Your Low Back Pain Isn't From Playing Too Hard — It's From Sitting Too Long
You felt great playing. Now your back is locked up. It's not because you played too hard — it's a pattern that starts at your desk Monday through Friday. Here's what's actually happening and how to fix it.
By Dr. Matt Heisig, DC | Athlete Lab Performance Chiropractic | Long Beach, CA
You played some beach sports, lifted weights or went for a run over the weekend. Hours in the sand cutting hard, time on the gym floor lifting heavy, or some miles out on the strand stride after stride. You felt great doing it.
Monday morning you can barely get out of bed.
Your low back is locked up, your hips feel like they're made of concrete, and you're walking like you aged twenty years overnight. You tell yourself you'll stretch more next time. Maybe warm up better. Maybe take it easier.
But the same thing happens the following weekend. And the weekend after that.
This isn't bad luck. It isn't age. And it isn't because you played too hard. It's a structural pattern that starts Monday through Friday — and doesn't get addressed until it's too late.
The Real Problem Starts at Your Desk
Here's what's actually happening: most people spend forty-plus hours a week sitting. Sitting at a desk job, sitting when you hit the couch after work, heck, even sitting on the toilet scrolling Instagram a little too long. Sitting shortens your hip flexors — specifically the psoas and iliacus, a muscle group that attaches from your lumbar spine through your pelvis to your femur. These muscles help bring your thigh toward your torso. When these muscles stay in a shortened position for hours at a time, five days a week, they stop lengthening the way they're designed to.
By Friday afternoon, your hip flexors are essentially stuck in a shortened state. Your pelvis has tilted forward into anterior pelvic tilt. Your lumbar spine gets pulled into extension. And your glutes — which are supposed to be the primary movers in running, cutting, and jumping — have been neurologically inhibited by the shortened hip flexors pulling from the front.
Then the weekend arrives and you spend a couple hours sprinting out onto a beach for your sports, hit the strand for that run, or go pump some weights in the gym.
The research backs this up. A cohort study of ice hockey players found that athletes with hip flexor tightness were more than three times more likely to develop low back pain than those with normal hip flexibility — missing significantly more games and practices as a result. While this research focused on hockey players, the mechanism is identical regardless of your sport — hip flexor tightness creates measurable increased risk of low back pain whether you're on the ice, the sand, or the gym floor.
The problem isn't those few hours. The problem is the forty hours that came before it.
What Anterior Pelvic Tilt Actually Does to Your Low Back
Anterior pelvic tilt — where the front of your pelvis drops and your low back arches excessively — changes everything about how your spine loads under movement. When your pelvis is in this position:
Your lumbar vertebrae compress into extension with every running stride
Your glutes can't fully activate because their mechanical leverage is compromised
Your hip flexors do even more work than they should — perpetuating the cycle
Your core can't stabilize properly because the foundation it sits on is tilted
Every sprint, every lateral cut, every deadlift, every mile happens on top of this already compromised foundation. The low back isn't the weak link — it's the structure absorbing the load that should be distributed across your entire posterior chain.
By Sunday evening the muscles around your lumbar spine are exhausted from compensating for a pattern that was set up days before you even stepped foot on the sand, the strand, or the gym floor.
Why Sand Makes It Worse — For Beach Sport Athletes
Playing on sand creates significantly higher demands on your hip extensors and stabilizers than playing on grass or hardwood. Every stride requires more force to push off. Every cut requires more stability to control. Every landing requires more absorption through the lower extremity chain.
For a posterior chain that's already inhibited and a pelvis already in anterior tilt — sand is the worst possible surface to throw that much load at. Your low back ends up doing work your glutes and hips were supposed to do.
The PRI Lens — What Nobody Else Is Looking At
In the PRI world, we don't just look at the low back in isolation. We look at the whole pattern — how your pelvis, ribcage, and diaphragm relate to each other and how asymmetry in that system drives uneven loading through your spine.
Most people with chronic low back pain after long work weeks and heavy weekend activity have a Left AIC (Left Anterior Interior Chain) pattern — a predictable neurological asymmetry where the left hip flexors and right low back extensors are overworked while the right glutes and left posterior chain are underutilized. This isn't a weakness problem. It's a neurological pattern that doesn't resolve with stretching alone.
This is why two athletes can have the same job, play the same sport, and train the same hours — but one gets low back pain after every weekend and the other doesn't. The one who doesn't has a more balanced neurological pattern driving their movement. The one who does has an asymmetry nobody has identified or addressed.
Quick Self-Check: Is Your Low Back Set Up to Fail?
Stand in front of a mirror barefoot.
Does one hip sit higher than the other?
Does one foot turn out more than the other at rest?
When you put your hands on your hips, does one side feel more forward than the other?
Does your low back feel compressed or tight when you stand up straight?
If yes to any of these — your pelvis is already in a pattern that's loading your low back asymmetrically. Every sprint, cut, deadlift, and mile is happening on top of that.
What Actually Fixes It
Three things that most treatment protocols either skip or rush through:
1. Release the overworked tissue. Deep soft tissue work to address the psoas, TFL, lumbar paraspinals, and other muscles that have been chronically overworked. This isn't a foam roll — this is targeted manual therapy to the specific structures that are driving the pattern.
2. Reposition the pelvis. PRI-based repositioning exercises that restore the neurological balance between your hip flexors and posterior chain. The goal isn't just stretching the hip flexors — it's restoring the relationship between your pelvis, ribcage, and diaphragm so the pattern doesn't immediately return.
3. Activate the right muscles. Once the pelvis is in a better position, your glutes and posterior chain need to be activated in that new position. This is the piece most people skip — and why stretching alone never seems to hold. If you don't activate the muscles that are supposed to be working, the overactive ones just take over again.
The Pattern That Changes Everything
The athletes who stop getting low back pain after every weekend aren't the ones who stretched more or warmed up longer. They're the ones who addressed the underlying pattern — the anterior pelvic tilt, the neurological asymmetry, the inhibited posterior chain — and gave their low back a foundation it could actually work from.
You shouldn't have to choose between your career and your weekend activities. You shouldn't have to spend Monday limping around the office paying for a weekend you loved.
Come see me at Athlete Lab before that pattern gets any deeper.
Dealing with chronic low back pain or hip tightness after weekend activity? Book your Initial Evaluation at Athlete Lab Performance Chiropractic in Long Beach. No referral needed — just show up ready to move.
McHugh MP, Tyler TF, Schmitt BM, Kwiecien SY, Nicholas SJ. "The Association Between Hip Flexibility and Low Back Pain in Ice Hockey Players." Orthopaedic Journal of Sports Medicine. 2025. PMID: 41660292. DOI: 10.1177/23259671251404068
About the Author: Dr. Matt Heisig is a Doctor of Chiropractic and founder of Athlete Lab Performance Chiropractic in Long Beach, CA. A graduate of Southern California University of Health Sciences with a sports medicine emphasis, Dr. Matt utilizes PRI methodology, active movement rehab, and performance-focused care for athletes at all levels. He sees patients at Long Beach Rising on weekends.
Athlete Lab Performance Chiropractic is located inside Long Beach Rising at 205 E Anaheim St, Long Beach, CA 90813. Dr. Matt Heisig, DC sees patients on weekends and accepts HSA/FSA.
Why Your Ankle Keeps Rolling — And Why the Problem Isn’t Actually Your Ankle
If you've sprained the same ankle two or three times, rest and tape aren't the answer. Here's what's actually driving the recurrence — and what fixes it for good.
Why Your Ankle Keeps Rolling — And Why the Problem Isn’t Actually Your Ankle
By Dr. Matt Heisig, DC | Athlete Lab Performance Chiropractic | Long Beach, CA
You’re playing beach soccer out in the Belmont Shores sand on a Sunday morning. You plant your foot to cut left, your ankle rolls outward, and you feel that familiar pop. You hobble off, ice it, tape it up, and tell yourself you’ll be fine by next weekend.
And you probably will be.
Until it happens again.
If you’ve sprained the same ankle two, three, or four times — welcome to one of the most common and most misunderstood injury patterns in sports. Almost half of all sports-related injuries are ankle sprains, and the vast majority of athletes who sprain their ankle once will do it again. That recurrence rate isn’t bad luck. It tends to be a structural problem that nobody addressed the first time.
What Actually Happens When You Sprain Your Ankle
An ankle sprain occurs when the foot rolls inward or outward beyond its normal range and the ligaments on the outside of the ankle get stretched or torn. The most common version — the lateral (inversion) ankle sprain — involves the anterior talofibular ligament (ATFL) and sometimes the calcaneofibular ligament (CFL). These structures are responsible for keeping your ankle from rolling outward.
There are three grades of severity:
Grade I — ligament stretching, mild swelling, you can still walk
Grade II — partial ligament tear, significant swelling and bruising, walking is painful
Grade III — complete ligament rupture, major instability, usually requires more aggressive intervention
Most beach athletes deal with Grade I and II sprains repeatedly. They rest it, tape it, and get back out there — without ever understanding why the ankle keeps giving way.
The Real Reason It Keeps Happening
Here’s what the RICE protocol and a week of rest don’t fix: proprioception.
Proprioception is your body’s ability to sense where your joints are in space — its position sense. When you sprain your ankle, you don’t just damage ligaments. You damage the mechanoreceptors embedded in those ligaments — the sensory nerve endings that tell your nervous system where your foot is relative to the ground at any given moment.
When those receptors are damaged and never properly retrained, your ankle loses its ability to self-correct in real time. The next time you plant your foot on uneven sand or make a quick lateral cut, the nervous system doesn’t respond fast enough to prevent the roll. The ligaments take the load again. You sprain it again.
This is why taping helps in the short term — it provides external proprioceptive input — but it doesn’t fix the underlying deficit. You’re compensating for a problem, not solving it.
Here's something that surprises most athletes: research shows that repeated ankle sprains on one side can create neurological deficits on the opposite ankle — a 2019 study found that individuals with recurrent ankle sprains demonstrated postural instability and neuromuscular control deficits on their unaffected side. Because those motor feedback signals are processed centrally in the brain, the compensation patterns don't stay local. Your "good" ankle may already be affected in ways you can't feel yet — which is why a thorough assessment of both sides matters, even when only one has been visibly injured.
The good news — proper rehab works bilaterally too. Retraining the proprioceptive system on the injured side has positive carryover effects on the uninjured side as well.
Why Sand Makes This Worse
Not all athletes are playing in the sand — but as a fellow weekend sand sport participant myself, I can tell you firsthand: beach volleyball, beach soccer, and flag football on sand are genuinely harder on your ankles than grass or hardwood. And not just because the surface is uneven.
Sand requires constant micro-corrections from your ankle and foot with every step. Your stabilizing muscles have to work significantly harder to maintain balance and generate force. For an ankle with compromised proprioception and ligament integrity from a previous sprain, that demand is exactly what drives re-injury.
Add in the fact that most Long Beach beach athletes are playing multiple hours of sport on a Sunday after a week of sitting at a desk — cold, stiff, and without a meaningful warm-up — and you have a setup that makes ankle re-injury almost inevitable.
The Upstream Problem Nobody Looks At
Here’s the part that surprises most athletes: chronic ankle sprains often have a root cause that has nothing to do with the ankle itself.
In the PRI world, we look at the entire kinetic chain — how your foot, ankle, knee, hip, pelvis, and ribcage relate to each other structurally. As I've written about in previous posts, the body's compensation patterns don't stay local — a shoulder injury affects the opposite shoulder, and a hip asymmetry affects how your ankle loads the ground. A pelvis that’s shifted or rotated asymmetrically changes how load is distributed through your lower extremities. A hip that’s not loading correctly changes how your foot contacts the ground. A foot that’s consistently supinating (rolling outward) on contact is often doing so because of something happening upstream at the hip or pelvis — not because of weak ankle ligaments.
This is why two athletes can have the same ankle sprain and one recovers fully while the other keeps re-injuring: the one who keeps re-injuring has a structural pattern driving the problem that nobody ever found.
Quick Self-Check: Is Your Ankle Structurally Vulnerable Right Now?
Stand barefoot on one foot for 10 seconds. Then switch.
• Does one side feel noticeably less stable than the other?
• Does your ankle wobble or compensate more on one side?
• Does the foot that sprains most often turn out more at rest than the other?
If yes to any of these — your proprioceptive system is already compromised on that side, or you have an existing asymmetry that’s loading that ankle differently. Both are worth addressing before the next sprain happens rather than after.
What Actually Fixes It
Effective ankle sprain rehab has three components that most treatment protocols either rush through or skip entirely:
1. Clear the tissue
Soft tissue work to address the swelling, adhesion, and restricted mobility that builds up around the ankle, subtalar joint, and lower leg after a sprain. RockFloss compression band flossing is particularly effective here — it restores joint mechanics quickly and reduces swelling that limits range of motion.
2. Retrain Proprioception
This is the piece that determines whether you sprain it again — and it’s the piece most athletes skip entirely.
After a sprain, the mechanoreceptors in your ankle ligaments need to be systematically rechallenged and rebuilt. At Athlete Lab we use Propriofoot graduated balance platforms — a progression-based training system that starts with a stable base and works through increasing levels of instability, forcing the nervous system to rebuild its position sense from the ground up.
The progression matters. Jumping straight to single-leg balance on an unstable surface before the basic sensory pathways are restored is like trying to run before you can walk — you’re training compensation, not proprioception. The Propriofoot system’s graduated levels mean we meet your ankle where it actually is, not where you think it is.
This doesn’t happen passively on a treatment table. It happens on your feet, with progressive loading, until your ankle can self-correct faster than the sprain mechanism can occur.
3. Address the upstream cause
If there’s a hip, pelvis, or ribcage asymmetry driving how your foot loads the ground, it needs to be identified and corrected. PRI-based repositioning work addresses the neurological patterns that predispose one ankle to loading asymmetrically. Without this piece, you’re managing symptoms indefinitely.
Propriofoot graduated proprioceptive training platforms used at Athlete Lab Performance Chiropractic. Each color represents a progressive level of instability — from the most stable base to the most challenging — systematically rebuilding the sensory feedback loop between the ankle and the nervous system after a sprain.
Single-leg balance training on a Propriofoot proprioceptive platform during an active rehab session at Athlete Lab Performance Chiropractic in Long Beach, CA. This progressive stability work is a core component of chronic ankle sprain treatment — retraining the mechanoreceptors that are damaged during a sprain and never properly rehabilitated through rest alone.
The Bottom Line
An ankle sprain is not just a sprained ankle. It’s a proprioceptive deficit, a potential structural pattern, and — if not addressed properly — a recurring problem that compounds with every re-injury. Ligaments that are repeatedly sprained develop scar tissue, lose tensile strength, and create progressively more instability over time.
The athletes who sprain their ankle once and never again are the ones who did the full work — not the ones who iced it and taped it and hoped for the best.
If you’re on your second, third, or fourth ankle sprain, the answer isn’t more tape. It’s finding out what’s actually driving it — and fixing that.
Dealing with a recurring ankle sprain? Book your Initial Evaluation at Athlete Lab Performance Chiropractic in Long Beach. No referral needed — just show up ready to move.
Gillman SF. "The Impact of Chiropractic Manipulative Therapy on Chronic Recurrent Lateral Ankle Sprain Syndrome in Two Young Athletes." Journal of Chiropractic Medicine. 2004;3(4):153-159.
Lee JH, Lee SH, Choi GW, Jung HW, Jang WY. "Individuals with recurrent ankle sprain demonstrate postural instability and neuromuscular control deficits in unaffected side." Knee Surgery, Sports Traumatology, Arthroscopy. 2019;27(8):2500-2508. PMID: 30291398.
About the Author: Dr. Matt Heisig is a Doctor of Chiropractic and founder of Athlete Lab Performance Chiropractic in Long Beach, CA. A graduate of Southern California University of Health Sciences with a sports medicine emphasis, Dr. Matt utilizes PRI methodology, active movement rehab, and performance-focused care for athletes at all levels. He sees patients at Long Beach Rising on weekends.
Athlete Lab Performance Chiropractic is located inside Long Beach Rising at 205 E Anaheim St, Long Beach, CA 90813. Dr. Matt Heisig, DC sees patients on weekends and accepts HSA/FSA.