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Repeated Sports Injuries 101: Lower Back Pain, Achey Knees & Hamstring Pulls (And How to Fix Them)

Why You Keep Getting Lower Back Pain When You Exercise

Ever wonder why you keep getting lower back pain,  repeated hamstring injuries, as well as those achy knees when you play basketball?

As it turns out, they’re all related.

If You Repeatedly Pull Your Hamstrings, Have Frontal Knee Pain, Or Have Lower Back Pain

Lower crossed syndrome

Ahhh. The sitter’s disease.

What’s called “lower crossed syndrome” is just a really dorky name for “overly tight hip muscles and an overly arched back.”

In lower crossed syndrome (which is extremely common in people who sit a lot), there is an exaggerated arch in the lower back. The hamstrings are pulled tight, and the hip flexors are really in overdrive. The abs are also stretched out.

If you sit all day, you probably have this.

What happens? There is an exaggerated amount of pressure on the spine and lower back because of the overly-dramatic arch (do you get lower back pain when running? How about deep squatting? yep…). The other thing is that the knees have increased strain in the front.

What’s going on that is causing you pain?

There are two things going on here: the back is overly arched, and the hips are losing their ability to really fully extend.  So what happens is that when you exercise, your lower lumbar spine is taking more of a load than it normally would.  Once you get that back straightened out, it will load weight properly again.

Priority: Get that lower back straight baby!

How to fix it:

  1. Stretch the shortened muscles: gastrocnemius/soleus, hip flexors, spinal erector muscles
  2. Strengthen the weakened muscles: glutes (medius, maximus), abdominal muscles (transversus abdominus, internal obliques)

Stretch the Shortened Muscles:

I would recommend doing 2 sets of 30 – 60 seconds for each side of the body, ideally every day. Five minutes a day will go a long way towards helping fix the pain and align the body better.

A. Leaning gastrocnemius/calf stretch

Static gastrocnemius

B. Wall calf stretch


D. Hip flexor stretches

hip flexor

Strengthen the weakened muscles:

I would recommend doing 4 sets of 8-12 reps for all of these exercises, ideally up to 2x a week.

Gluteal Muscles

Glute Bridge


Gluteus Medius Exercises

The Clam

Abdominal Muscles



Lower crossed syndrome recap and re-training:

So what’s going on on here?

Basically because of a combination of muscle tightness and muscle weakness, your lower back is overly arched.

This causes a couple issues: the knees begin to have issues, hamstring pulls become more common (because the hamstrings are pulled tight), and if you are doing any kind of exercising, you are probably experiencing lower back pain (especially if doing squats).

With an overly-arched back, it’s crazy important to remember to clench your abs tight when you do any overhead movements, or any squatting movements. The tendency is to stick the butt out and arch the back, which will produce back pain.

The key is to be aware of your posture when exercising: when squatting for example, make sure to clench the core tight and focus on maintaining that as you go down.

How Often Should I Do All These Things?

If you’ve been repeatedly getting the same injuries or pain, then you should just incorporate these into a 5 or 10 minute mobility session 5+ times a week.

Throwing in 5 minutes 4-5 days a week will actually go a long way towards improving that mobility and will produce noticeable pain relief.

Why You’re Suffering From Chronic Pain And Repeated Injuries

In my own experience these are mostly issues caused by sedentary life.

Being sedentary does two major things:

  1. A. Lets muscles atrophy (basically everything if you aren’t exercising)
  2. B. Tightens certain muscle groups (like the hips and groin, or neck and back)

The result? These two things lead to poor bodily alignment – which is especially problematic when exercising.

Poor bodily alignment leads us to a few things:

  1. Chronic tension (like upper back pain from hunching over a computer all day).
  2. Improper muscle activation and bio-mechanics when exercising (back pain or knee pain when running? Shoulder pain when bench-pressing or doing pushups?)
  3. Forces certain body parts into positions they don’t like to be in for a long time (like your neck from looking at a computer screen. This is actually why I had insomnia for close to two years – pain! – and no one had any idea what was going on.)

These all lead us down the road to chronic pain.

Just check out my “Why Cavemen Never Had Backpain” post. Look at the pictures of people’s posture in the 1800s and 1900s compared to now. It’s scary.

A lot has changed in the last hundred years. We really do need to treat health as modern health. The requirements for modern humans to get healthy, fix pain, or lose weight are far different from someone 100 years ago.

So just remember these few key points when you exercise, do stretches when you can throughout the day, and then let me know how it goes.

That’ll help get you on the path back to recovery.

— Alex

Have You Read My New Book Yet?

  Read more about this in my book Master The Day. You’ll learn the nine daily success habits I learned interviewing people that lost 100+ pounds and kept it off in a healthy way – by changing their habits. Plus, you’ll get a free $100 bonus video course if you show me your receipt. You can get the audiobook here too.

2 comments… add one

  1. Spot on with all the other research and tests ive done. Thanks.

  2. This article is fantastic, thanks so much for writing it! Truly the sitting disease, but so great to see some solutions!!


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