Tight hip flexors can also make it harder for your glutes to activate—since they're opposing muscle groups, when one is really tight the other becomes lengthened. When a muscle is more lengthened than it should be, it takes away some of its ability to contract. When your glutes are in this compromised position, it can cause other muscles to do more work than they should, making your workouts less efficient and sometimes, increasing your risk of injury.


Marvelously progressive, concise, and cogent guidelines for physicians on the treatment of low back pain. These guidelines almost entirely “get it right” in my opinion, and are completely consistent with recommendations I’ve been making for years on PainScience.com. They are particularly to be praised for strongly discouraging physicians from ordering imaging tests only “for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected.”

That is, the parts of your body that touch a saddle when riding a horse: groin, buttock, and inner thighs. I experienced rather intense, terrifying awareness of symptoms in this area in the aftermath of my wife’s car accident in early 2010. With a mangled T12 vertebrae, she was at real risk of exactly this problem. Fortunately, she escaped that quite serious problem. But, sheesh, I was vigilant about it for a while! “Honey, any numbness in your saddle area today?” BACK TO TEXT
Enthoven WT, Geuze J, Scheele J, et al. Prevalence and "Red Flags" Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma. BACK TO TEXT
Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.
There are differences in symptoms between spinal stenosis pain and herniated or ruptured disc pain. A herniated disc often is more painful when sitting and relieved by standing or walking (opposite of stenosis). A herniated disc can cause sciatica (so can stenosis) and can be a result of degenerative changes in the disc. Sciatica will commonly radiate or travel down the backside of the thigh, into the calf and sometimes the foot itself.>
In addition to these exercises, there are simple things you can do every day to help reduce your risk of hip flexor pain.  If you sit at a desk for long periods of time, try to get up and move around every hour or so.  Warm up properly before any physical activity, and stretch regularly at the end of each workout.  Your hips will thank you for it! 
However, runners are infamous for imbalances in their hip muscles. The most common weak ones are the hip abductors, the muscles on the side of your butt responsible for moving your leg out away from your body to the side. Lev Kalika, D.C., clinical director of New York Dynamic Neuromuscular Rehabilitation & Physical Therapy, tells SELF that since most runners run, run, and only run, they are constantly training their hip flexors and extensors through a very small range of motion. That can lead the hips to be unstable on the less-frequent occasions when you bring your knee all the way to your chest or thrust your hips forward.

The piriformis muscle connects the top of the femur to the spine, and it’s the main one that supports the outward movement of the hip, upper leg, and foot. The sciatic nerve can sometimes pass through this muscle and thus cause sciatica symptoms, otherwise known as piriformis syndrome, characterized by pain in the lower back and hips, poor movement, and balance. Therefore, the main cause of sciatica is the swelling or constriction of the piriformis muscle, but it can also be a result of some other factors as well.


You’ve heard the saying: it’s all in the hips, but for many of us, our hips – or more precisely, our hip flexors – are tight, stiff and inflexible. If you’re an office worker you can probably thank sitting down at your desk 8 or more hours a day for your tight hip flexors. Habitual sitting causes your hip flexors to tighten and shorten – adjustable standing desks, anyone?
How to: Start feet hip-width apart, with your arms straight out in front of you. Step one foot back on a diagonal, feet flat. Once your foot reaches the floor, lower into a shallow lunge. Keep your knee bent and butt back, twist your pelvis, and rotate your arms back behind your body until they frame the knee. Return to starting position. That's one rep. Do eight reps on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
Unilateral exercises like step-ups and single-leg toe touches are particularly effective at strengthening the glutes, while walking lunges, lateral lunges, air squats, and jump squats will zero in on all the muscles surrounding the hips. Whether you’re at the gym or heading out for (or back from!) a run, these five moves will strengthen and open your hips, keep them loose long-term, and not only make you a better runner, but make running feel better to you.
You'll need a resistance band for this one. With this exercise you're focusing on four movements—flexion, extension, abduction and adduction. Try and stand up straight while doing the exercise. If you have to lean excessively, step closer to the anchor point of your band to decrease resistance. You'll find that not only are you working the muscles of the leg that's moving, the muscles of your stance leg will work quite hard stabilizing and balancing.
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful (especially in the early stages). For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!

In the vast majority of patients with low back pain, symptoms can be attributed to nonspecific mechanical factors. However, in a much smaller percentage of patients, the cause of back pain may be something more serious, such as cancer, cauda equina syndrome, spinal infection, spinal compression fractures, spinal stress fractures, ankylosing spondylitis, or aneurysm.
In this study, one patient with sciatica was sent for ten MRIs, which produced 49 distinct “findings,” 16 of them unique, none of which occurred in all ten reports. On average, each radiologist made about a dozen errors, seeing one or two things that weren’t there and missing about ten things that were. Yikes. Read a more detailed and informal description of this study.

There is controversy and scientific uncertainty about trigger points. It’s undeniable that mammals suffer from sensitive spots in our soft tissues … but their nature remains unclear, and the “tiny cramp” theory could be wrong. The tiny cramp theory is formally known as the “expanded integrated hypothesis,” and it has been prominently criticized by Quintner et al (and not many others). However, it’s the mostly widely accepted explanation for now. BACK TO TEXT

While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.
2016 — More editing, more! Added some better information about pain being a poor indicator, and the role of myofascial trigger points. This article has become extremely busy in the last couple months — about 4,000 readers per day, as described here — so I am really polishing it and making sure that it’s the best possible answer to people’s fears about back pain.
Marvelously progressive, concise, and cogent guidelines for physicians on the treatment of low back pain. These guidelines almost entirely “get it right” in my opinion, and are completely consistent with recommendations I’ve been making for years on PainScience.com. They are particularly to be praised for strongly discouraging physicians from ordering imaging tests only “for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected.”

The piriformis muscle connects the top of the femur to the spine, and it’s the main one that supports the outward movement of the hip, upper leg, and foot. The sciatic nerve can sometimes pass through this muscle and thus cause sciatica symptoms, otherwise known as piriformis syndrome, characterized by pain in the lower back and hips, poor movement, and balance. Therefore, the main cause of sciatica is the swelling or constriction of the piriformis muscle, but it can also be a result of some other factors as well.
Squats. Using a squat machine will strengthen your quadriceps muscles on the front of your thigh and the hamstring muscles on the back of your thigh, both of which attach to your hip and give it support. The squat machine may be vertical, in which case you’ll start in a standing position and bend your knees until your thighs are parallel to the floor, or it may be on a sliding incline board.
While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.
The side of the pain on its own doesn’t tell us much, and most of the one-sided sources of pain are viscera that usually cause abdominal pain instead of back pain, or in addition to it. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other red flags or significant non-back symptoms.
• Scoliosis. Instead of running straight up the center of the back, a spine with scoliosis twists to one side. Scoliosis can be classified as true (meaning it has to do with abnormal development of the spine) or functional (meaning its cause is not directly related to the spine). Functional scoliosis may occur when a discrepancy in leg length causes the pelvis to tilt to one side to compensate. The cause of true scoliosis is largely unknown, although doctors suspect that it may be the result of imbalanced growth in childhood.
Sit on floor with knees bent and shins stacked with right leg on top. Use your hand to position right ankle on left knee. Ideally, the right knee will rest on the left thigh, but if your hips are tight, your right knee may point up toward the ceiling (overtime, as your hips become more open, your knee will lower). Keeping your hips squared to the front of the room, hinge at the hips and slowly walk hands slightly forward. If this is enough of a stretch, hold here, or fold your torso over your thighs to go deeper. Hold for at least 30 seconds, then repeat on opposite side.
Ankylosing spondylitis is a type of arthritis that specifically affects the spine. Ankylosing spondylitis causes a severe inflammation of the spinal vertebra that can cause debilitating pain throughout the back region. This condition can cause stiffness and pain not only in the spine but also inflammation, pain and stiffness in the ribs, shoulders, ribcage, hands, and feet as well. Symptoms include a dull pain in the lower back and buttocks, stiffness and lack of mobility in the hips, back, and legs, loss of appetite, fever, and general malaise. Treatment includes physical therapy, medication, hot and cold therapy, and exercises that reinforce good posture practices.
The sciatic nerve is the largest and longest nerve in the body. It arises from the spinal cord as a collection of fibers from the lower vertebrae. This nerve is responsible for the sensation of the skin of the foot and entire lower leg except for a small area on the inner side. It also supplies muscles in the anterior, lateral and posterior compartments of the leg.

Unilateral exercises like step-ups and single-leg toe touches are particularly effective at strengthening the glutes, while walking lunges, lateral lunges, air squats, and jump squats will zero in on all the muscles surrounding the hips. Whether you’re at the gym or heading out for (or back from!) a run, these five moves will strengthen and open your hips, keep them loose long-term, and not only make you a better runner, but make running feel better to you.
To complete this stretch, take a knee in front of a wall so that the toes of the leg you have raised are pressing against the wall. Place that same hand against the wall. Reach behind you with your other hand and grab your leg that’s sitting on the floor by the ankle, and bend it back towards your body. Hold this position and lunge forward towards the wall to complete the stretch. Hold this stretch for 10 seconds, then repeat on the other side of your body.
• Sciatica. This is inflammation of the sciatic nerve. The largest nerve in the human body, the sciatic nerve runs from the lower part of the spinal cord, through the buttock and down the back of the leg to the foot. The most common causes of sciatica include compression of the nerve where it exists the spine by a herniated disc, or a rupture of one of the structures that cushions the vertebrae in the spine. Sciatica may be felt as a sharp or burning pain that radiates from the hip. It may also be accompanied by low back pain.

Tight hip flexors can result in lower back pain, hip pain and injury.  A lot of strain is put on those muscles during activities that involve sprinting and kicking.  For example, runners are more prone to hip flexor injuries because of the small, repetitive movement during running.   But even if you’re not an athlete, hip flexor injuries can occur during everyday activities (for instance, slipping and falling or running to catch a bus).  When those tight muscles are suddenly stretched beyond what they are accustomed to, you might also experience pain in the upper groin region, typically where the hip meets the pelvis.   
These issues tend to be more rampant in women because they generally have wider pelvises than men, Ali Kotek, M.A., A.T.C., P.E.S., a performance enhancement specialist and fellow endurance program manager at Athletico, tells SELF. So to keep the thighs vertical, rather than angled in toward each other, the outer hips have to be even stronger. That’s especially true for women who are bounding from one foot to the other as they run down trails and treadmill belts.
Treatment for arthritis focuses on relieving symptoms and improving mobility. Your doctor may recommend anti-inflammatory medications and/or pain relievers. They might also prescribe disease-modifying antirheumatic drugs (DMARDs) — drugs meant to slow or stop your immune system from attacking your joints. Your doctor may also recommend physical therapy to strengthen your joints and increase your range of motion. For more severe cases, surgery may be required.
The cross-legged twist will stretch the outside of your hips and part of your buttocks. Sit crossed-legged on the floor and then lift your right leg and place your foot on the outside of the bent left leg. Twist your upper body to look over your right shoulder. You can reach your left arm to the outside of your right leg to hold the stretch and place your right hand on the floor behind you for support. After 30 to 40 seconds, switch sides.

Tight hip flexors can also make it harder for your glutes to activate—since they're opposing muscle groups, when one is really tight the other becomes lengthened. When a muscle is more lengthened than it should be, it takes away some of its ability to contract. When your glutes are in this compromised position, it can cause other muscles to do more work than they should, making your workouts less efficient and sometimes, increasing your risk of injury.
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