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!
With a roster of muscles ranging from the powerful glutes to the small and agile abductors, the hips control practically all your movements. Almost every endurance athlete overworks some hip muscles while underworking others, causing severe imbalances: Runners are infamous for having weak hip adductors—the muscles on the side of the hip that help you step laterally—while cyclists tend to have massive quads and tiny glutes.
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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.
• 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.
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.

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 you tell your doctor your hip hurts, the first thing she should do is confirm that your hip is actually the problem. Women might say they have hip pain, but what they may mean is that they have pain in the side of the upper thigh or upper buttock, or they may be experiencing lower back pain, says Stephanie E. Siegrist, MD, an orthopedic surgeon in Rochester, New York, and a spokeswoman for the American Academy of Orthopaedic Surgeons. Hip pain is often felt in the groin or on the outside of the hip directly over where the hip joint (a ball-and-socket joint) is located.

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.
Back pain can suck the joy out of your days for week, months, even years. It can definitely be “serious” even when it’s not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
Spartacus is worthwhile, but the sex and violence is over-the-top: there’s no sugar-coating it. Definitely not a family drama. But the dramatic quality is excellent. After a couple of campy, awkward episodes at the start, the first season quickly gets quite good: distinctive film craft, interesting writing, and solid acting from nearly the whole cast. Andy Whitfield’s Spartacus is idealistic, earnest, and easy to like. I found it downright upsetting when I learned that he had passed away — as did many, many other fans I’m sure. See my personal blog for a little bit more of a review of Spartacus. BACK TO TEXT

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.

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.

Along with mobility and strength exercises, it's a good idea to do some flexibility work on a regular basis, especially as the season progresses and you start increasing your training mileage. Yoga is a great option—variations of hip openers and other poses can really help the overall function of your hips. The following stretches will help increase flexibility in your hips.

2016 — More editing, more! Added some better information about pain being a poor indicator, and the role of myofascial trigger points. This article has become extremely busy in the last couple months — about 4,000 readers per day, as described here — so I am really polishing it and making sure that it’s the best possible answer to people’s fears about back pain.
• Osteoporosis. Osteoporosis is a condition in which the bones loose so much mass that they become brittle and prone to break with slight trauma. The condition, which can occur with aging, inactivity, a low-calcium diet or use of corticosteroid medications, commonly affects the spine. When this occurs in the spine, the inner spongy bone and more solid outer portion of the vertebrae become porous. The weakened vertebrae can break – an injury called a compression fracture – and lose about one-half of their height. In most cases, compression fractures, are painful. In some cases, the resulting back pain is severe. Usually, the pain resolves within a few weeks, but for some people, it is long-lasting.

Cancel, pause, or adjust your order at any time, hassle free. Your credit card will only be charged when your order ships. The discount applied every time is 15% off. Since it would be weird to subscribe to a kettlebell, the subscriptions and subscription discounts are only for things you'll need often, like supplements, foods, and personal care items.

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.


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Kidney pain, kidney stones, kidney failure, and advanced kidney infections can cause radiating lower back pain, especially pain that affects the lowest ribs in the back and higher buttock area. Kidney issues can also cause pain in the groin area and difficulty urinating. Groin pain in women, especially pregnant women, is a special concern and the patient should be taken to the ER immediately. If you think a kidney issue is causing your back pain, get to an ER—because once a kidney issue is advanced enough to cause back pain, it is usually quite serious.
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.
Back pain can suck the joy out of your days for week, months, even years. It can definitely be “serious” even when it’s not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
“Red flags” are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing there really is something serious going on… and sometimes they are a false alarm.18 Check off all that apply … hopefully none or few or only the least alarming of them!
Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, typically affects one side of the body and can cause pain in the back of the right or left hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.
Those are some great stretches! I own a personal training studio in Severna Park, Maryland. Majority of my clients have physical limitations – so it’s important for them to stay flexible. I send these to my clients and even do these exercises for myself. I highly recommend these stretches to anyone, even people without physical limitations. I love the fact these are actually videos and not just stretches because it’s so much easier for people to figure out how to perform the stretches. You guys are the real MVP!
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.
When lifting weights, it's important to find out how much weight is appropriate for you. Pariser recommends visiting your physical therapist to discuss how to safely lift weights without injuring your hip. “The lightest weight on the machines might be five or 10 pounds,” Pariser says. “That might be too hard for some people.” A good rule of thumb: Always use a weight that's light enough for you to lift comfortably.
While sciatica is healing, try to remain active. Motion can actually help reduce inflammation and pain. A physical therapist can show you how to gently stretch the hamstring and lower back. Practicing tai chi or yoga can help stabilize the affected area and strengthen your core. Depending on your medical condition, certain exercises may not be recommended. Your doctor may also recommend taking short walks.
Cancel, pause, or adjust your order at any time, hassle free. Your credit card will only be charged when your order ships. The discount applied every time is 15% off. Since it would be weird to subscribe to a kettlebell, the subscriptions and subscription discounts are only for things you'll need often, like supplements, foods, and personal care items.
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.
Treatment for arthritis focuses on relieving symptoms and improving mobility. Your doctor may recommend anti-inflammatory medications and/or pain relievers. They might also prescribe disease-modifying antirheumatic drugs (DMARDs) — drugs meant to slow or stop your immune system from attacking your joints. Your doctor may also recommend physical therapy to strengthen your joints and increase your range of motion. For more severe cases, surgery may be required.
Before recommending exercises, physical therapists evaluate their patients to develop a routine that’s appropriate for their specific condition. Pariser says the following exercises, done at home and at the gym, are generally safe for everyone. “If a patient has already received a total hip replacement, however, certain precautions should be taken,” he says.
These exercises can be done three to five times per week; be sure to build in a rest day here or there to allow your hip muscles to recover. Working to strengthen your knees and ankles can be done as well to be sure you completely work all muscles groups of your lower extremities. Remember, your ankle and knee muscles help control the position of your hips, just as your hip muscles control the position of your knees and ankles. They all work together in a kinetic chain.

Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, typically affects one side of the body and can cause pain in the back of the right or left hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.
2016 — More editing, more! Added some better information about pain being a poor indicator, and the role of myofascial trigger points. This article has become extremely busy in the last couple months — about 4,000 readers per day, as described here — so I am really polishing it and making sure that it’s the best possible answer to people’s fears about back pain.
Strong ligaments and muscles support the SI joints. There is a very small amount of motion in the joint for normal body flexibility. As we age our bones become arthritic and ligaments stiffen. When the cartilage wears down, the bones may rub together causing pain (Fig. 1). The SI joint is a synovial joint filled with fluid. This type of joint has free nerve endings that can cause chronic pain if the joint degenerates or does not move properly.
Kneel on your mat with thighs perpendicular to the floor and tops of of your feet facing down. Place a yoga block between your feet. 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 on the yoga block. Use your hands to turn the top of your thighs inward. Allow the backs of your hands to rest on your thighs. Hold for at least 30 seconds.

The pain of back pain almost always makes it seem worse than it is. The most worrisome causes of back pain rarely cause severe pain, and many common problems (like slipped discs) are usually much less serious than people fear. Only about 1% of back pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.

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