But mobile hip joints don’t just relieve pain. They’re also essential for walking, hiking, running, jumping, dancing, playing sports, and pursuing virtually any fitness goal safely and effectively. Want to develop stronger, more muscular legs? Hip mobility allows you to lunge and squat more deeply so you can reach your muscles’ potential. Want to avoid injury? Hip mobility improves range of motion so you can perform exercises more safely.
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.
Progress to add core engagement.  Once they can master the posterior pelvic tilt, I usually progress to assist by curing core engagement.  You can do this by pacing both hands together on top of your front knee and push straight down, or by holding a massage stick or dowel in front of you and pushing down into the ground.  Key here is to have arms straight and to push down with you core, not your triceps.

“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.”
A recent study from Florida Atlantic University found that doing 45 minutes of chair yoga twice per week reduced pain and improved overall quality of life in older adults with osteoarthritis. Chair yoga is practiced sitting in a chair or standing while holding the chair for support, so it’s a great option for beginners or anyone dealing with an injury or balance problems.
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.
Trochanteric bursitis is a condition which causes pain in the hip region. Trochanteric bursitis is inflammation of the bursa at the outside area of the hip, which is called the greater trochanter region. When this bursa becomes irritated or inflamed, it causes severe pain in the hip area. Treatment may include stretches for hip pain, NSAIDs and anti-inflammatory medications, opiate pain medications, and physical therapy.
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.
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.
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.
Mobility and exercise (e.g., walking, running, stretching, etc.) help to more evenly distribute the forces of impact and weight through this ball-and-socket joint. As people age or find themselves living a more sedentary lifestyle from (e.g., sitting a lot at work), the wear and tear of the hip joint is less distributed, taking place in a smaller area within the socket.
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.

Ankylosing spondylitis is a type of arthritis that specifically affects the spine. Ankylosing spondylitis causes a severe inflammation of the spinal vertebra that can cause debilitating pain throughout the back region. This condition can cause stiffness and pain not only in the spine but also inflammation, pain and stiffness in the ribs, shoulders, ribcage, hands, and feet as well. Symptoms include a dull pain in the lower back and buttocks, stiffness and lack of mobility in the hips, back, and legs, loss of appetite, fever, and general malaise. Treatment includes physical therapy, medication, hot and cold therapy, and exercises that reinforce good posture practices.
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.

For example, one workout you may want to do lateral lunges with mini-band ankle walks. Another workout you may choose rotational step-ups with the 4-way cable hip exercise. The activation, mobility, and flexibility exercises can be done more frequently and not necessarily as part of a stand-alone workout. There's no one-right way to incorporate these exercises, so don't be afraid to experiment.

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.
Yuri Elkaim is one of the world’s most trusted health and fitness experts. A former pro soccer player turned NYT bestselling author of The All-Day Energy Diet and The All-Day Fat Burning Diet, his clear, science-backed advice has transformed the lives of more than 500,000 men and women and he’s on a mission to help 100 million people by 2040. Read his inspiring story, “From Soccer to Bed to No Hair on My Head” that started it all.
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