It is without question when analyzing the workforce atmosphere, more and more of us remain sitting at an office desk for longer periods throughout the day. A postural nightmare in regards to the human movement system. This sedentary altered anatomical position creates a tremendous amount of neuromuscular dysfunctions in the Human Movement System that contributes to altered movement patterns throughout our joint locations. Looking at an individual who remains sitting throughout most of the day will more than likely create static malalignments around the lumbar pelvic hip complex. The sitting position will ultimately tighten the muscles of the psoas (hip flexor), which will decrease the neural output to the antagonist muscle of the gluteus maximus (hip extensor), which causes the CNS to call upon the synergistic output of the hamstrings to produce the necessary joint force. This altered joint motion creates hypomobility and myofascial adhesions of the hip joint. The static malalignment alters the normal length-tension relationship of the hip joint and leads to synergistic dominance of the hamstrings. Once this joint hypomobility occurs in the hip joint, this person may begin to experience spasms in the activated joints to help minimize the stress at the hip joint (Lippincott, Williams and Wilkins 2012). The resulting factor of this reciprocal inhibition would be lower back pain with possible hamstring spasms during normal daily acitivity.
To understand a little more about the static malalignments that are occurring around the hip joint, one can understand that since the hips are in a flexed position (angle of the hip joint is decreased), that the body in order maintain posture, must keep these muscles in an isometrically contracted position while seated. Reciprocal Inhibition means that since these muscles of the psoas (hip flexors) are over active, the direct opposing muscle of the psoas, which is the Gluteus Maximus, will receive less neural input or signal, from the Central Nervous System, which will minimize the force output of this muscle. Since the Gluteus Maximus, which is the primary muscle for extending the hip when we walk or run, is no longer creating enough force, this means the synergistic muscles that help with hip extension, in this case, the hamstrings, must “pick up the slack” and will become overworked, leading to muscle spasms.
This altered malalignment of the hip joint will also create an altered length-tension relationship of the knee joint that will eventually lead to patellafemoral pain (PFP) and possible ACL injury. Given the sedentary occupation with activity that dominates the sagittal plane of extension and flexion(squatting down or extending the knee), this would present a neuromuscular dysfunction in the lateral subsystem of the frontal plane movements. This PFP would decrease the optimal muscle patterns of the gluteus medias and hip external rotators and would increase the likelihood of knee valgus(image left) with excessive internal rotation and stresses to the lower extremity and pelvis, which may lead to an increased strain on the surrounding joints. These altered mechanics has shown to increase ground reaction forces during landing, which is a common symptom of potential PFP and ACL injury (Clark and Lucett 2011)
Helping to prevent or minimize any potential injuries would require this individual to begin a moderate resistance training program to help strengthen the stabilizer muscles, predominantly in the muscles that activate the frontal and transverse planes. Primarily, the muscles of the gluteus medias, tensor fascia latae, adductor complex and quadratus lumborum, oblique complex, in addition to strengthening the erector spinae and rectus abdominus to help maintain posture as well as stabilizing the sacroiliac joint.
Exercises To Help With Lower Back Pain
Clark, Micheal, and Scott Lucett. NASM Essentials of Corrective Exercise Training. Philadelphia, PA: Lippincott Williams & Wilkins, 2010. Pr