The Posterior Chain: It’s all in the Hips
So what is the posterior chain?
The primary muscles included in the chain are the lower back, glutes, hamstrings, and calves. Unfortunately, the posterior chain is all too often neglected for two reasons:
Second, since most of what we do is in front of us and we can’t see behind us, the posterior chain is often neglected. It’s the out-of-sight, out-of-mind theory. This often leads to severe muscle imbalances between muscles groups which often hinders athletic performance and can lead to possible injury. Even people leading an active fitness lifestyle that includes strength training, usually overwork anterior muscles. They end up neglecting the more important posterior side. This is especially common in runners. Compared to the quads, the glutes and hamstrings are more powerful muscles for stabilization. Sedentary lifestyles and lack of proper exercise lead to suboptimal muscular activation patterns within the posterior chain. This is a recipe for acute and chronic lower back pain syndromes.
The solution to low back pain isn’t always found in the back, but rather in the hips. You must work the hip to protect the spine. When the hip does not work properly or move the way we need it to, there will be increased spinal motion and potential back problems. Hip mobility requires the right muscles moving the hip joint to decrease the movement and load of the lumbar spine as a substitute. This means core stability is directly correlated to hip mobility.
A major part of the core are the glutes. The body will take the necessary motion from the lumbar spine if it is not getting it from the hip. Often with back pain, inability to flex the hip past 90 degrees will cause flexion of the lumbar spine to compensate, giving the illusion of flexing the hips. This dysfunctional movement pattern will ultimately lead to tissue damage.
Glute muscle activation and proper symmetry are essential to proper hip function. The ability of the glutes to work is critical, because if the glutes can’t work, there will be lower back pain. Weak glutes = Bad back! This inadvertently effects the hamstrings, because now the hamstrings take on the role of extending the hip, contributing to chronic tightness, fatigue and spasm. This can contribute to anterior hip capsule pain as well.
Once we have removed fixations and restored proper mobility, you then progress to stability and strengthening exercises. Here are some of the most effective exercises and fundamental movement patterns you can use to strengthen the posterior chain:
Kettlebell Swings: are great for glute activation and hip extension. They also give your lower back, hamstrings and hips a really good workout.
Deadlifts: Yes, I said deadlifts! In reality, a properly executed deadlift is the perfect exercise for strengthening your back and teaching hip hinging. The problem is that this exercise is so often performed incorrectly. This movement pattern is probably the most effective thing you can do to teach proper biomechanics. They are not only the best muscle-building exercise, but are also superb for strengthening the hamstrings and lower back while improving posture.
Cook hip lifts: Named after Gray Cook, hip lifts are a great beginning gluteal activator and are meant to be used as a precursor to the glute bridge, because it solves a problem of not being able to tell the difference between lumbar range of motion and hip range of motion. When trying to target the glutes and hamstrings with a regular glute bridge, patients mistakenly use a lot of lumbar extension rather than hip extension to preform the movement. The Cook lift solves this by maintaining the lumbar in a neutral position and effectively isolating the glutes.
Stability ball leg curl: The stability ball leg curl combines coordinated movements that work the back, abdominals, hamstrings, glutes, quadriceps and abductors. The muscles work together to stabilize and balance the body, thereby developing core strength and balance. Strengthening the posterior chain will not only make you feel better; it will also improve your treatment outcomes.
Not sure if your posterior chain is weak… come see us!
-Dr. Jill Thomson DC., MS., CCSPby