Skip to main content

Extension Intolerance

We’ve been talking about back pain this week. First, we made a distinction between the different causes of back pain and the different types of back pain. Next, we talked about flexion intolerance, it’s causes, and how to fix it. In this post, we are covering the other kind of common back pain, Extension intolerance.

Remember, this information assumes no structural issues with you back. If you believe you have something like a bulging disc, see a professional.

Extension Intolerance

If flexion intolerance is when you have pain bending over, extension intolerance is when you have pain standing straight up or leaning back.

If you have back pain from standing for long periods of time, or bending over makes your back feel better, you likely have extension intolerance. Sometimes, extension intolerance pain is described as a pinching feeling in the low back when you lean backward.


Extension intolerance isn’t actually an issue with our low back. Tightness in the surrounding muscles and/or weakness in the core is usually the cause.

When tightness is the cause of our low back pain, extension pain usually stems from tightness in our hips. The quad and hip flexor muscles all attach in the front part of our hips. When these muscles are tight, it can pull the upper crest of our hip forward. This is known as an anterior pelvic tilt. An anterior pelvic tilt causes compression forces on our low back and we get pain.

Assuming we have plenty of mobility around the hip joint, a weak core can also cause extension pain. The core muscle also help keep the hips in alignment. When our core is weak, the hips will fall out of alignment, especially when we move. This can cause the low back to move into a vulnerable position. Lifting objects in this vulnerable position can lead to acute extension intolerance.

How Do We Fix It?

Knowing the likely causes of extension intolerance, we know how to fix it.

First, address the mobility issue. Make sure you quads and hip flexors are loose. If you sit a lot during the day, you likely have tight hip flexors. An anterior pelvic tilt is also seen quite often in women who wear high heel shoes. Any quad stretch will help. However, we really like the Couch Stretch or the Samsun Stretch.

Once the mobility has improved, you need to increase your core strength in this new range of motion. Unfortunately, increased mobility can be a cause of new pain if you don’t teach yourself control in that new position. Our favorite movement for core strength is a simple Plank Hold.