Teaching the Hips to Help the Lower Back

The lower back and hips work together very closely to produce movement. They are part of the overall core. Very often, people with persistent back pain have major limitations at the hips which place undue stress on the lumbar spine.

Inadequate Hip Flexion
Hip flexion refers to pulling the thigh up to the chest. When bending forward, the chest is bending toward the thigh (hip flexion in reverse). When the hip stops bending, all the stress is then placed on the lower back. Here is a typical stretch to help with hip flexion.

Inadequate Hip Extension
Hip extension refers to pulling the thigh back behind you. Normal isolated hip extension should result in a 20 degree angle at the hip.

For many, the hip barely gets to a 0 degree angle, because either the hip joint or the muscles in front of the hip (illiopsoas, rectus femoris) are tight. This means that during walking for example, the lower back has to pull your leg behind you. Here is an excellent stretch to help with hip extension.

Inadequate Hip Internal Rotation
A normal hip should rotate inward at least 35-45 degrees. When this does not occur, the lumbar spine must move more when rotating the body. This places excess strain on the lumbar discs. Here is a stretch that can help improve hip internal rotation.

Weak Gluteal Muscles
The gluteal muscles (gluteus maximus, gluteus medius, gluteus minimus) should be a strong source of power during movement. For many patients with lower back pain, these muscles are weak and inactive. As a result, the muscles of the lower back must compensate by helping to pull the legs back during walking.

DISCLAIMER:
The information presented on DaiseyPT.com is provided for educational purposes only and is not intended to be a substitute for professional medical or physical therapy advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

The exercises presented in these articles pose risks if performed incorrectly or if performed by persons who may be inappropriate for them. They are provided for informational purposes only and to provide education and insight into a particular interest. Daisey Physical Therapy & Sports Medicine Inc. does not recommend performing them without a complete history and examination as well as professional instruction. Daisey Physical Therapy & Sports Medicine assumes no liability for any injury that may occur by attempting the exercises presented here.