Life Time has partnered with the sports health experts at NYU Langone Health to provide insights into the common health issues that have the potential to prevent you from moving freely and functioning at your best.
Meet the Experts

- Heather Milton, MS, clinical exercise physiologist, NYU Langone Health
- Kathryn Coyle, Leadership Development Manager and former National Pilates Manager, Life Time
Q: I’m trying to get back into my fitness routine, but I’m often sidetracked by low-back pain. Is this normal?
A: Low-back pain affects up to 70 percent of people at some point in their lives and is the leading cause of activity limitation — whether at work or working out. While there are many sources of lower-back pain, a common one is weakness in the “posterior chain.”
Ranging from your calves, hamstrings, and glutes to all the muscles in your back, the posterior chain includes large and small muscles that propel us forward and keep us upright.
“In terms of athletic performance, the posterior chain is important for movements like jumping, bounding, running, and sprinting,” says Heather Milton, MS, clinical exercise physiologist in the Department of Rehabilitation Medicine in the Sports Performance Center at NYU Langone Health. “It includes the muscles that help extend our hips, bend our knees, and extend our ankles.”
The posterior chain also includes muscles that stabilize your spine, whether you’re performing agility movements or maintaining a healthy posture at your desk.
“We run into trouble when little stabilizing muscles try to do big movements, or when big muscles try to stabilize us and hold us upright,” says Kathryn Coyle, Leadership Development Manager and former National Pilates Manager at Life Time. “That’s usually where pain and movement dysfunction come from.”
For example, you may over-recruit the bigger muscles in your back instead of the smaller muscles that run up the spine. If your glutes are weak, you may recruit your spinal erectors to do the work of larger muscles.
The Weak Link
Most of us can blame posterior-chain weakness on lots of sitting. “When your posterior chain muscles are not supporting good posture, you can end up with neck pain, headaches, back pain, even soreness lower down the chain,” says Milton.
Posterior-chain weakness also sets you up for injury. One of the most common injuries is muscle strain, such as when you bend over to pick something up and pull a muscle in your back, says Coyle.
The best way to prevent a weak posterior chain is to stay active, including focusing on mobility and strength training, and balancing anterior and posterior exercises to support your spine. If you’re dealing with pain and weakness, Coyle recommends simple mat Pilates exercises to wake up and strengthen the posterior chain.
- Glute Bridge: Lie on your back with your legs no wider than sitz-bone width apart and your arms lightly pressing into the floor beside you. Squeeze your glutes and lift your hips up until your shoulder, hips, and knees are all in a straight line. Hold for 30 seconds, then lower to the starting position. Perform five to 10 reps.
- Prone Firing Pattern: This movement wakes up the back body and prepares you for “flight” (the next move). Lie on your stomach, legs sitz-bones width apart. Press the tops of your feet into the mat and lift your knees. Pull your tail bone toward your heels and tighten your glutes. Hold for 10 seconds then relax. Perform five to 10 reps.
- Flight: Lie on your stomach with your legs together, arms alongside you, palms down. With your pelvis anchored into the mat, fire your glutes and inhale as you lift your upper body and legs off the ground. Hold for five full breaths, then lower to the floor. Perform five to 10 reps.