I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
This restorative pose will stretch your shins, knees, hips, spine, and arms. Start with your hands and knees on the mat. Point your toes behind you, allowing your big toes to touch, and spread your knees slightly wider than your hips. Keeping your back flat, sit back on your heels and lower your torso between the legs as you reach as far forward as you can with your arms. Keep your elbows elevated, and rest your forehead on your mat if you can. Take 10-15 breaths, and then release.

• 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.
Some back pain is caused from a "ruptured disc". This pain is often experienced in the gluteal region of the body. Many people call this the "hip" region although it is not usually indicative of a hip joint problem. This is actually behind the hip, an important anatomic thought when considering hip pain, rather than in the hip itself. A condition related to degeneration of the lower back creating narrowing of the spinal canal or adjacent areas is called spinal stenosis and frequently causes pain in the hip region. The history of stenosis has to be compared with hip joint pain. Spinal stenosis can cause leg pain while walking as well as fatigue in the legs even when rising from a chair. Stenosis pain is relieved with sitting and will re-occur when walking is resumed.

• 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.
Back “spasms” are a largely a myth — there’s no such thing a sustained painful contractions of muscles in otherwise healthy people (see Cramps, Spasms, Tremors & Twitches) — but the kernel of truth in the idea of “spasms” may be the idea of trigger points, which are hypothetical “micro cramps,” tiny patches of painfully contracting muscle. Although this idea is controversial, it is nevertheless one of the most likely explanations for common aches and pains that mostly stick to one area (especially the back) and have no other obvious cause. See Back Pain & Trigger Points. BACK TO TEXT
Avulsion fractures of the apophyses of the pelvis are rare injuries. This injury occurs mainly in young persons, between the ages of 8 and 14, before they've fully grown. That is because fusion of these bones does not occur until between the ages of 15 and 17 years. The cause is typically a contraction of muscles during extreme sports activity. Treatment includes rest and physical therapy as well as pain medications.
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Some of these red flags are much less red than others, especially depending on the circumstances. For instance, “weight loss” is common and often the sign of successful diet! (Well, at least temporarily successful, anyway. 😃) Obviously, if you know of a harmless reason why you have a red flag symptom, it isn’t really a red flag (duh!). But every single actual red flag — in combination with severe low back pain that’s been going on for several weeks — is definitely a good reason to get yourself checked out.

In cases of strains, tears, and other injuries, strapping or taping your lower back will provide the extra support it needs. Alternatively, for extra support, try the Elastoplast back brace. This will not only promote the natural shape of your lower back during exercise or daily life, but also limit any extra strain placed on your back. For tips on how to apply strapping and tape effectively, see our section on tape and strapping preparation.

The materials and information provided in this presentation, document and/or any other communication (“Communication”) from Onnit Labs, Inc. or any related entity or person (collectively “Onnit”) are strictly for informational purposes only and are not intended for use as diagnosis, prevention or treatment of a health problem or as a substitute for consulting a qualified medical professional. Some of the concepts presented herein may be theoretical.

While leg lifts, certain ab exercises, and even hula hooping can all help work the hips, the hip flexors can still be a tricky part of the body to stretch Kinetics of hula hooping: An inverse dynamics analysis. Cluff, T., Robertson, D.G., and Balasubramaniam, R. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. Human Movement Science, 2008 Aug; 27 (4): 622-35.. To get them even stronger and more flexible, try these five simple hip flexor stretches:


The hip joint is designed to withstand a fair amount of wear and tear, but it’s not indestructible. For example, when you walk, a cushion of cartilage helps prevent friction as the hip bone moves in its socket. With age and use, this cartilage can wear down or become damaged, or the hip bone itself can be fractured during a fall. In fact, more than 300,000 adults over 65 are hospitalized for hip fractures each year, according to the Agency for Healthcare Research and Quality.


The hip is a common site of osteoarthritis. To help protect the hip joint from "wear and tear," it is important to strengthen the muscles that support it. Your hip also controls the position of your knee, and strengthening your hips may be one component of your rehab program for knee pain. Your physical therapist may also prescribe hip exercises after total hip replacement if you have a hip labrum tear or as part of your hip exercise program for hip pain.
At the very least, the tension and/or spasm in muscles that cross over the hip and attach onto the pelvis can contribute to imbalance, in terms of how strong and flexible each muscle group is in relation to the others. But muscle imbalance in the hips and the spine may make for pain, limitation and/or posture problems. It can also increase the healing challenge put to you by an existing injury or condition, for example, scoliosis.

If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency — do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention. (Few people will have symptoms like this without having already decided it’s an emergency, but I have to cover all the bases here.)

Outer hip pain and lateral hip pain, though typically not cause for alarm (as the hip is not sitting near any major organs like the heart, lungs, kidneys, or liver), can be a sign of a serious bone condition, such as arthritis in the back, rheumatoid arthritis, osteoarthritis, or tendonitis but can also indicate a more serious bone condition like a fracture, labral tear, or conditions such as snapping hip syndrome or osteonecrosis.
Good points on isolating the single joint hip flexors and avoiding compensations. I am curious about your perspective (and others) on why this is less likely to stress the anterior capsule? I tend to add trunk side ending before finalizing the stretch to bias the psoas. The stretch you have outlined seems like an iliacus and ant. capsule biased stretch. Thoughts? If I really want to protect the anterior capsule, I’ll also add a slight amount of hip internal rotation.
There are thousands of low back pain books — what’s special about this one? The problem is that 90% of doctors and therapists assume that back pain is structural, in spite of mountains of scientific evidence showing … exactly the opposite. Only a few medical experts understand this, and fewer still are writing for patients and therapists. Supported by 462 footnotes, this tutorial is the most credible and clarifying low back pain information you can find. Ships with a free copy of PainScience.com’s trigger point tutorial! Buy it now for $19.95 or read the first few sections for free!
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.
Premkumar et al present evidence that the traditional “red flags” for ominous causes of back pain can be quite misleading. The correlation between red flags and ominous diagnoses is poor, and prone to producing false negatives: that is, no red flags even when there is something more serious than unexplained pain going on. In a survey of almost 10,000 patients “the absence of red flag responses did not meaningfully decrease the likelihood of a red flag diagnosis.“ This is not even remotely a surprise to anyone who paid attention in back pain school, but it’s good to have some harder data on it.
“For millions suffering from lower back pain (LBP), most do not realize that tight hip flexors are also a source of what’s hurting us,” said Sherwin Nicholson, a medical research scientist with SN Health Resources. “If you neglect [your hip flexors and hamstrings], not only will they tighten up, but your back can suffer and anything that you do will become a chore instead of an activity.”
Too much sitting is the enemy of stiff or achy hips, says Lisa Woods, a personal trainer and yoga teacher in Eagle, Colorado. The big problem, though, isn’t just the discomfort in the sides of your thighs. It’s the chain of pain that dysfunctional hips can create, including often-debilitating sciatic nerve pain that can start in your lower back and go down the backs of your legs.
There are cases of low back pain that have alarming causes, but it’s rare. Once in a while back pain is a warning sign of cancer, autoimmune disease, infection, or a handful of other scary culprits.7 Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous.8 The further you are from 55, the better your odds.
The iliotibial band is a thickening of the fascia lata, the deep fascia of the thigh. Think of it as a thick long ligament like structure that connects the hip to the lower leg along the outside of the thigh.  Tightness in the iliotibial band can cause patellofemoral pain, trochanteric bursitis, and friction syndromes at the knee. This is a hip stretch I commonly prescribe to runners and people suffering from knee pain.
For example, your quadriceps muscles are a group of four that are located at the front of the thigh; one of the group members, the rectus femoris flexes the hip, which brings your lower extremity (thigh, lower leg, and foot) forward, in front of you. On the other hand, your hamstring muscles are located at the back of the thigh. When they contract, they extend the lower extremity, bringing it behind you.
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.
Line up your hips parallel to each other, continually pressing the left hip toward the floor. If this position is too difficult, place a blanket under your bottom. To intensify the stretch, move the right foot away from the left side of your body and drop to the elbows or chest. To make this pose less intense, move the right foot closer to your right leg and stay on the hands instead of folding.
Why is back pain still a huge problem? Maybe this: “It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
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?
Why is back pain still a huge problem? Maybe this: “It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
How to do it: Begin with your hands and knees on the floor in a tabletop position. Grab a resistance band and hold it directly beneath your shoulders. Loop one foot through the band so it sits halfway down the foot. When ready, move only the banded leg backward, keeping the knee at a 90-degree angle. Your foot should be facing the ceiling, and your hip, thigh, and knee should all be in alignment and parallel to the floor. As you move your leg backward, focus on contracting the glute and not moving the knee joint. When you can’t extend back farther without changing your leg position, stop. Slowly lower to the start position. That’s one rep. Repeat this movement, alternating sides each time.
Located deep in the front of the hip and connecting the leg, pelvis, and abdomen, the hip flexors— surprise, surprise— flex the hip. But despite being some of the most powerful muscles in our bodies (with a clearly important role), it’s easy to neglect our poor hip flexors— often without even knowing it. It turns out just working at a desk all day (guilty!) can really weaken hip flexors since they tend to shorten up while in a seated position. This tightness disrupts good posture and is a common cause of lower back pain. Weakened hip flexors can also increase the risk of foot, ankle, and knee injuries (especially among runners) Hip muscle weakness and overuse injuries in recreational runners. Niemuth, P.E., Johnson, R.J., Myers, M.J., et al. Rocky Mountain University of Health Professions, Provo, VT. Clinical Journal of Sport Medicine, 2005 Jan; 15 (1): 14-21.. So be sure to get up, stand up every hour or so! And giving the hip flexors some extra attention is not just about injury prevention. Adding power to workouts, working toward greater flexibility, and getting speedier while running is also, as they say, all in the hips The effect of walking speed on muscle function and mechanical energetics. Neptune, R.R., Sasaki, K., and Kautz, S.A. Department of Mechanical Engineering, The University of Texas, Austin, TX. Gait & Posture, 2008 Jul; 28 (1): 135-43..

The big idea of classification-based cognitive functional therapy (CB-CFT or just CFT) is that most back pain has nothing to do with scary spinal problems and so the cycle of pain and disability can be broken by easing patient fears and anxieties. For this study, CFT was tried with 62 patients and compared to 59 who were treated with manual therapy and exercise. The CFT group did better: a 13-point boost on a 100-point disability scale, and 3 points on a 10-point pain scale. As the authors put it for BodyInMind.org, “Disabling back pain can change for the better with a different narrative and coping strategies.” These results aren’t proof that the confidence cure works, but they are promising.
This pose is similar to seated forward fold, and provides the same benefits. It also stretches your groin. Assume the same starting position as the forward fold, but slide the sole of your left foot against your right inner thigh. Keeping your right foot flexed, lower your left knee as far as you can into a half-butterfly position. Walk your hands down the sides of your right leg as you fold forward as far as you can with your torso. Hold for 8-10 breaths, and then slowly rise back up. Switch legs and repeat.
Hamstring squeeze. Use the machine that works your hamstrings; you will either lie on your stomach or sit with a pad behind your knee. Push against the pad, moving your knee up toward the ceiling or backward (depending on which position you’re in). “In other words, bend your knees,” Pariser says. But to avoid cramps in your hamstring muscles, don’t bend your knee so much that your heels are too close to your buttocks.
This restorative pose will stretch your shins, knees, hips, spine, and arms. Start with your hands and knees on the mat. Point your toes behind you, allowing your big toes to touch, and spread your knees slightly wider than your hips. Keeping your back flat, sit back on your heels and lower your torso between the legs as you reach as far forward as you can with your arms. Keep your elbows elevated, and rest your forehead on your mat if you can. Take 10-15 breaths, and then release.
Although some of us are familiar with a pinched nerve, which is associated with sciatic-like pain in the leg, irritation or inflammation of nerves in the low back region can also cause a sensation in the upper leg or hip region. It is important to realize there are many things that can go wrong in the spine. Remember, sciatica is not a diagnosis but, instead, a symptom of an underlying problem. It is possible to feel back-related pain in the hip region and upper leg as well. It depends on the nerves involved and ultimately the actual diagnosis. Back pain or hip pain is not a diagnosis but simply an explanation of the area of pain. Symptoms are correlated with physical examination and confirmed through x-rays and similar tests.
If most inner-thigh openers feel too easy (and your ankles and knees are injury-free), try Frog Pose. Get down on all fours, with palms on the floor and your knees on blankets or a mat (roll your mat lengthwise, like a tortilla, and place it under your knees for more comfort). Slowly widen your knees until you feel a comfortable stretch in your inner thighs, keeping the inside of each calf and foot in contact with the floor. Make sure to keep your ankles in line with your knees. Lower down to your forearms. Stay here for at least 30 seconds.

Relaxing in a full squat works for releasing the psoas if you’re comfortable. If you’re desperately trying not to fall over backwards, then you’re probably tightening your hip flexors to hold yourself up. This defeats the entire purpose of a resting squat. Grab something like a pillow or a couple books to throw under your heels and see if you can sink down and “rest” into a resting squat. Hold that for a little bit taking some really deep breaths directing the air and pressure of your breath into your back. Then stand up and move around. I bet your hip flexors will feel looser than before the resting squat.
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