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.
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.
If, like most of us, your hip joints could use some TLC, help has arrived. All you need to do is spend a moment or two before and after your workouts — or, heck, while watching TV — on a time-honored fitness activity few of us do enough of: stretching. Below, we’ll show you some of the best hip stretches to improve flexibility and mobility, hopefully making up for all that time on the couch.
But there are some pretty serious causes for back and hip pain as well. Lower back pain, in particular, can be a sign of various serious conditions such as advanced kidney infections or a condition called interstitial cystitis, which can cause inflammation of the tissues of the bladder. Sciatica causes lower back pain, pain in the back of the knee, pain in right buttock cheek, unilateral (one-sided) pain, thigh pain, pain behind the knee and calf, and muscle weakness in legs as well.
Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy — just think about how painful a Charley horse is! Regardless of what’s actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points — tiny muscle cramps, basically11 — could be the entire problem, or a complication that’s more painful and persistent than the original problem. It’s hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.

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.
Hi John, Thank you for the video and instructions. My question to you is that I’m schedule to have a reconstructive hip repair (Laberal tear) in July for my right hip and (second) and told that I have a tear in the right as well. I’ve been suffering from back pain too and know its because of the hips and my sitting because of work. If I can tolerate the exercise, would your recommend to do them? And if so, should I take it down from your suggested reps? I’ve been doing DDP Yoga for the last week and besides general soreness and some discomfort in my right hip, i’ve been able to make it through a full workout as well as do the core exercises. Your response would be greatly appreciated.
When lifting weights, it's important to find out how much weight is appropriate for you. Pariser recommends visiting your physical therapist to discuss how to safely lift weights without injuring your hip. “The lightest weight on the machines might be five or 10 pounds,” Pariser says. “That might be too hard for some people.” A good rule of thumb: Always use a weight that's light enough for you to lift comfortably.
Meanwhile, it’s extremely common for non-life-threatening low back pain to be alarmingly severe and persistent — to have a loud bark! Your doctor may not appreciate how true this is, and may over-react to all persistent low back pain, even without other red flags. In most cases, you shouldn’t let them scare you. Being “freaked out” about persistent back pain is the real threat: it can make low back pain much worse, and much more likely to last even longer (a tragic irony).

Before recommending exercises, physical therapists evaluate their patients to develop a routine that’s appropriate for their specific condition. Pariser says the following exercises, done at home and at the gym, are generally safe for everyone. “If a patient has already received a total hip replacement, however, certain precautions should be taken,” he says.

Stack the right leg on top of the left, lining up the right ankle to the left knee and the right knee to the left ankle. If you find this position too difficult, you can use blocks as support to lighten the pose. The Fire Log Pose is a deep hip stretch and good stretch for the glutes as well. It’s a pose that also stretches and strengthens the groin, calves, thighs, and abdominal muscles.
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.

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.
Consult your physician and follow all safety instructions before beginning any exercise program or using any supplement or meal replacement product, especially if you have any unique medical conditions or needs. The contents on our website are for informational purposes only, and are not intended to diagnose any medical condition, replace the advice of a healthcare professional, or provide any medical advice, diagnosis, or treatment.

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!

I think you should mention that for some people, stretching is not the solution and that it will deteriorate their posture. Some people need stretching, but most people I know need to strengthen their "overstretched" hip flexors. Many people can't do a single hanging leg raise. Check this site if you want to know more about the importance of hip flexors bit.ly/Unlock_Your_Hip_Flexor Report
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.
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.”
Downward facing dog can help stretch and strengthen your feet, calves, hamstrings, lower back, shoulders, neck, and hands. Begin on your hands and knees with your shoulders directly above your wrists and your hips directly above your knees. Spread your fingers wide and press your palms into the floor. Now lift your hips and push back with your hands to form an upside down V with your body. Work your heels toward the floor, and let your head hang to relieve any tension you’re holding in your neck. Take 8-10 breaths, and then release.
If most inner-thigh openers feel too easy (and your ankles and knees are injury-free), try Frog Pose. Get down on all fours, with palms on the floor and your knees on blankets or a mat (roll your mat lengthwise, like a tortilla, and place it under your knees for more comfort). Slowly widen your knees until you feel a comfortable stretch in your inner thighs, keeping the inside of each calf and foot in contact with the floor. Make sure to keep your ankles in line with your knees. Lower down to your forearms. Stay here for at least 30 seconds.
The good news is that a well-rounded strength-training program—like the one Félix provides below—can target every muscle in your hips to build better overall strength. Add this routine to your workout two or three times a week to target every muscle in your hips. For each move, complete three rounds of ten reps. If it’s a single-leg exercise, repeat those reps on each leg.
There are thousands of low back pain books — what’s special about this one? The problem is that 90% of doctors and therapists assume that back pain is structural, in spite of mountains of scientific evidence showing … exactly the opposite. Only a few medical experts understand this, and fewer still are writing for patients and therapists. Supported by 462 footnotes, this tutorial is the most credible and clarifying low back pain information you can find. Ships with a free copy of PainScience.com’s trigger point tutorial! Buy it now for $19.95 or read the first few sections for free!
To ease the pain and lower your odds of an injury, don’t try to do too much at once. “Start with just 10 minutes,” says Arina Garg, MD, a rheumatology fellow at The Center for Excellence for Arthritis and Rheumatology at the Louisiana University Health Sciences Center. “Every few days, increase that time by 5 to 10 minutes.” Your goal is to work up to 30 minutes of aerobic exercise, 5 days a week.

Tight hip flexors occur for a variety of reasons. Those who run frequently or engage in other activities that put strain on the hip flexors are likely to experience hip flexor tightness at one time or another. A blow to the hip or poor conditioning can also be causes of tight hip flexors. These causes can usually be attributed to tiny tears that occur to our hip flexors through rigorous activity.
Keeping your hips mobile is important for overall hip function and athletic performance. Mobility refers to the ability of your joints to move through a pain-free, unrestricted range of motion. For cyclists, hip mobility is critical since pedaling occurs in one plane of motion, and after miles and miles in the saddle, hip tightness and restriction may develop. The following movements will help with hip mobility.
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.
“Red flags” are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing there really is something serious going on… and sometimes they are a false alarm.18 Check off all that apply … hopefully none or few or only the least alarming of them!
On the contrary, the following piriformis stretches offer incredible effects in the treatment of sciatica pain. Note that you need to warm up before the stretches for a few minutes, and remain within the comfort limits. It is important to consult your spine specialist first. Then you can start with these 10 piriformis stretches for sciatica relief, and you will be surprised by the positive effects!
If your hips are killing you, you probably spend a lot of time sitting—in the car, at work, on that SoulCycle seat—which puts your hips in near-constant "flexion", says Cori Lefkowith, NASM-certified personal trainer and owner of Redefining Strength in Orange County, California. Even running involves a repetitive flexion movement that can cause pain.
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