor and physician visits as well as treatments for the condition. As we, even young people, fight to survive our desk jobs and the estimated 6.4 hours a day we spend sitting in chairs, an increasing number of people are struggling with pain, worrying about their posture, and anxiously doing crunches with the hope they can support their low back by training their “core."
This might be one piece of the puzzle, and the benefits of having strong muscles can’t be understated. When the muscles that are responsible for stabilizing your hips, pelvis, and spine are functioning in harmony, you have a reduced risk of experiencing discomfort in your low back and hips (even in your ankles and knees).
But if doing countless ab exercises isn’t helping, the real culprit may be the other muscles of your core: your hips and butt.
Your core isn’t just your abs
Yes, many people believe their “core” is just their abs, and that any kind of ab work is sufficient to "strengthen their core." In reality, abs are just one part of the whole group of muscles responsible for stabilizing your back and hips.
Every part of the human body is interconnected. Our skeletal muscles (the muscles responsible for moving our limbs and keeping our spine stable) continuously work in intricate ways to balance, carry load, and meet resistance, every moment of every day.
When someone with a fully functional and strong core bends over to pick something up off of the floor, their large glute muscles ( large in relation, at least, to all the other muscles in the body) contract to bring them upright, and the other muscles of the core, including lower back muscles, assist. In someone with a weak core, particularly their hips and butt, if their body is unable to call on their glutes to do most of the heavy lifting to complete the movement, their lower back muscles may have to step in.
So what causes your butt to “turn off”?
The average office worker sits even more than most Americans, with some estimates as high as 15 hours a day. During long sitting sessions, blood flow to the glutes is restricted, and the muscles of the hips are contracted. As discussed earlier, when one muscle group contracts, its opposing muscle group relaxes. Over time, all this sitting can have a negative impact on your core’s ability to properly stabilize, which means your lower back muscles have to work overtime.
Body movements are powered by specific sets of muscles working together. When the “prime movers” (or “agonists,” in technical terms) contract during any given movement, the nervous system tells its opposing muscle group, or antagonist, to relax. If you arch your body backward, the muscles of the lower back are contracting, while your abdominal muscles relax so the spine is not pulled forward.
If your lower back hurts and feels “tight,” training your abdominals to help them relax feels like a logical choice. But this potentially treats the symptom instead of the cause.
Supporting muscles called “synergists” help the agonist muscles, which are cued by the brain to take on the additional workload if an agonist muscle fails to fire correctly. Over time, synergist muscles can become “overactive,” meaning they function in place of the muscled supposed to be doing that job in ways they were not designed to. When this happens, the muscles supposed to be doing the movement get even weaker and even less likely to do their job, and cause the overactive muscle to take on too much work and possibly cause pain.
The muscles of the butt are connected to your pelvis, and play important roles in stabilizing your hips and spine during movement. The gluteus maximus is one of the largest and most powerful muscles in the body used for many frequent functions, including standing up from a chair, walking, running, and squatting. The gluteus medius and gluteus minimus help to stabilize your hips and keep them in a neutral position during movement. People with chronic, non-specific low back pain may have weaker glute medius muscles than their pain-free peers.
So, what do I do to address low back pain, if endless crunches aren’t doing anything?
One way is to add butt-building exercises into your routine, with the help of a physical therapist, if you need it.
Strengthening the muscles of your butt and increasing the mobility of your hip flexors is a fundamental element of building a strong core. For most, low back pain does not have to be a fact of life, or an inevitability for people who are still in their late 20s working at desk jobs.
In order to build a good foundation, warm up with movements that heighten your body awareness; it’s important to first work on your ability to actually feel your glutes activate during your workout.
So begin with unweighted, higher repetition movements, like the glute bridge, side-lying leg lift, and body weight squat. Focus on squeezing your butt and notice what other muscle groups (like your low back, hamstrings, and quads) try to dominate the movement.
Body weight movements are great to perform as part of your warmup in order to “wake up” your glutes and encourage you to be more mindful of using them throughout your life and workouts. It may sound silly, but for some, it can actually be this simple. You have the ability to feel your muscles working and make them stronger, including your glutes.
In addition to building a bigger butt to alleviate lower back pain, you can try standing more and sitting less, so that your hip flexors aren’t in a fixed, contracted state so much. Hip flexor stretches can help alleviate tightness in the moment (including at the gym), but a lifestyle adjustment, like getting up from your desk and walking around at least once every hour, may be necessary for long term relief.
Experiencing nonspecific low back pain can elicit fear that sufferers are becoming fragile with age and that pain is simply a new fact of life. In reality, the majority of low back pain goes away on its own, or is manageable with movement. If your pain persists, neglecting your glutes while working your core might be one reason.