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
It’s well established that about eight in 10 people in the U.S. will experience back pain at some point in their lives. And while the causes of such pain often vary, say physical therapists and other medical professionals say that increasingly, in a world that accommodates a more sedentary lifestyle, the blame for low-back pain can often be traced to an area a little lower in the kinetic chain: the hips.

How to: Get on your hands and knees, in a tabletop position (a). Slowly widen your knees out as far as they can go and bring your feet in line with your knees. Your shins should be parallel with one another (b). Flex your feet and ease yourself forward onto your forearms. (If the stretch is too intense, try putting your arms on a block or firm pillow.) Hold for eight to 12 breaths (c). If holding the stretch for longer, try slowly moving your hips forward and backward to bring the stretch to different parts of your hips.
Hip hikers (also known as the pelvic drop) are great exercises to get your gluteal muscles working in a weight bearing position. To do the exercise, stand sideways with one foot on a step and the other hanging off. Keeping both knees straight, lower down your pelvis on one side so your foot moves toward the floor. Both knees should remain straight; the motion should come from your hip joint. Once your pelvis is lowered down, slowly raise it back up to the starting position. Repeat the exercise for 10 repetitions.
But mobile hip joints don’t just relieve pain. They’re also essential for walking, hiking, running, jumping, dancing, playing sports, and pursuing virtually any fitness goal safely and effectively. Want to develop stronger, more muscular legs? Hip mobility allows you to lunge and squat more deeply so you can reach your muscles’ potential. Want to avoid injury? Hip mobility improves range of motion so you can perform exercises more safely.

Strength training is another key part of the “do” category, Dr. Vasileff says. “It’s a good idea to focus on quad, hamstring, and gluteal strength,” he says. These muscles surround your hips and provide support, along with your core—which is another area to focus on. “Strengthening your core helps to normalize your walking pattern and stabilize how your pelvis and hips move,” Dr. Vasileff says. That translates to less pain and better hip mobility.
How to: Lie on your back with your right knee bent and foot flat on the floor (a). Extend your left leg up to the ceiling and wrap a strap around the sole of your left foot (b). While holding both ends with your left hand, extend your right arm directly out to the side in order to anchor yourself (c). Slowly let the left leg fall toward the left while keeping your right side grounded. Hold for six to eight breaths, then repeat on the opposite side.

Strength training is another key part of the “do” category, Dr. Vasileff says. “It’s a good idea to focus on quad, hamstring, and gluteal strength,” he says. These muscles surround your hips and provide support, along with your core—which is another area to focus on. “Strengthening your core helps to normalize your walking pattern and stabilize how your pelvis and hips move,” Dr. Vasileff says. That translates to less pain and better hip mobility.
Correct posture and a protected spine requires strong muscles, and strong muscles require exercise. Rather than sit around waiting for lower back pain to fix itself, keeping active and exercising regularly can actually help it recover and stay in shape much more quickly. Not only that, regular exercise will help you lose weight which, in turn, will take pressure off your legs, hips, and back.
Don’t medically investigate back pain until it’s met at least three criteria: (1) it’s been bothering you for more than about 6 weeks; (2) it’s severe and/or not improving, or actually getting worse; and (3) there’s at least one other “red flag” (age over 55 or under 20, painful to light tapping, fever/malaise, weight loss, slow urination, incontinence, groin numbness, a dragging toe, or symptoms in both legs like numbness and/or tingling and/or weakness).

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Mike, I cannot thank you enough for this instruction on stretching the hip flexor muscle. Over the past three years, my driving has increased dramatically. It is not uncommon for me to drive 1,000 business miles or more each week. I have always been very fit, but now, in my early 50’s, I am finding that it is easier to get “wracked up” by things like excessive driving.

Why so different? If you pay in United States dollars (USD), your credit card will convert the USD price to your card’s native currency, but the card companies often charge too much for conversion, well above the going exchange rate — it’s a way for them to make a little extra money. So I just offer my customers prices converted at slightly better than the current rate.
Lucky for us, there are tons of different ways to stretch hip flexors. We’ve put together a broad selection of some of the most popular tight hip flexor stretches below. Some of these stretches may work better for you than others, and there’s also many more hip flexor stretches you can try beyond these. So, experiment with all different kinds of stretches and decide which ones are best for your body.
The same lack of correct breathing also perpetuates a diastasis. Without proper deep breathing, you can compensate a couple ways. The first is to draw in your belly button and go into a shallow breathing pattern and the second is to have belly only expansion. Both of these can hinder diastasis healing. The cool thing is that I’ve actually had women experience spontaneous firming of their diastasis when we get down a correct breathing pattern. It’s a phenomena that always amazes me. The same thing can happen with decreasing prolapse symptoms.
Lie on your back with your knees bent and your feet flat on the floor. Tighten the muscles in your buttocks, then lift your hips off the ground and hold for about five seconds before slowly lowering yourself back down. Be sure to breathe throughout the exercise. As with the first exercise, you can work up to doing 30 repetitions, resting for a few seconds (or longer) between each. “If you start to get tired, stop and rest for a couple of minutes,” Pariser says.
Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy — just think about how painful a Charley horse is! Regardless of what’s actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points — tiny muscle cramps, basically11 — could be the entire problem, or a complication that’s more painful and persistent than the original problem. It’s hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.
Both types of problems are frequently helped by anti-inflammatory medications particularly in mild to moderate situations. Some types of analgesics can be used intermittently as well. It's important to realize that both problems can be helped significantly by weight loss, proper forms of exercise and conditioning. In fact, back pain can become chronic without a commitment to the appropriate exercises necessary to stabilize and strengthen the spine. Epidural blocks (corticosteroids are injected into the canal of the low back to reduce inflammation and pain) can help several types of back disorders. Using a cane when walking can help both hip and back pain.
Arthritis is a common cause of radiating lower back pain. Symptoms include back pain that fluctuates, coming and going throughout the day and night and numbness in the neck area, as well as stiffness and lack of mobility. Recommended treatment for arthritis of the back includes heat, ice, rest, exercising and stretches, and over the counter anti-inflammatories. In severe cases, patients seek surgery but sometimes, surgery does more harm than good.
Consult your physician and follow all safety instructions before beginning any exercise program or using any supplement or meal replacement product, especially if you have any unique medical conditions or needs. The contents on our website are for informational purposes only, and are not intended to diagnose any medical condition, replace the advice of a healthcare professional, or provide any medical advice, diagnosis, or treatment.
Gait analysis studies in the elderly show that they typically have a shortened step length. Whether that is a result of tight hip flexors or due to reduced balance, the propensity to walk with shorter steps will itself lead to tightness in hip flexors and anterior joint structures. Hip stretches may be a relatively easy preventative strategy for the elderly with gait abnormalities and may help to prevent falls.

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.

Greater trochanteric pain syndrome describes pain that is felt along the outer hip area. Causes include sports injury, muscle tears, and injury due to motor vehicle accidents. The pain is caused by a combination of inflammation in two distinct areas: the bursa of the hip and pain in the buttock (gluteal muscles). Pain may also be caused by tendinitis of the hip abductor muscles. Symptoms of greater trochanteric pain syndrome include hip pain at night lying on side, dislocated hip symptoms, and hip muscle weakness. Hip pain relief can be sought through anti-inflammatory medications, physical therapy, and stretches for hip pain.


You can use over-the-counter remedies such as Motrin or Advil (ibuprofen) or Aleve (naproxen) to help with pain and swelling. Tylenol (acetaminophen) works for pain relief, but it doesn't treat inflammation and swelling. If you have heart disease, high blood pressure, kidney disease, or if you've had ulcers or internal bleeding, check with your doctor before taking any of these medications.
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