• 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.
Strong muscles support and protect your joints. “Strengthening the lower body takes some of the pressure off of the hip and knee joints,” says William Oswald, DPT, a physical therapist and clinical instructor of rehabilitation medicine at NYU Langone Health. This can relieve some of the pain and protect against more damage. “It can also make daily tasks, such as climbing the stairs, easier,” he says.
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Kneel on your mat with your thighs perpendicular to the floor and tops of your feet facing down. Bring your inner knees together. Slide your feet apart so they are slightly wider than your hips and press the tops of your feet evenly into the mat. Slowly sit down between your feet. Use your hands to turn the top of your thighs inward. Then, lean back onto your forearms and slowly lower torso to floor. Hold for at least 30 seconds.
Your doctor may order imaging tests, such as an MRI, to get more information about the location and cause of the irritated nerve. An MRI can show the alignment of vertebral disks, ligaments, and muscles. A CT scan using contrast dye can also provide a useful picture of the spinal cord and nerves. Determining the cause of sciatica can help guide the course of treatment. X-rays can help identify bony abnormalities but can't detect nerve problems.
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.
When a muscle contracts, it shortens. Take the biceps for example. Without getting too technical, the biceps are attached at the forearm and shoulder. When your biceps contract, they shorten and bring those two points closer together. When you rest, the muscle returns to its normal length, and the two points move farther away. Constantly contracting your biceps over a long period of time would cause them to get shorter, even at rest.
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.
How to: Start with your left foot back behind your body, with feet flat on the ground and legs straight. With the back foot, take one step farther away from your body—engage the glutes as you do. Then reach overhead with the opposite arm and stretch through the side of your body. Return to starting position. That's one rep. Repeat eight times on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions — for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus (which is worthwhile, but rated very, very R17). The first sign of the cancer that killed him in 2011 was steadily worsening back pain. It’s always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of history’s most famous gladiator. Back pain didn’t seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first! It was many long months before he was diagnosed — not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.
An ideal pose for stretching out your hips, lower back, glutes, hips, and knees, it also can help to relieve sciatica. Start on your back with your knees bent, and your feet hip-width apart and flat on the floor. Raise your right foot and rest it on top of your left thigh above your knee. Thread your right hand between your legs and grip the back of your left thigh, bringing your left hand to meet it. Pull both legs toward your chest as far as you can. Take 8-10 breaths, and then release. Switch legs, and repeat.
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
The hip flexor stretch has become a very popular stretch in the fitness and sports performance world, and rightly so considering how many people live their lives in anterior pelvic tilt. However, this seems to be one of those stretches that I see a lot of people either performing incorrectly or too aggressively. I talked about this in a recent Inner Circle webinar on 5 common stretches we probably shouldn’t be using, but I wanted to expand on the hip flexor stretch as I feel this is pretty important.
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.
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Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray… which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT
When was the last time you got on your gym's abductor or adductor machine and got in a good workout? It's probably been a while. Both are machines that don't get a lot of use, and they are often the target of coaches' ridicule on those "useless gym moves we should all skip" lists. Perhaps rightly so, especially if you're hopping on those machines hoping for a slimming effect.
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.
Approximately 15 degrees of hip extension is required to walk normally. If hip flexors are tight then in order to walk, compensatory movement needs to take place through the lower back causing back pain and premature disc degeneration. Like other joints, if we fail to take them through their full range on a regular basis we eventually lose mobility.
Keeping your hips mobile is important for overall hip function and athletic performance. Mobility refers to the ability of your joints to move through a pain-free, unrestricted range of motion. For cyclists, hip mobility is critical since pedaling occurs in one plane of motion, and after miles and miles in the saddle, hip tightness and restriction may develop. The following movements will help with hip mobility.
When it comes to your workouts, low-impact aerobic exercises are generally best and least likely to cause issues, says Kelton Vasileff, M.D., an orthopedic surgeon at The Ohio State University Wexner Medical Center. “I recommend swimming, walking, elliptical, cycling, and stationary biking for general exercise,” he says. All of these are great ways to move your body without pounding your joints.
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
Note: Exercises that strengthen the hip flexors also involve contracting (shortening) these muscles. So if tight hip flexors are a problem for you, it might be wise to limit how many direct hip-strengthening exercises you perform. These exercises are more geared toward people who have been told they have weak hip flexors that need strengthening or are looking for targeted exercises to build more power and stamina in the hip flexors.
Sit at the front of your chair with knees bent and feet flat, holding onto the sides for balance. You can do this exercise with eyes open. Or for deeper concentration and a balance challenge, try it with your eyes closed. With your knee bent, lift your right leg about six inches off the ground (or as far as you can). Hold for three counts, and then lower it back to the floor. Repeat with your left leg for one rep. Do 10 reps total.
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.
Starting in a seated position, place your bent right knee on top of your bent left knee. Try to have your knees perfectly stacked, one on top of the other, and to have your feet flexed to protect your knees. Both of your sit bones should be pressing into the ground. If this is not possible, then prop your hips up onto a blanket or pillow to allow equal and even weight on both sit bones.
Holland also suggests doing strength work in different planes of motion to keep all the muscles in and around your hip flexors, especially your glutes, firing correctly.“You can’t have good hip flexion if your glutes are tight or weak,” Nurse says, “so it’s super important that you’re always stretching and strengthening the front of your hip flexor and the back, which are the glute muscles.”
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!
Leah Sugerman is a yoga teacher, writer, and passionate world traveler. An eternally grateful student, she has trained in countless traditions of the practice and teaches a fusion of the styles she has studied with a strong emphasis on breath, alignment, and anatomical integrity. Leah teaches workshops, retreats, and trainings both internationally and online.
Without back body expansion during each breath we continue to perpetuate the tight hip flexor scenario. This is often accompanied by decreased pelvic floor recovery since the pelvic floor works in synch with the diaphragm. These women will often be dealing with sneeze pee, leaking with jumping or prolapse. Without awesome diaphragm expansion, we can’t have a great pelvic floor. They are too intertwined in their functioning.
Imagine not being able to climb stairs, bend over, or even walk Changes in hip joint muscle-tendon lengths with mode of locomotion. Riley, P.O., Franz, J., Dicharry, J., et al. Center for Applied Biomechanics, University of Virginia, Charlottesville, VA. Gait & Posture, 2010 Feb; 31 (2): 279-83.. All pretty essential if you ask us! But that’s what our bodies would be like without our hip flexor muscles. Never heard of ‘em? It’s about time we share why they’re so important, how your desk job might be making them weaker (ah!), and the best ways to stretch them out.
The gluteus medius is a muscle that sits on the outside of the hip area. This muscle is used for standing upright and walking. When injured, these muscles will cause a limp. If these muscles are torn, it can cause severe pain when walking, sitting, or sleeping. Treatment usually involves rest, physical therapy, and sometimes surgery to repair the torn muscle, if no other treatments bring relief from pain.
I’m just going to briefly touch on this because this will look different for each person. But know that if your hip flexors are or always feel tight, there is a reason. Muscles don’t get tight with no cause, and it’s usually because they are compensating for a weakness elsewhere or are constantly in a shortened position (as is the case with sitting).
Lie on your back with your knees bent and feet flat on the floor. Place left ankle right below right knee, creating a “four” shape with left leg. Thread left arm through the opening you created with left leg and clasp hands behind right knee. Lift right foot off floor and pull right knee toward chest, flexing left foot. Hold for 30 seconds, then repeat on opposite side.
Today’s guest post comes from Dr. Sarah Duvall, a physical therapist who specializes in women’s health and pelvic function, and who also loves to lift stuff off the floor while helping others do the same. She also has an awesome new course on Postpartum Corrective Exercise for fitness professionals which closes on January 22nd, so definitely check it out.