Think you have a “bad back”? Maybe it’s time to check your knees and hips instead! Pain is not always what it seems. The body is a complex system where each part influences the others. While we often think in terms of individual body parts, the truth is that we always move as a whole. When one area is not moving the way it should, another area often steps in to compensate. This concept is known as regional interdependence. Physiopedia defines it as “the concept that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint.” In simpler terms, this means that pain felt in one area may actually be coming from somewhere else. For example, knee pain might not be a knee issue at all, but instead the result of an ankle that has been sprained multiple times. Similarly, low back pain may not be a back problem, but rather the result of hips that are not moving as they should. As shown in the image above, certain joints in the body are designed primarily for mobility, while others are designed more for stability. Mobile joints like the hips and shoulders move through large ranges of motion in multiple directions. Joints designed for stability, such as the knees, move through more limited ranges. The knee, for example, primarily moves forward and backward with minimal rotation or side to side motion. Problems arise when this balance is disrupted. Let’s look at a common example. Imagine a soccer player who suffers an ACL tear. The knee is meant to be a stable joint, but now one of its key stabilizing structures is compromised. As a result, the knee becomes more mobile than it should be. When this happens, the body looks for stability elsewhere. Often, this leads to reduced motion at the hip as it tries to compensate for the instability at the knee. This compensation can then continue up the chain. If the hip loses mobility but the athlete still needs to sit, run, jump, and cut, all of which require significant hip motion, the next area to make up the difference is often the low back. Over time, the low back begins to move more than it is designed to. The muscles in that area are forced to work harder and absorb stresses they are not well equipped to handle. Eventually, this can lead to persistent low back pain. In this scenario, what presents as low back pain may actually stem from an old knee injury. The body is remarkably good at adapting. It will find ways to work around injuries and limitations so you can continue functioning. Unfortunately, these compensations can eventually create pain in areas that were never the original problem. This is why low back pain, shoulder pain, or other chronic issues are not always problems of the area where the pain is felt. To truly resolve pain, it is often necessary to zoom out and look at how the entire body is moving. If treatment focuses only on the painful area, it is easy to get stuck in a cycle of treating symptoms without ever addressing the true source of the problem. If any of this sounds familiar, consider consulting a licensed professional who can evaluate your body as a whole and help identify what is really driving your pain. Reference: https://www.physio-pedia.com/Regional_Interdependence#:~:text=Purpose%20%26%20Definition,-The%20purpose%20of&text=Simply%20put%2C%20regional%20interdependence%20is,with%2C%20the%20patient's%20primary%20complaint.

Low back pain is almost as universal as catching a cold. Nearly everyone will experience it at some point in their lifetime, and how severe it becomes is often unpredictable, setting aside obvious traumatic causes. What is just as common as experiencing low back pain is being told that the solution is to strengthen your core or improve core stability. That advice is not always wrong, but it is often incomplete. In some cases, it can even work against long term spinal health and physical function, especially for people who have dealt with recurring low back pain. When most people are told to improve core stability, they are usually instructed to lock their midline into a fixed position, create high levels of tension through the abdominal and back muscles, and then move their arms and legs without allowing the spine to change position. Training the spine to resist motion is important. The ability to brace and limit movement is a necessary skill in certain situations. When carrying something heavy, creating tension through the trunk can make the task more efficient by reducing unnecessary movement and wasted energy. After an acute back injury, resisting motion can also be appropriate. When tissues are strained or sprained, the spine may not tolerate much movement early on. Exercises that emphasize resisting motion can allow someone to keep exercising and reduce pain without aggravating sensitive structures. Here is the part that often gets overlooked. Most people who experience low back pain will improve on their own with time. Many do not need to permanently change how their core muscles coordinate to recover. One factor that may slow recovery for some people is the belief that their back is fragile or unstable and that they must brace their spine for everything they do to avoid reinjury. Picking clothes up off the floor should not require squeezing your entire body as hard as possible. Brushing your teeth should not demand a perfectly rigid hip hinge. If, after the early phase of injury has passed, the only thing you ever train your spine to do is resist motion, you gradually lose access to the motion your spine is capable of creating. When motion is no longer used, the tissues involved are no longer exposed to those forces. Over time, they decondition and tolerate less stress. A strategy that was protective in the short term becomes limiting in the long term. If bending over feels difficult or threatening, it may not be because bending is inherently dangerous. It may be because your spine has been trained to stay rigid all the time. Clinically, when patients present this way, we often start with movements like a hooklying two arm reach. This helps reintroduce hip and pelvic motion that supports spinal flexion and allows the lower back to begin bending again in a controlled way. [embed]https://youtu.be/C7hLRzrWF_4[/embed] Once the foundational mechanics are restored, we progress to movements that directly retrain spinal motion while encouraging bending, such as a heel elevated toe touch. This helps move away from constant bracing and begins re exposing the spine and its supporting muscles to load through flexion. [embed]https://youtu.be/RQ28YFF8rdg[/embed] A full range of motion Jefferson curl is an excellent later stage option. It allows the spine to bend through its available range while building strength and control in positions where people often feel vulnerable. These are often the exact positions where back tweaks occur, likely because the spine has not been trained to handle load there. Training your back to resist motion is only one piece of the puzzle. A resilient spine should also be able to create motion when needed and tolerate load in a wide variety of positions. The body adapts to what it is repeatedly exposed to and allowed to recover from. In many cases, retraining your spine to bend is not harmful. It is the missing ingredient that restores lost function after a back injury and helps build long term strength and confidence.

If you are dealing with low back pain, even basic daily activities can feel difficult, not to mention workouts. While these foam roller exercises are not meant to be long term solutions, they can provide a valuable window of relief. That relief can help calm symptoms so you can get through your day and continue moving while you work on addressing the deeper root causes of your back pain. Foam rolling in the traditional sense, meaning rolling out tight muscles, is often most effective as a warm up or for short term relief of tightness. However, foam rollers can be used in many other ways. They can help encourage pelvic and rib cage mobility, improve muscle activation, and reduce sensitivity in certain areas. Try the five exercises below and focus on the ones that feel best both during and after performing them. 1. Traditional Foam Rolling: Hip & Thigh Muscles (Glutes, piriformis, quads, hamstrings, IT band) Low back pain often stems from restrictions in the hips or thigh muscles. When these areas are tight, they can pull on the pelvis and limit its movement, which increases stress on the lower back. You may notice significant tenderness when rolling areas such as the IT band or deep hip muscles. This is often a sign that your pelvis is positioned in a way that increases load through these tissues and that hip range of motion is limited. While these positional issues need to be addressed for lasting relief, foam rolling these areas can temporarily reduce restrictions and create some relief. Spend extra time on the most sensitive spots and move slowly. Improving hip mobility can help give your lower back a more supportive foundation. 2. Lazy Rolling [embed]https://youtu.be/2rgBt_1D4bU[/embed] Low back pain can also come from a lack of relative motion at the pelvis. Relative motion refers to the ability of the hips and lower back to move independently from one another, which is necessary for walking, running, squatting, and most lower body activities. This lazy rolling variation encourages small, gentle movements at the pelvis. It is especially helpful for individuals with SI joint pain, which is located where the spine meets the pelvis. Try this exercise on both sides and notice if one side feels more sensitive. The movement should require very little effort and should feel slow and relaxed, just as the name suggests. 3. Wall Supported Hip Hikes [embed]https://youtu.be/jwQc2zq3iMA[/embed] Many people fall into what is often called a right dominant pattern. In this pattern, more weight is shifted into the right leg and hip, and the pelvis adapts accordingly. This can be difficult to notice on your own but is commonly identified during a movement assessment. One key to shifting out of this pattern is learning how to properly use the right glute to move your body back toward the left. You may have been told you have weak glutes, but often the issue is difficulty activating them rather than true weakness. This exercise helps specifically recruit the right glute to counteract a right dominant pattern. When performed correctly, you should feel a strong muscle burn in the right glute. 4. Hip Mobilizations: Sit Bone Decompression [embed]https://youtu.be/UA6h5ng74Js[/embed] The area around the sacrum and sit bones is another common location for muscle tightness and restriction. When these tissues stiffen, they can affect how the lower back moves and manages load. Sit bone decompression can feel surprisingly uncomfortable. If it does, that is often a sign that the area needs attention. Start with a small towel roll to reduce intensity and make the position tolerable. As comfort improves, progress to using the foam roller. 5. Rib Cage Mobilization [embed]https://youtu.be/JdF1w3ulrFs[/embed] While many low back strategies focus on what is happening below the spine, restrictions in the rib cage can also contribute to low back pain. The rib cage should expand during an inhale and close down during an exhale. When this movement is limited, the body can get stuck in one extreme. Lying over a foam roller helps close the bottom side of the ribs while allowing the top side to expand. This exercise can also be sensitive at first. If you have trouble relaxing over the foam roller, start with a rolled towel or folded pillow to reduce discomfort. As tolerance improves, gradually transition to the foam roller. These foam roller exercises can be a helpful short term tool for calming low back pain and improving how your body moves. If pain persists or limits your ability to perform these movements, it may be time to seek guidance from a licensed professional to address the underlying causes more directly.