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!
Tight hip flexors can also make it harder for your glutes to activate—since they're opposing muscle groups, when one is really tight the other becomes lengthened. When a muscle is more lengthened than it should be, it takes away some of its ability to contract. When your glutes are in this compromised position, it can cause other muscles to do more work than they should, making your workouts less efficient and sometimes, increasing your risk of injury.
Why is back pain still a huge problem? Maybe this: “It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
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.
How to do it: With your bar on the floor in front of you, place your feet slightly narrower than hip-width apart. Make sure the bar is as close to your shins as possible, and position your hands on the bar, just outside your shins. With your shins perpendicular to the floor, flex your hamstrings and lift your butt up and back, extending your legs so they’re nearly straight, with only a slight bend in the knee. Slide the bar up and toward the shins. Then, bend your knees slightly and proceed to lift the bar all the way off the floor in a straight line. Extend your hips fully at the top and stand tall with neck relaxed, arms straight. Pinch your shoulder blades together, squeezing your abs and glutes. Keeping the bar close to your body and with a straight back, reverse the movement. That’s one rep.
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
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.
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 achieve this stretch, start out on your hands and knees. Slowly widen your knees out as far as they can go, and make sure to keep your lower legs in line with your knees. Your lower legs and feet should be parallel with one another. Next, ease your upper body forward on your forearms and reach forward until you feel the stretch. Hold this pose for about 10 seconds.
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
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.
A pinched nerve is an uncomfortable condition that may cause shooting pain, tingling, and discomfort, particularly if it occurs in your back, spine, or hip. A pinched nerve occurs when too much pressure is applied to a nerve by surrounding bones, muscles, or tissues. The pressure interrupts proper nerve function, causing pain, numbness, and weakness.
How to do it: Rest the barbell across the upper traps on the back of your shoulders, as if it’s sitting on the collar of your shirt. Begin with your feet about shoulder-width apart, toes pointing about 15 degrees out, then widen your stance as needed so you’re comfortable. Make sure your knees are pushed out and your glutes stabilize your position. When you’re ready, push your glutes back as if you’re sitting in a chair. Aim for dipping your butt below your knees, but go down as far as you can without bending forward or losing balance. When you get the bottom of your squat, squeeze your glutes and drive up and through your heels back to start position.
Stretching is your next move, but not just any stretches. "Before your workout, you want to go for dynamic stretches, or stretches that put the joint through a full range of motion," says Lefkowith. Moves like squats and lunges will get your muscles fired up (especially if you focus on squeezing your butt at the top of those squats), says Lefkowith.
Quadriceps stretch: Stand at an arm's length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.
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.
A diagnostic SI joint injection may be performed to confirm the cause of pain. The SI joint is injected with a local anesthetic and corticosteroid medication. The injection is given using X-ray fluoroscopy to ensure accurate needle placement in the SI joint. Your pain level is evaluated before and 20-30 minutes after injection, and monitored over the next week. Sacroiliac joint involvement is confirmed if your pain level decreases by more than 75%. If your pain level does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain.
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.
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
Place a mini band around your ankles and spread your feet about shoulder-width apart. Keeping your legs relatively straight (you want the motion to come from your hips) and toes pointing forward, walk forward 10 steps, then backward 10 steps. Take a short break and then walk to the right 10 steps, then to the left 10 steps. Again, focus on keeping your legs straight and toes pointing forward.
Wrapping a Thera-Band around your ankles before you perform Lateral Walks or Shuffles increases resistance, strengthening your hip abductors and gluteus medius. When you perform this exercise, you will quickly find out if you have weak hips. This is most beneficial for basketball players, who are required to be in a crouched defensive stance and shuffle when playing defense.
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful (especially in the early stages). For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!
Grade II (moderate): A larger tear in your muscle that makes it difficult to move and causes a moderate amount of pain, especially when you move the affected muscle, swelling, and tenderness. You may have 5 percent to 50 percent loss of function and you may be limping. You can't go back to sporting activities until the tear is completely healed. These injuries can take anywhere from a couple weeks to a few months to heal, depending on how bad they are.