Krystyn Strother

SPEAKER + EDUCATOR + ADVENTURER

Give Your Back Pain A Hip Check.

Erin Clougherty, DPT

Eighty percent of Americans will experience significant back pain in their lifetime. This is a serious and all too common problem our society faces. I see people in my practice more often for lower back pain than any other injury. In reviewing clients’ histories, nearly all have experienced prior back pain episodes. However, many will quickly follow with “but it's never more than the normal back pain." Back pain is not normal. Common, yes, but normal, not exactly.

 A sore lower back, much like sore legs after a strenuous activity, may be normal and resolve in one or two days. Pain you might describe as sharp, shooting, catching, locking-up, cramping, or aching, should never be ignored, even if it fades in a few days. Trading in your spine for a new one is a difficult feat so ensuring its health is imperative.

Limited hip motion leads to a compensatory increase in lower back range of motion. All hip muscles attach directly to either the spine or pelvis. Hip flexor tightness tends to be a problem from sitting a lot and can lead to increased lower back curve (often referred to as sway back). Tight hamstrings make it difficult to sit up straight creating excessive forward bend in the spine, which increases the risk of disc injury or pinched nerve. 

Similarly, in another plane, hip rotation limitations will increase the demands on your lumbar spine. If, when sitting, you cannot easily place one ankle on top of the opposite knee, you have some level of external rotation tightness. This can limit your ability to sit up straight. Limits in the opposite direction more often create problems with high-level physical activities, or if limited a lot, with walking.

Take caution: Just simply stretching the hips may not be the answer. Especially if you already do and still have back pain. Consider your posture in every hip stretch you do. Can you keep your spine neutral (slight crescent curve open behind you)? Can you keep both “sits bones” on the ground? Always check with your yoga instructor, physical therapist, or other health and fitness expert if you are not sure. If you have poor posture/alignment in a hip stretch, you will only continue to aggravate the part that is hurting.

In non-traumatic injuries, pain is rarely where the problem will be found. Pain is simply your body’s way of calling out for help. It is a message from a victim saying, “I cannot keep doing this for you. Someone else has to help me.” Try to resist thinking "It’s just that bad back of mine again". Instead, try to identify the true cause of the problem.

 Be Well,

 Erin Clougherty, DPT

Physical Therapist

Before trying any exercise that is new, you should always consult your primary care provider about your readiness for exercise. Regardless of your familiarity with these stretches, go to your doctor first if you experience any of the following: pain shooting down one or both legs, numbness in one or both legs, loss of control of any bodily functions (even if it seems temporary), or low back pain that makes your back "lock up" and you are unable to stand up straight.

For relatively minor aches and pains:

What you might feel:

Increasing lower back pain (especially pinch quality) with prolonged walking or standing...

What you should do:

Stretch hip flexors (iliacus and psoas): All the lunge poses (Warrior 1, 2, crescent) will do this as long as you keep the spine neutral (think "Tall") and tailbone pointing toward forward heel.

What you might feel:

Aching lower back pain more on one side when turning to that side OR while trying a supine twist (lying on your back knees bent and letting knees fall off to side opposite where the pain occurs)...

What you should do:

Stretch the hip joint to increase internal rotation: Lie on your back with knees bent and feet wide. If stretching the left hip, you will let the left knee fall in (to the right) but keep the left pelvis on the floor as best you can. Increase the stretch intensity by placing the right ankle on the outer left knee to draw the left knee closer to the floor and further press into the stretch.

What you might feel:

Aching tightness in low back when standing up from a chair you have been sitting in for a while OR getting out of bed in the morning...

What you should do:

Stretch your hamstrings: Sit at edge of a chair or bench with one leg out straight, heel on the floor and the other leg bent and foot flat. Grow your spine tall and slowly lean forward bending at the hips and keeping the spine neutral (trying to "stick your tail out" as you lean forward will help isolate hip movement from lumbar spine motion). Just lean forward far enough to feel a stretch in the back of the straight leg's thigh.

What you might feel:

Aching tight back pain when sitting in the car/driving for extended periods...

What you should do:

Stretch hip joint to increase hip external rotation: butterfly stretch (in yoga terms this is Baddha Konasana or bound angle pose), figure four stretch on you back also works well.

 

If your pain persists despite these efforts, fret not! There are many causes and contributing factors to low back pain and most are low load repetitive stresses that are not obvious. All these stretches are most effective as prevention. Some comditions will require the skilled hands of a physical therapist to identify the specific problem and recommend a tailored proram specific to your needs. Trying these stretches is not a wasted time if you still need to see a professional. You will at least be able to tell your physician or physical therapist what you have tried and that these were not helpful which helps your provider narrow the diagnosis more efficiently.

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