Hip & Low Back Pain Management
Lack of hip mobility, specifically hip internal/external rotation, and hip extension, are very closely related to low back pain. In fact, just a 10 degree loss in hip extension can cause daily low back pain and aches.
Loss of hip mobility can be caused by sitting majority of the day, lack of exercise, but also due to the way we walk, how we carry things, prolonged jogging, and what side we choose as our dominate side in sports/everyday life. Yes, hip IM-mobility can be caused by overuse of other hip motions in your sport/activity of choice. I do want to make note on the fact that if you sit at a desk for work, for a minimum of 40 hour weeks, that equates to 10,000 hours of sitting per year (50 weeks). At minimum! Not to mention the time you spent sitting in your car to drive to work, then sitting for lunch, sitting on the ride back to work, sitting for dinner, then sitting again to hang out with friends/family, do more work, then finally bed.
There are many muscles that support the hip and low back and often spasm/get tight with overuse and immobility.The psoas is a deep hip flexor muscle that originates at the lumbar spine and wraps around to connect in to front of the pelvis the the greater trochanter on our femur. This is a major hip flexor muscle; it contracts and lifts your hip/leg up. Now if you are sitting majority of the day, placing this muscle in a shortened position, then it’s going to get tight, spasm and pull on the low back area where it originates at. Hence, causing low back pain and tightness. The piriformis, tensor fascia latae, and glut medius are the lateral hip musculature that contribute to low back pain. They are responsible for externally rotating the hip, stabilizing the leg in single leg stance, and supporting your pelvis, spine, and posture. They often are the key players when it comes to low back and hip pain.
These are 6 stretches you can start today to help improving your hip mobility and reducing low back pain.
1. Adductor split stance with arm reach
Kneel onto a pillow with one knee, and extend the other leg straight out to the side. You’re then going to gently ease your hip back down onto the heel of the kneeling leg. Use your hands at your side for support to monitor how far you can go down. Do not push through pain. Then rise back up into tall kneeling and swing your arms overhead and look back. Run through this 3 times each side. Then continue this but now take your arm and reach across your body, causing a rotation of your spine and look back. Repeat 3 times each side.
-Modification= If this bother’s your knee too much, try the frog pose. Kneel on both knees in a wide stance, and slowly walk your arms out in front of you. Your feet may come together in the back, and then you are gently rocking back and forth in this position. This is great for pelvic floor tension, especially when pregnant.
- Assume the pigeon pose position with one knee tucked up under your chest, pillow under the knee if knee pain occurs or severely limited in hip mobility, and the other leg extended back under you. Now gently lean forward and over your bent knee in front, and then come back up, and when coming back up, try and reach your arms and hands overhead and arch back. This will really open those hips and back. Repeat 2-3 times. Then, take 1 arm and reach across and back, causing a spinal rotation. Repeat 2-3 times on each side.
-Modification= Perform while seated in a chair.
You can perform this with a stable chair, couch, a step, or you can just step through a doorway if you do not have an elevated surface to place your foot on. Start by placing one foot on the chair in front, and then lean forward reaching your hands forward, and then come back reaching your hands over head and back. The heel needs to stay down on the front foot on the chair. You should feel a stretch in the hamstring, calf, knee of the elevated leg, and a stretch in the front of the hip (hip flexors) of the stance leg behind. Repeat 2-3 times, then start with the rotations, reaching your arms across and looking back 2-3 times each side.
4. Hip Rocking
Start on the ground with your knees bent and rotated to one side so your knees are touching the ground, and try as best as you can to keep both gluts on the ground. Then keeping your back upright, start to rotate the knees to the other side, all while keeping the hips glues to the ground. If you want to challenge yourself, bring your arms overhead the whole time while doing this.
5. Hip CARS (Controlled Articulating Rotations):
A. Kneeling on all fours= Stabilize your shoulders by pushing the ground away, brace your core (do not sag through your back), drive the right knee up to the outside of the right elbow, push out to the side, extend back and kick your foot up to the ceiling, then bring the knee back by the elbow. Try in reverse as well.
B. Standing Hip CARS= Hold onto a wooden dowel, doorway, chair, or something to help stabilize your core/stance leg. Drive through the standing leg, and bring the opposite knee up to hip height, rotate out to the side, back into extension with your foot facing the ceiling, and return to the ground. Try in reverse.
6. Psoas Trigger Point Release
Try this release only if you have no stomach/pelvic issues, and are not pregnant. Grab a lacrosse ball or soft theraball, or tennis ball, place fingers 2 finger widths inside your pelvic bone, raise the thigh of that same side to feel the psoas contract under your fingertips. This is where you'll place the ball. Gently lye on your stomach with the ball at the area, breath deep and relax over the ball. Try different drivers with your head, chest, or foot to improve the trigger point release.
