The gluteus medius is a muscle that sits on the outside of the hip area. This muscle is used for standing upright and walking. When injured, these muscles will cause a limp. If these muscles are torn, it can cause severe pain when walking, sitting, or sleeping. Treatment usually involves rest, physical therapy, and sometimes surgery to repair the torn muscle, if no other treatments bring relief from pain.

When it comes to your workouts, low-impact aerobic exercises are generally best and least likely to cause issues, says Kelton Vasileff, M.D., an orthopedic surgeon at The Ohio State University Wexner Medical Center. “I recommend swimming, walking, elliptical, cycling, and stationary biking for general exercise,” he says. All of these are great ways to move your body without pounding your joints.
While leg lifts, certain ab exercises, and even hula hooping can all help work the hips, the hip flexors can still be a tricky part of the body to stretch Kinetics of hula hooping: An inverse dynamics analysis. Cluff, T., Robertson, D.G., and Balasubramaniam, R. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. Human Movement Science, 2008 Aug; 27 (4): 622-35.. To get them even stronger and more flexible, try these five simple hip flexor stretches:

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.

The more than 20 muscles that make up your hips are responsible for stabilizing your pelvis, moving your legs from side to side, and shortening to draw your knees toward your chest every time you sit down, run, jump or pedal, explains Kelly Moore, a certified yoga instructor and co-founder of Mindfuel Wellness, which brings health and wellness initiatives to companies throughout Chicago.
An ideal pose for stretching out your hips, lower back, glutes, hips, and knees, it also can help to relieve sciatica. Start on your back with your knees bent, and your feet hip-width apart and flat on the floor. Raise your right foot and rest it on top of your left thigh above your knee. Thread your right hand between your legs and grip the back of your left thigh, bringing your left hand to meet it. Pull both legs toward your chest as far as you can. Take 8-10 breaths, and then release. Switch legs, and repeat.
Muscle Imbalances – The front of your hips, your hip flexors, are the muscles that will tighten and shorten while you are sitting for hours each day. While you are sitting, the back of your hips, your glutes and your hip extensors, are being overstretched. But just because they are being tightened and stretched respectively, doesn’t benefit either of them. They are also being weakened because of the lack of use of each muscle group.

How to: Sit on the floor with knees bent so that your right shin is positioned in front of you, your left shin behind you and your left hip dropped all of the way to the floor (a). Inhale and press your left hip forward until you feel a stretch in the front of your hip (b). Exhale and press left hip back to the floor. That’s one rep (c). Complete six to eight reps, working each time to increase your range of motion. Repeat on the opposite side.

3. Tendinitis and bursitis Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities. One of the most common causes of tendinitis at the hip joint, especially in runners, is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee.
Your hip flexors and psoas muscles help drive your legs up when you are running. To stretch these muscles, kneel on the floor and then step out forward with your left leg so that your left foot is on the floor. With your back straight, lean forward so that your weight is on the front foot and you feel a stretch in the hip of the back leg. Perform the stretch on both sides.
However, even the things you do every day — like sitting in front of a computer or at a desk for hours — can both weaken and shorten (tighten) your hip flexors, making them more prone to injury. Because of this, exercises (such as squats) and targeted stretches which focus on strengthening the hip muscles and improving hip mobility are key to preventing injuries.

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Located deep in the front of the hip and connecting the leg, pelvis, and abdomen, the hip flexors— surprise, surprise— flex the hip. But despite being some of the most powerful muscles in our bodies (with a clearly important role), it’s easy to neglect our poor hip flexors— often without even knowing it. It turns out just working at a desk all day (guilty!) can really weaken hip flexors since they tend to shorten up while in a seated position. This tightness disrupts good posture and is a common cause of lower back pain. Weakened hip flexors can also increase the risk of foot, ankle, and knee injuries (especially among runners) Hip muscle weakness and overuse injuries in recreational runners. Niemuth, P.E., Johnson, R.J., Myers, M.J., et al. Rocky Mountain University of Health Professions, Provo, VT. Clinical Journal of Sport Medicine, 2005 Jan; 15 (1): 14-21.. So be sure to get up, stand up every hour or so! And giving the hip flexors some extra attention is not just about injury prevention. Adding power to workouts, working toward greater flexibility, and getting speedier while running is also, as they say, all in the hips The effect of walking speed on muscle function and mechanical energetics. Neptune, R.R., Sasaki, K., and Kautz, S.A. Department of Mechanical Engineering, The University of Texas, Austin, TX. Gait & Posture, 2008 Jul; 28 (1): 135-43..


Kelly is a certified Personal Trainer with NASM, a Yoga Alliance Registered Yoga Teacher, and has her Bachelor’s Degree in Kinesiology from San Diego State University. In addition to wellness coaching, she runs yoga and wellness retreats around the world with her company Elevated Retreats. She believes that having fun with well-rounded exercise and healthy eating is the key to maximizing strength, flexibility, and mental health. You can find more on Kelly at her website www.kellycollinswellness.com or on Instagram @kellymariecollins.
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Too much sitting is the enemy of stiff or achy hips, says Lisa Woods, a personal trainer and yoga teacher in Eagle, Colorado. The big problem, though, isn’t just the discomfort in the sides of your thighs. It’s the chain of pain that dysfunctional hips can create, including often-debilitating sciatic nerve pain that can start in your lower back and go down the backs of your legs.

• Rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disease of the joints that occurs when the body’s immune system – which normally protects us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. Although rheumatoid arthritis most commonly affects the hips, knees, hands, wrists, feet, elbows and ankles, it can also affect the facet joints in the spine, causing pain and, in severe cases, destruction of the joints. This may allow the upper vertebra to slide forward on top of the lower vertebra, a condition called spondylolisthesis. The slipped vertebra may put pressure on the spinal cord and/or the nerve roots where they exit the spine.
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.
• 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.
Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain. Physical therapy, stretching exercises, pain medication, and joint injections are used first to manage the symptoms. Surgery to fuse the joint and stop painful motion may be recommended.
Take a step back and think about where you spend most of your day. If you're a young athlete, you probably spend most of your time at school or maybe work or practice and  even a little time at home, if you're lucky. Now think about what position your body is in during those periods. I would bet that you spend most of your day sitting down. You may walk to class or run in practice, but the majority of your day is spent in a seated position.

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.

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
The hip is a common site of osteoarthritis. To help protect the hip joint from "wear and tear," it is important to strengthen the muscles that support it. Your hip also controls the position of your knee, and strengthening your hips may be one component of your rehab program for knee pain. Your physical therapist may also prescribe hip exercises after total hip replacement if you have a hip labrum tear or as part of your hip exercise program for hip pain.
Below, you’ll find six hip exercises to help strengthen your hips so they can better support your body and running goals. All you need to do them is a mini looped resistance band, so you can easily fit them in at home or wherever your workouts take you. Try out the moves below in sets of 10 to 15 reps and add some (or even all!) of them to your cross-training workouts.
The side of the pain on its own doesn’t tell us much, and most of the one-sided sources of pain are viscera that usually cause abdominal pain instead of back pain, or in addition to it. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other red flags or significant non-back symptoms.
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.

Obtaining an accurate diagnosis is the first step to resuming activities and living an active lifestyle. Let's discuss the reasons for confusion and see if we can realize the causes and treatments for both hip and back pain. Some of a patient's misunderstanding about the origin of the pain is due to not understanding hip and back anatomy. Sounds odd but it's true. The hip joint lies just behind the groin area on each side of the body. At the same time, the spine runs from the base of the skull to the tip of the tailbone. The lumbar spine contains specific nerves that can influence the feelings in the region around the hip area.
People routinely have no pain despite the presence of obvious arthritic degeneration, herniated discs, and other seemingly serious structural problems like stenosis and spondylolistheses. This surprising contradiction has been made clear by a wide variety of research over the years, but the most notable in recent history is Brinjikji 2015. There are painful spinal problems, of course — which was also shown by Brinjikji et al in a companion paper — but they are mostly more rare and unpredictable than most people suspect, and there are many fascinating examples of people who “should” be in pain but are not, and vice versa. Spinal problems are only one of many ingredients in back pain. BACK TO TEXT
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
Acute back pain is often the result of muscle sprains or strains. Sprains occur when your ligaments are overstretched and sometimes torn. Strains, on the other hand, are caused by stretching — and possible tearing — of your tendons or muscles. Though the immediate reaction is pain in your back, you may also experience dull aches or discomfort in your hip.
In this study, one patient with sciatica was sent for ten MRIs, which produced 49 distinct “findings,” 16 of them unique, none of which occurred in all ten reports. On average, each radiologist made about a dozen errors, seeing one or two things that weren’t there and missing about ten things that were. Yikes. Read a more detailed and informal description of this study.
To do this stretch, sit on the floor with your legs about three or four feet apart, depending on how tall you are. Make sure your toes and knees are pointed straight up. Next, take a deep breath, and on the exhale, slowly fold your upper body forward. Rest your hands on your feet, legs, or the floor in front of you and hold this stretch for five deep breaths.

However, even the things you do every day — like sitting in front of a computer or at a desk for hours — can both weaken and shorten (tighten) your hip flexors, making them more prone to injury. Because of this, exercises (such as squats) and targeted stretches which focus on strengthening the hip muscles and improving hip mobility are key to preventing injuries.

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