I’m a runner and started experiencing some familiar tightness in my hip and started getting worse everyday I ran. It’s always gotten sore after running for a long extent for the last 4 years or so. I’m glad I found this page because all of these stretches helped me realize what needed to be stretched and how tight I really was! I hope this will fix my overwhelming soreness. Thank you!
So, who cares right? Wrong. Everyone has seen that little old man walking with a cane, hunched over almost to the point of staring at the ground. Do you think he always walked like that? I'd bet you he didn't. Maybe he had an injury that never healed properly, or maybe after spending years and years in a similar position, his body became tighter and tighter until eventually he ended up bent over.
A thorough history and physical examination is a good start when sorting out symptoms. X-rays will attest to specific bony/cartilage changes but x-rays don't always correlate with the pain. It is possible to have little pain and much damage on the x-rays or visa versa. It is important to treat the patient, not the x-rays alone. Secondly, x-rays of the back can reveal degeneration of the discs or small joints in the spine but the person does well. Contrary, the back may look degenerative and because of the subsequent bone spurring and symptoms as arthritis progresses, it is important to obtain an MRI to confirm nerve impingements that are suspected. X-rays alone will not show nerve impingement. As you can see, it is important to undergo the history and physical examination and tests that can confirm your diagnosis before treatment begins.
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.
A basic bodyweight glute bridge is one of Lefkowith's favorites. Want to try it? Lie on the ground with your knees bent and your feet flat on the floor, and push your hips up toward the sky, squeezing your glutes at the top. This will not only help get your glutes in the game, but it also gives your hip flexors a chance to stretch out. (Try these five hip openers, too.)
Why does it tighten down so much when overworking as a spinal stabilizer? Remember that length tension relationship we talked about? Well, if the psoas is tight, it can compress the spine easier, thus providing spinal stability. Plus, it has to work a lot to stabilize the spine. When you don’t have correct functioning of the diaphragm and abdominals, the psoas holds a great deal of tension to do the job. This tightness or tension makes it a very ineffective hip flexor.
If the problem originates in the hip joint itself, common symptoms include groin pain on the affected side, and sometimes down the inner aspect of the thigh in the front of the leg. This pain can move to the knee and sometimes feels like a knee problem instead of a hip problem. Walking worsens the pain and with continued activity, the pain increases. Rest relieves it; however, when hip arthritis becomes severe, you may have pain most of the time. Minimal activity such as slight movements while in bed can worsen the pain. Other conditions such as advanced congenital hip dysplasia or avascular necrosis of the hip can cause these symptoms as well.
If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency — do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention. (Few people will have symptoms like this without having already decided it’s an emergency, but I have to cover all the bases here.)
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.
To complete this stretch, take a knee in front of a wall so that the toes of the leg you have raised are pressing against the wall. Place that same hand against the wall. Reach behind you with your other hand and grab your leg that’s sitting on the floor by the ankle, and bend it back towards your body. Hold this position and lunge forward towards the wall to complete the stretch. Hold this stretch for 10 seconds, then repeat on the other side of your body.
Lie on your back with your knees bent and your feet flat on the floor. Tighten your buttocks and lift your hips off the floor. Tighten your abdominal muscles and lift one foot a couple of inches off the floor. Then put it down and lift the other foot a couple of inches, all while remembering to breathe. “It’s like taking alternate steps,” Pariser says. Work up to doing 30 steps at a time.
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.
This pose is one of the most comfy ones for the lower back and hips. It will also stretch your neck, shoulders, and chest. Lie on your back and hug your knees into your chest. Breathe in deeply, and then exhale completely, lowering both legs to the floor on your left (keep your knees higher than your hips). Position your arms out to your sides, or place your left forearm on your right thigh (as pictured) to encourage a deep stretch, relaxing both shoulders to the floor. Shift your gaze over your right shoulder. Close your eyes, take 10 deep breaths, and then release. Repeat to your other side.
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.
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.
Back “spasms” are a largely a myth — there’s no such thing a sustained painful contractions of muscles in otherwise healthy people (see Cramps, Spasms, Tremors & Twitches) — but the kernel of truth in the idea of “spasms” may be the idea of trigger points, which are hypothetical “micro cramps,” tiny patches of painfully contracting muscle. Although this idea is controversial, it is nevertheless one of the most likely explanations for common aches and pains that mostly stick to one area (especially the back) and have no other obvious cause. See Back Pain & Trigger Points. BACK TO TEXT
Keep it a one joint stretch. Many people want to jump right to performing a hip flexor stretch while flexing the knee. This incorporates the rectus and the psoas, but I find far too many people can not appropriately perform this stretch. They will compensate, usually by stretching their anterior capsule too much or hyperextending their lumbar spine.
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.
Often you’ll perform static stretches seated or lying down, and focus on breathing slowly and deeply to facilitate relaxation — sometimes for several minutes at a time. Static stretches can be very effective at loosening you up, but they also inhibit performance in the stretched muscles for a short time afterward. So they’re best reserved for after a workout, or as an anytime stress reliever — just not right before a workout involving the muscles you’re stretching.
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.9) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.
The best thing about this stretch is that you can easily adjust where you feel it simply by changing the position of your foot. First, try bringing your foot inward (effectively externally rotating your hip), and repeat the same sequence of instructions. Then, do the same with turning your foot out (internally rotating the hip). Wherever you feel the biggest stretch is likely the version you should be doing more of.
Lie faceup with knees bent and feet flat on the floor, arms resting at sides. Press into heels and engage glutes to lift hips. Transfer weight to left leg and extend right leg straight out for five breaths. Inhale as you lower right leg to hover over floor for five breaths, then exhale as you lift it back up. Perform 8 reps, then repeat on opposite leg.
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 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.
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.
Relaxing in a full squat works for releasing the psoas if you’re comfortable. If you’re desperately trying not to fall over backwards, then you’re probably tightening your hip flexors to hold yourself up. This defeats the entire purpose of a resting squat. Grab something like a pillow or a couple books to throw under your heels and see if you can sink down and “rest” into a resting squat. Hold that for a little bit taking some really deep breaths directing the air and pressure of your breath into your back. Then stand up and move around. I bet your hip flexors will feel looser than before the resting squat.
• 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.
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.