The key role of joint stability in low back pain relief

Tl;dr

Your spine needs two types of stability to stay healthy: static stability, which holds the vertebrae in place and dynamic stability, which allows smooth movement while keeping your core and hips working correctly.

Rebuilding both is key for managing low back pain, improving posture, and moving more effectively. And it’s not just about strengthening the lower back muscles.

What is static stability and why does my spine need it?

Static stability is your spine’s ability to stay in place.

The five lumbar vertebrae have no bony structures holding them together, so the muscles and fascia around them have to do that job.

Key contributors to static stability include quadratus lumborum (QL) and psoas, the thoracolumbar fascia, which connects to spinal processes and other muscles, bringing in the longissimus, iliocostalis, and latissimus dorsi. Plus the glute muscles, which stabilise the pelvis from underneath.

These muscles hold your spine steady even when you’re not moving, which is crucial to protect your lower back.

What is dynamic stability and how is it different?

Dynamic stability is stability while moving. Unlike static stability, which is about holding your spine in place, dynamic stability is about muscle timing and coordination during movement.

Even if you have strength, your muscles need to contract at the right time. When pain is involved, muscle function often becomes disrupted, sending your movement patterns “out of kilter.”

This makes it vital to use targeted exercise to rebuild proper muscle timing and restore dynamic stability.

How can I tell if I have dynamic instability?

Look for smoothness of movement.

Some signs you might have dynamic instability include:

• Trouble balancing on one leg
• Wobbly walking lunges
• Difficulty walking along a beam or curb

These issues often indicate dynamic instability in the hips or ankles. This can affect your lower back further up the chain.

What is a hip hinge and why is it important for my lower back?

The hip hinge is a movement pattern that allows you to differentiate between the hips and lower back.

Moving at the hips allows you to keep your lower back neutral, which can help protect it, especially if you have a flexion-based injury. What’s more, using the glutes (especially glute max) as the primary mover, instead of the lower back muscles (longissimus, iliocostalis, multifidus), increases lifting capacity, stability, and performance.

Hip hinge movements are fundamental for dynamic stability, helping your core and hips work together efficiently.

Do I just need to strengthen my lower back?

No, focusing solely on lower back strength is not enough. A healthy spine requires:

1. Static stability of the lumbar vertebrae
2. Dynamic stability through the hips
3. Proper muscle timing
4. Hip and lower back coordination
5. Movement differentiation between hips and lower back

These five components are key when rehabilitating your lower back and maintaining long-term spinal health.

Lower back rehabilitation isn’t just about lifting more or making your back muscles stronger. It’s about building both static and dynamic stability, restoring proper muscle timing and integrating your hips and lower back in a way that protects your spine and improves movement.