Low back pain commonly is experienced in the back itself. However, due to the complexity of the spinal cord and associated nerves being an intricate part of the low back, pain may and frequently can radiate or travel further down the course of the nerves. This is similar to striking your "funny bone" in the elbow and feeling the sensation in the hand below the elbow.
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.
3. Hug it out. Start the supine hip flexor stretch the same as the glute bridge, but keep the right leg relaxed on the floor. Pull shoulder blades down and back to lift hips. Grab the back thigh of the left leg and pull the knee toward the chest. Keep the right leg straight and push its heel into the floor (to feel it in the butt). Hold for 30-45 seconds and switch legs.
I’m a runner and started experiencing some familiar tightness in my hip and started getting worse everyday I ran. It’s always gotten sore after running for a long extent for the last 4 years or so. I’m glad I found this page because all of these stretches helped me realize what needed to be stretched and how tight I really was! I hope this will fix my overwhelming soreness. Thank you!
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.
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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.
“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.”
The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to  postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.
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.
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.
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.
• 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.
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.

An ischial apophysis avulsion is an injury to the sitting bone where the hamstring muscle meets the bony protrusion of the sitting bone or ischial tuberosity. An avulsion is an injury in which movement or injury results in a violent and sudden contraction of the hamstring which pulls a piece of the sitting bone with it. This injury typically affects young athletes, aged 13 to 25 years. Symptoms include ischial tuberosity pain, swelling and pain in the thigh area, muscle spasms, and muscle weakness in the legs. To heal the injury, extended rest and massage are typically in order as well as stretching exercises and gait work.
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.

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! 


Preventing hip flexor injury focuses on good flexibility, as well as making sure you warm up before you go full speed. Warm muscles are much less likely to be injured. So take the time to warm up and start slowly before you go all out. A good flexibility program will also help to reduce the tension on the muscles, and reduce your likelihood for injury.

If you’re lucky, you won’t notice your hips are tight until you’re trying to do the Half Pigeon pose in your yoga class. But if you’re not so fortunate, your tight hips are making themselves known every time you so much as walk to the bathroom or sit on the couch—expressing themselves in the form of lower back pain and muscle stiffness. Tight hips can even shorten your stride, slowing your 5K goal time!
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.9) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.
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.
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.
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.
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.”
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 main work of your hip flexors is to bring your knee toward your chest and to bend at the waist. Symptoms associated with a hip flexor strain can range from mild to severe and can impact your mobility. If you don’t rest and seek treatment, your hip flexor strain symptoms could get worse. But there are many at-home activities and remedies that can help reduce hip flexor strain symptoms.
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