Stretching is one of the most commonly used methods to reduce back pain. Unfortunately, most stretches for lower back pain can cause more harm than good.
The lower back is one of the most misunderstood areas of the human body, perhaps only second in that category to the brain. Many so-called treatments completely ignore the functional anatomy of the lower back. Due to this misunderstanding, there are three stretches for back pain that are frequently recommended but can actually increase your pain when performed over time.
The number one offender is the lower back rotational stretch. This is the stretch that involves laying down on your back and twisting your legs in either direction while holding your shoulder blades against the ground.
The truth is that the lumbar vertebrae are not built for rotation. If you have seen one of these vertebrae in person before, you would notice that the lumbar vertebrae are much bigger than their thoracic and cervical counterparts. As a result, the lumbar vertebrae do not have much capacity for rotation.
In fact, each lumbar vertebra can normally only rotate by a few degrees (usually 1 to 3), while each thoracic vertebra can rotate almost 10 degrees.
As a result, most of our spine’s rotational capacity stems from the middle and upper spine, not the lower back. Attempting to get more rotation from the lumbar spine by performing the rotational stretch is a recipe for more pain over time rather than relief. The expression “forcing a square peg into a round hole” fits perfectly here.
The reason this stretch (and the next stretch) remain popular is due to the fact that they feel good while you are performing them. Picking a scab also feels good, but does not help the tissue heal! The relief from these stretches is temporary and the injury is perpetuated. This “feel good” mentality is a trap; just because something feels good does not make it healthy. Extra rotational capacity at the spine only leads to a higher risk of injury.
The next common but dangerous stretch is “knee to chest” stretch. This stretch for the lower back involves laying down on your back and pulling your knees to your chest. This stretch invokes something known as the “stretch reflex”; this forces the stretched muscle to relax and prevents it from contracting properly for about 20 minutes. This also provides a pain-relief effect.
The net result is that your lower back muscles can no longer contract effectively (reducing spinal stability) and the area is numbed (making it hard to tell if you are injuring yourself). Due to the lowered stability and sense of pain, it is easy to injury your lower back during this 20 minute refractory period. Additionally, once this reflex wears off, the person performing the stretching is back in pain and none the better for it.
The final stretch is the “toe-touch” stretch, which involves bending forward and trying to touch your toes. This stretch can cause further injury because the spine is in its most susceptible position to injury when it is flexed. Additionally, tight hamstrings are often used by the brain to splint the spine and prevent further injury. It is not always appropriate or effective to stretch a muscle just because it is tight.