Cauda equina syndrome can be causes by spinal birth defects in children or, in adults, falls, inflammation, malignant tumors, injuries, or, and this is the most prevalent cause—a ruptured disc in the lumbar region of the spine. Symptoms of cauda equina include radiating pain in the lower back, pain and numbness in the legs and lower back, weakness in the lower body, loss of sexual function, and loss of bladder control. Another prominent symptom is upper leg pain, sharp pain in the thigh, loss of sensation in the upper leg muscles, and inner thigh pain. It is critical to seek immediate medical care and often including a neurosurgery consultation,
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.
To start, get into a lunge position with your right knee up and your left knee on the floor. Rest your hands on the ground, directly underneath your shoulders. Next, flex your raised right knee outward, so that you’re resting on the outside of your right foot. Press your chest forward to increase the stretch. Hold this pose for 10 seconds, then repeat on the other side of your body.

Before discussing different strength and mobility exercises, we should first look at activation exercises for your Gluteus Maximus (referred to as the glutes) muscles. The reason for needing to activate your glutes is simple—as a population, we spend way too much time sitting, and as a result, what happens is what noted spinal researcher Stuart McGill terms gluteal amnesia—your glute muscles can "go to sleep" and not function properly.


4. Just swing it. For the front-to-back hip swing stretch, lie on the left side with hips stacked, propped up on the left elbow. Bend the left leg to a 90-degree angle and raise the right leg to hip level with toes pointed. Keep abs tight and swing the right leg all the way in front, then swing it all the way to the back, squeezing the booty along the way. Switch sides.
While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.

The more common name for diabetic amyotrophy is diabetic neuropathy. It is a condition caused by advanced diabetes mellitus which affects the nerves in the legs, feet, hips, and buttocks. Symptoms include a wasting of the muscles of the legs as well as weakness of the leg muscles and severe, chronic pain in the buttocks, legs, and feet. Treatment includes monitoring blood glucose and keeping blood sugars well controlled as well as physical therapy and rest.


Even though it seems like your legs are moving forward and backward when you’re running, in reality, the femur (your thigh bone) both rotates and tilts in the hip socket, Kalika explains. It’s the hip adductors—most notably the gluteus medius—that keeps the femur sitting in the socket as designed. (The hip adductors are the muscles that move your legs inward.) Any weaknesses make the joint unstable, and can contribute to poor running mechanics, hip drop (when the pelvis drops to one side), too-narrow stances, and aggravated tissues throughout the entire body, Sauer says.
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.
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.

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.

3. Hug it out. Start the supine hip flexor stretch the same as the glute bridge, but keep the right leg relaxed on the floor. Pull shoulder blades down and back to lift hips. Grab the back thigh of the left leg and pull the knee toward the chest. Keep the right leg straight and push its heel into the floor (to feel it in the butt). Hold for 30-45 seconds and switch legs.
The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions — for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus (which is worthwhile, but rated very, very R17). The first sign of the cancer that killed him in 2011 was steadily worsening back pain. It’s always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of history’s most famous gladiator. Back pain didn’t seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first! It was many long months before he was diagnosed — not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.
Mike, I cannot thank you enough for this instruction on stretching the hip flexor muscle. Over the past three years, my driving has increased dramatically. It is not uncommon for me to drive 1,000 business miles or more each week. I have always been very fit, but now, in my early 50’s, I am finding that it is easier to get “wracked up” by things like excessive driving.
How to: Start in a standing position with your feet hip-width apart. Bend your knees slightly, and sit your hips back into a slight squat position. Keep your arms lifted at shoulder height, with your elbows bent and facing the side of the room. Bring one foot up, rotate your hips, and place that foot down on the ground, diagonally behind your body. Pause, then return to starting position. That's one rep. Do eight reps on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
John Wolf is Onnit's Chief Fitness Officer, and an expert in unconventional training methods such as kettlebell, steel club, and suspension training. With 15-plus years of experience in the fitness industry, he has worked with rehab clients and athletes of all levels. He moves like Spider Man and can deadlift more than 500 pounds any day of the week.

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?
Ligaments connecting your back to your pelvis: Straining the ligaments around your buttocks and pelvis may result in this type of pain. This area can also be referred to as the sacro-iliac joint. Due to this area linking your lower back and hip you may feel your pain from your lower back through to your hip. Treatment in this presentation should be primarily to the ligament that is strained and addressing posture as well as back stretching exercises when indicated.
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
“For millions suffering from lower back pain (LBP), most do not realize that tight hip flexors are also a source of what’s hurting us,” said Sherwin Nicholson, a medical research scientist with SN Health Resources. “If you neglect [your hip flexors and hamstrings], not only will they tighten up, but your back can suffer and anything that you do will become a chore instead of an activity.”

This pose is similar to seated forward fold, and provides the same benefits. It also stretches your groin. Assume the same starting position as the forward fold, but slide the sole of your left foot against your right inner thigh. Keeping your right foot flexed, lower your left knee as far as you can into a half-butterfly position. Walk your hands down the sides of your right leg as you fold forward as far as you can with your torso. Hold for 8-10 breaths, and then slowly rise back up. Switch legs and repeat.

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.
Enthoven WT, Geuze J, Scheele J, et al. Prevalence and "Red Flags" Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma. BACK TO TEXT
Strong muscles support and protect your joints. “Strengthening the lower body takes some of the pressure off of the hip and knee joints,” says William Oswald, DPT, a physical therapist and clinical instructor of rehabilitation medicine at NYU Langone Health. This can relieve some of the pain and protect against more damage. “It can also make daily tasks, such as climbing the stairs, easier,” he says.
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).

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.
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.
You might not think of too much cash as a source of pain, but a fat wallet can trigger piriformis syndrome. The condition can affect men who wear their wallet in the back pocket of their pants. This puts chronic pressure on the piriformis muscle and can aggravate the sciatic nerve over time. You can avoid this problem by keeping your wallet in a front pocket or jacket pocket.
Unilateral exercises like step-ups and single-leg toe touches are particularly effective at strengthening the glutes, while walking lunges, lateral lunges, air squats, and jump squats will zero in on all the muscles surrounding the hips. Whether you’re at the gym or heading out for (or back from!) a run, these five moves will strengthen and open your hips, keep them loose long-term, and not only make you a better runner, but make running feel better to you.
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The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to  postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.

To complete this stretch, get into the same kneeling position from the half kneeling hip flexor stretch. Whichever leg you have raised, place that hand on your hip. (So, if you’re doing this exercise with your right leg, place your right hand on your right hip, and vice versa.) Next, tighten your glute muscles, and reach around your body with your free hand to grab that foot. Pull that foot upwards towards your upper body
Sacroiliac joint pain can occur when movement in the pelvis is not the same on both sides. Uneven movement may occur when one leg is longer or weaker than the other, or with arthritis in the hip or knee problems. Autoimmune diseases, such as ankylosingspondyloarthropathy, and biomechanical conditions, such as wearing a walking boot following foot/ankle surgery or non-supportive footwear, can lead to degenerative sacroiliitis.
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.
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.
4. Just swing it. For the front-to-back hip swing stretch, lie on the left side with hips stacked, propped up on the left elbow. Bend the left leg to a 90-degree angle and raise the right leg to hip level with toes pointed. Keep abs tight and swing the right leg all the way in front, then swing it all the way to the back, squeezing the booty along the way. Switch sides.
Most back pain is harmless – caused by sleeping in an awkward position, stretched muscles, overexertion, sitting down too long or falling on the ischial tuberosity (the bones of the butt that you sit on), or minor hip injuries caused by twisting a certain way during sports like volleyball. Many injuries arise simply from improper form during exercise, sports injuries, or strains.
How to: Stand with your feet hip-distance apart. Your feet should be flat, and your legs should be straight. Step your right back behind your body, keeping your hips parallel, and stretch your right hand up overhead at the same time. Step back up to starting position. That's one rep. Repeat eight times on each side. Do three to four sets before moving on to the next move, resting for 30 seconds in between each set.
When I do a deep knee bend like a sumo squat I get a popping in the outside of my left knee. It feels like a big tendon or ligament is slipping per something. It isn’t painful peer se but I’m afraid if I do it a lot it will be. Is that a relatively common symptom for a guy with tight flexors, it bands, etc? Should I just push through it or have it checked out?

Some back pain is caused from a "ruptured disc". This pain is often experienced in the gluteal region of the body. Many people call this the "hip" region although it is not usually indicative of a hip joint problem. This is actually behind the hip, an important anatomic thought when considering hip pain, rather than in the hip itself. A condition related to degeneration of the lower back creating narrowing of the spinal canal or adjacent areas is called spinal stenosis and frequently causes pain in the hip region. The history of stenosis has to be compared with hip joint pain. Spinal stenosis can cause leg pain while walking as well as fatigue in the legs even when rising from a chair. Stenosis pain is relieved with sitting and will re-occur when walking is resumed.


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.


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.


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 question of pain in the hip region is not always a simple one and frequently involves specialized evaluation. Once the diagnosis is determined, options are many and should be discussed with you prior to instituting a treatment plan. The purpose of this article is to help to better assess pain, whether it's coming from the back or the hip itself. Remember, there are many options for treatment. Diagnosis is the first step to successful treatment.
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.
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.
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