AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.

The piriformis muscle connects the top of the femur to the spine, and it’s the main one that supports the outward movement of the hip, upper leg, and foot. The sciatic nerve can sometimes pass through this muscle and thus cause sciatica symptoms, otherwise known as piriformis syndrome, characterized by pain in the lower back and hips, poor movement, and balance. Therefore, the main cause of sciatica is the swelling or constriction of the piriformis muscle, but it can also be a result of some other factors as well.
The condition is cauda equina syndrome. It involves “acute loss of function of the neurologic elements (nerve roots) of the spinal canal below the termination (conus) of the spinal cord,” where the nerves spread out like a horse (equina) tail. Again, this condition causes symptoms in the “saddle” of the body: butt, groin, inner thighs. BACK TO TEXT
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.
I use this for people that really present in an anterior pelvic tilt, or with people that appear to have too loose of an anterior hip capsule.  In fact, this has completely replaced the common variations of hip flexor stretches in all of our programs at Champion.  This works great for people with low back pain, hip pain, and postural and biomechanical issues related to too much of an anterior pelvic tilt.
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

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! 

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This standard recommendation reinforces the alarming idea that low back pain that lasts longer than a few weeks is Really Bad News. It’s not. It’s a clue. It’s a reason for concern and alertness. But many cases of low back pain that last for 6 weeks will still go away. Once again, see the 2009 research published in the British Medical Journal, which showed that more than 30% of patients with “new” chronic low back pain will still recover without treatment. BACK TO TEXT
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.
Of course, you know what it feels like to have a tight muscle. But tight hips aren't just uncomfortable—they can lead to all sorts of other aches and pains, especially in the lower back. "People focus on the hips and say their hips are tight, but we don't always think about the fact that the lower back connects to our legs at the hip," Charlee Atkins, C.S.C.S., instructor at Soul Annex in New York City and creator of Le Stretch class, tells SELF. Tight hip flexors make it harder for your pelvis to rotate properly, which can cause your lower back to overcompensate, "and this can be a setup for lower-back injury," Teo Mendez, M.D., an orthopedic surgeon at NY Orthopedics who focuses on operative and non-operative management of sports-related injuries, musculoskeletal injuries, and arthritis, tells SELF.

Mononeuropathies can affect nerves in the legs, arms, or other parts of the body. Mononeuropathy means a single nerve or nerve group has been damaged, for example, by a lesion that has developed along a nerve or group of nerves. Carpal tunnel syndrome is a good example of a mononeuropathy, in this case, affecting the wrist area. With mononeuropathy symptoms may be sudden (acute) or may develop slowly (chronic). Some of the more common mononeuropathies are
Line up your hips parallel to each other, continually pressing the left hip toward the floor. If this position is too difficult, place a blanket under your bottom. To intensify the stretch, move the right foot away from the left side of your body and drop to the elbows or chest. To make this pose less intense, move the right foot closer to your right leg and stay on the hands instead of folding.
How to do it: Stand up tall while holding onto a sturdy object like a chair, or rest your hands on a wall. Keeping your back straight and core tight, raise one leg up and lift it out to the side and away from your body, keeping your leg straight. Pause for one to two seconds, then return to the start position. That’s one rep. Repeat this movement, alternating sides each time.
How to do it: Begin with a 20- to 30-inch box or bench right behind you. Straighten one leg and lift your foot in front of you, bend your standing leg, and push your hips back as far as possible as if you’re squatting on two legs, but just doing it on one. Continue until your butt hits the bench, pause, then squeeze your glutes and drive through your planted heel to stand up. Do not relax and release the tension in your muscles as you sit. Repeat this movement, alternating sides each time. (Once you master lowering to touch your glutes to the bench, lower the bench or try lowering to the floor.)
With lumbar stenosis nerves in the spinal cord and lower back become compressed. This type of injury can cause many of the symptoms of sciatica—including numbness and tingling in the legs and pain in the buttocks. Possible treatments include a sciatic nerve block, steroid injections, opioid pain medications, physical therapy, and rest. However, the use of epidural steroid injections is not supported by limited amount of available evidence.

Lay on your back on your mat and pull your knees to your chest. Place your hands on the inside arches of your feet and open your knees wider than shoulder-width apart. Keeping your back pressed into the mat as much as possible, press your feet into hands while pulling down on feet, creating resistance. Breathe deeply and hold for at least 30 seconds.
With lumbar stenosis nerves in the spinal cord and lower back become compressed. This type of injury can cause many of the symptoms of sciatica—including numbness and tingling in the legs and pain in the buttocks. Possible treatments include a sciatic nerve block, steroid injections, opioid pain medications, physical therapy, and rest. However, the use of epidural steroid injections is not supported by limited amount of available evidence.
To make a long story short, I have been experiencing acute pain in my right hip as a result of driving so much. It does not really hurt while I am driving, but when I try to get out of the vehicle, the pain can be quite severe (making it almost impossible to walk for a ten seconds or so). In fact, it had gotten so bad that I was having trouble after sitting period (i.e. in chairs, etc). I was beginning to fear that I was going to be fundamentally disabled unless something changed.
Start kneeling on your mat with knees hip-width apart and hips directly over knees. Press your shins and the tops of your feet into the mat. Bring your hands to your low back, fingers pointing down, and rest palms above glutes. Inhale and lift your chest, and then slowly start to lean your torso back. From here, bring your right hand to rest on your right heel and then your left hand to your left heel. (If you can't reach your heels, turn your toes under; it will be easier to reach your heels in this modification.) Press your thighs forward so they are perpendicular to the floor. Keep your head in a relatively neutral position or, if it doesn't strain your neck, drop it back. Hold for 30 seconds. To come out of the pose, bring your hands to your hips and slowly, leading with your chest, lift your torso as you press the thighs down toward the floor.
A sedentary lifestyle can lead to having weak and tight hip flexors as they are always in the shortened position. Tight hip flexors can lead to a limited range of motion, poor posture, lower back and hip pain, and even injuries. These muscles need to get a workout when you are standing and doing movements such as raising your leg to climb stairs, run, or ride a bicycle.​
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