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?
We all know the nursery rhyme about the hip bone being connected to the leg bone. It’s a simple song, but it contains a surprising amount of truth. The fact is that the body’s muscular, nervous, and skeletal systems truly are complex and intricately interconnected. Even a daily task such as walking down the street uses a complete network of a body’s muscles and bones, all of them reliant on each other. And when a strain, tear, or other injury happens in one part of your body, pain can often present itself in an entirely different part of your body.
How to do it: With your bar on the floor in front of you, place your feet slightly narrower than hip-width apart. Make sure the bar is as close to your shins as possible, and position your hands on the bar, just outside your shins. With your shins perpendicular to the floor, flex your hamstrings and lift your butt up and back, extending your legs so they’re nearly straight, with only a slight bend in the knee. Slide the bar up and toward the shins. Then, bend your knees slightly and proceed to lift the bar all the way off the floor in a straight line. Extend your hips fully at the top and stand tall with neck relaxed, arms straight. Pinch your shoulder blades together, squeezing your abs and glutes. Keeping the bar close to your body and with a straight back, reverse the movement. That’s one rep.
But there are some pretty serious causes for back and hip pain as well. Lower back pain, in particular, can be a sign of various serious conditions such as advanced kidney infections or a condition called interstitial cystitis, which can cause inflammation of the tissues of the bladder. Sciatica causes lower back pain, pain in the back of the knee, pain in right buttock cheek, unilateral (one-sided) pain, thigh pain, pain behind the knee and calf, and muscle weakness in legs as well.
How to do it: With your bar on the floor in front of you, place your feet slightly narrower than hip-width apart. Make sure the bar is as close to your shins as possible, and position your hands on the bar, just outside your shins. With your shins perpendicular to the floor, flex your hamstrings and lift your butt up and back, extending your legs so they’re nearly straight, with only a slight bend in the knee. Slide the bar up and toward the shins. Then, bend your knees slightly and proceed to lift the bar all the way off the floor in a straight line. Extend your hips fully at the top and stand tall with neck relaxed, arms straight. Pinch your shoulder blades together, squeezing your abs and glutes. Keeping the bar close to your body and with a straight back, reverse the movement. That’s one rep.
Stand with your feet hip-width apart, knees slightly bent, and hands on hips. Brace your core—imagine you’re about to get punched in the stomach. Without changing the position of your knees, bend at your hips and lower your torso until it’s almost parallel to the floor (or as far as you can comfortably go without rounding your back). Pause, then lift your torso back to the starting position. Be sure to squeeze your glutes and push your hips forward to lift your torso back to the starting position. This ensures you’re engaging your hip muscles instead of relying on your lower back. Do 10 reps total.
On the contrary, the following piriformis stretches offer incredible effects in the treatment of sciatica pain. Note that you need to warm up before the stretches for a few minutes, and remain within the comfort limits. It is important to consult your spine specialist first. Then you can start with these 10 piriformis stretches for sciatica relief, and you will be surprised by the positive effects!
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.
Joint injections: Steroids can reduce the swelling and inflammation of the nerves. Joint injections are a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint (Fig. 2). While the results tend to be temporary, if the injections are helpful they can be repeated up to three times a year.
The hip is a very stable ball and socket type joint with an inherently large range of motion. The hip contains some of the largest muscle in the body as well as some of the smallest. Most people lack mobility due to a relatively sedentary lifestyle. Periods of prolonged sitting results in tightness of the hip flexors and hamstrings. Tightness in the muscles and ligaments can created joint forces that result in arthritis, postural problems, bursitis, and mechanical back pain.
• 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.
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.>
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.

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.


Lumbosacral plexopathy, more commonly called diabetic lumbosacral plexopathy is a condition caused by advanced diabetes, in which patients begin suffering with debilitating pain in the hips, thighs, and legs. With lumbosacral plexopathy there is typically a wasting of the leg muscles asymmetrically. This condition can affect individuals who have both type I or II diabetes. Treatment includes controlling blood glucose levels, and chronic neuropathic pain management achieved through anticonvulsant medications (such as gabapentin for back pain) and selective norepinephrine reuptake inhibitors (such as duloxetine).

Transitioning between these two poses will stretch your entire back, as well as your hips, core, chest, and neck. Start on your hands and knees with your shoulders directly above your hands and your hips directly above your knees. Spread your fingers and press your palms into the floor. As you breathe in, arch your back, lift your tailbone and head, and look toward the ceiling or sky. As you exhale, round your back and tuck your tailbone, tucking your chin against your chest as you shift your gaze to between your knees. Oscillate between these two poses for 10-15 breaths.
The sacroiliac joint typically has little motion. Small movements at the joint help with shock absorption and forward/backward bending. The joint is reinforced by strong ligaments surrounding it, some of which extend across the joint in the back of the pelvis. This network of soft tissues provides support, limits movement at the joint, and assists with absorbing pressure.
• Osteoarthritis. The most common form of arthritis of the back, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. In the spine, this breakdown occurs in the cartilage of the facet joints, where the vertebrae join. As a result, movement of the bones can cause irritation, further damage and the formation of bony outgrowths called spurs. These spurs can press on nerves, causing pain. New bone formation can also lead to narrowing of the spinal canal, known as spinal stenosis.
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.
Grade III (severe): A complete tear in your muscle that causes severe pain and swelling and you can't bear weight on that leg, making it difficult to walk. You've also lost more than 50 percent of your muscle function. These injuries are less common and may need surgery to repair the torn muscle. They can take several months or more to completely heal.
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