One Quick Test Towards Fixing Your Back Pain

Written by Will Barlock, PT, DPT, CSCS

Low back pain can be a tricky thing to treat. In some of our previous blog posts, we have discussed the importance of determining the cause and treating it versus treating the symptoms. The back can have causes from the lower body, causes from the upper body, and causes from the neck, upper back, trunk and low back itself. All in all, to keep things short, there are a plethora of potential causes for the root cause of your back pain. One area I want to discuss, is the effect of glute strength levels and their potential to create back pain, especially for the golfer. 

The gluteus muscle group is composed of 3 muscles – the gluteus maximus, the gluteus medius and gluteus minimus. In this article, I will be primarily speaking about the gluteus maximus and refer to it as the ‘glutes’ from here on out. The glutes are the primary hip extensor of the body, and one of the strongest muscle groups. They are needed for daily function, such as with sitting and standing, walking, ascending and descending stairs, and are basically used any time you are on your feet. Specific to the golf swing, they assist with a few different key components. Firstly, they help provide the power behind the hip drive from the top of the back swing down towards impact and through impact. Secondly, they also act as a braking system upon your follow-through. As you twist and rotate over your lead leg, your glutes – especially on the lead leg – help you stop at the top upon your follow-through. One of the best in the game of golf at using their glutes is Rory Mcllroy. Next time you are watching him compete, take a look at his ability to (1) drive his hips towards impact and through the ball and (2) his ability to stop at the top of his swing to watch his shot. He will hold that position at the top and is able to do so because his glutes are very effectively firing and performing their duty to drive the hips and then step on the brakes. 

So, what does it look like when the glutes are not firing properly? A couple common indications that the glutes are not firing like they should is (1) you are unable to maintain your balance at the top of your follow-through and may need to flex your knee to maintain balance and (2) you need to swing your trail leg through  after impact (right leg for righties and left leg for lefties) at the top of your follow-through so that both feet are facing squarely to your target. If you have ever had either of these happen, then it may be indicative of underactive glutes. 

You may now be wondering why I am talking so much about the glutes. When the glutes are underfired in the swing and underperforming, the next biggest and strongest structure must step in to assist the lack of power output from the glutes. That next biggest structure is your back – more specifically your lumbar (lower) and thoracic (midback) spines. The back is a very strong structure that supports our entire body all day long. It absorbs daily stress and shock from the legs, arm, neck, and head, includes 31 spinal vertebrae, a very complex messaging system called the spinal cord, and includes multiple layers of muscles and ligaments to support all of this. With so many structures and functions, it is no wonder why 80% of Americans will deal with some form of back pain at some point in their life and 7% of those will develop chronic back pain1! If there is a structure underperforming, the surrounding structures can assist by tightening up and help with improving the lack of ‘strength’. The one thing that often occurs when this process happens, is that the tight muscles produce pain. 

If we apply this similar philosophy to a golf swing with under firing glutes, now the back will step in to assist with the hip drive and braking components of the swing. Although, you may be able to perform without the glutes, there is a whole heck of a lot more force being placed on your back now. Over time, this can compound and one day you may wake up with a serious bout of back pain, that may even be debilitating in some circumstances. The key is preventionbefore you even come close to opening the door for back pain to enter your life. 

TEST

Now back to the initial topic of this blog – a quick test towards fixing your back pain. The glutes are one potential cause for your back pain. Let us discuss how to determine if you have underfired glutes. To assess, you are going to attempt a test specific to the glutes – called the Glute Bridge Test. Below you can see what the glute bridge looks like:

A picture containing person, indoor, laying, young

Description automatically generated

Fig 1. Glute Bridge Starting Position

The glute bridge test can be performed first by placing yourself in the position as seen in Fig 1. The next step is to place one leg in the air, as seen in Fig 2, as seen below:

A picture containing person, indoor, young, playing

Description automatically generated

Fig 2. Glute Bridge Test Position

Hold this position (as seen in Fig 2.) for 10 seconds. As you perform this test, focus on what structures are performing the most work – between your low back, glutes, and hamstrings. Make sure to perform on both sides. Once completed, consider what you felt performing the most work. 

RESULTS

If you find that during the testing, you felt your glutes on both sides firing 100% of the time, then congratulations! That is a passing performance for the glute bridge test. If you found that you felt your lower back or hamstrings helping to hold this position, cramping was occurring in these regions or reproduction of your back pain was occurring, then you likely have some form of back pain produced due to your weak glutes. For more instruction on how to strengthen your glutes visit this link – Glute Strengthening Exercises

A quick note to the reader

Back pain can be a very complex issue for many experiencing it. It can be a result of poor function of the supporting structures, internal (more serious) problems, psychosocial factors or a mix of all of these factors. This article is strictly for educational use for the viewer and may be used for educational purposes. It by no means is a solution but may help guide you in your recovery process. A licensed medical practitioner should be referenced for a complete level of care. 

If you need help treating your back pain, sign up for an evaluation with one of our in-house licensed physical therapists! Click here to set up a physical therapy evaluation and learn how to fix your back (or any other problem) now! 

Use https://par4success.com/physical-therapy if the above links do not work. 

Sources

  1. Sayre, C. (2013) 12 Ways to Improve Back Pain. [Online] Available from: https://www.webmd.com/back-pain/features/12-back-pain-tips [Accessed 29 September 2020].