Treating your sore and weak hip flexors and hamstrings to avoid lower back pain

By Sherwin Nicholson, Honours Bachelor of Science, Author and Back Pain Specialist, SN Health Resources, Lowbackpainprogram.
Updated November 20, 2017 |SN Health Resources

Keeping them in proper shape is still the best way to reducing pain and protecting your back

It’s a very bold statement but it’s also very true.  If you neglect them, your back can suffer and anything that you do physically can become a chore instead of an activity.
Your hip flexors and hamstrings are among the most important groups of muscles to look after in your body.  They are essential for the long-term mobility and stability of your lower back.
Flexible, well-conditioned hip flexors and hamstrings are vital not just for preventing lower back issues, but for the prevention of both hip and knee problems.  If you neglect them, all three areas will suffer.

your hip flexors and hamstrings can cause back pain

Acute or chronic pain in these areas can be a sign of a medical concern which should be brought to your physician or health care professional.

If the root cause of the pain is found to be muscular, it is important for you to understand why it is occurring in the first place. With added help and support, you will be able to take the proper steps to correct the causes.

They Are Not As Well Understood as Other Muscle Groups

Compared to some of the more prominent muscle groups, the hip flexors and hamstrings are not as well understood.

Part of the problem with why we neglect them is because unlike the other more visible and muscular areas of the body, we cannot ‘see’ how well or poorly conditioned they have become.  Their importance often stands out only when symptoms of pain are experienced in the area surrounding the hip joint or the back of the thighs.

One thing that we all are guilty of that affects them is prolonged sitting.  Sitting is a big problem for both muscle groups because it makes them inactive.  When you do this, you start a cycle of atrophy and strain that you can learn to break.

Although there are many ways to treat and address these areas, it is important to identify and understand the mechanics of each muscle as will be discussed below.

Can Tight or Painful Hip Flexor or Hamstring Muscles Affect Each Other?

Yes, but the pain in one does not necessarily lead to pain in the other.  What they do both result in are issues in the lumbar region of the back.

Initially, it is common to have isolated hip and hamstring pain due to muscle weakness and tightness in that area. With time, however, as these regions become progressively weaker or tighter, the lower back is affected.

How to Manage Tight Hip Flexors and Pain

How Hip Flexor and Hamstring Issues Contribute to Lower Back Pain

The health of your lumbar spine (specifically the L1-L5 vertebrae and discs) is directly affected by the action of the hip flexors and hamstrings.

When there is an imbalance present in any number of these muscles, the lower back can easily be subject to strain and injury.  Corrective action is necessary to reverse this imbalance and therefore reduce the risk of damage to the spine.

Learn This Very Effective (and Lumbar Protective) Stretch for Tight Hamstrings

Do This Simple and Easy Stretch for Tight Hip Flexors

Try This Challenging Yet Helpful Stretch to Help Treat Hip Muscle Pain

Are You Hesitant or Lousy with Your Stretches? Take the Lazy Stretcher Test. Then Start Stretching!

Follow this ONE SIMPLE RULE to Protect Your Back, Engage Your Hip Flexors, Reduce Hip and Hamstring Pain, and Stimulate Hamstring Flexibility

Get started with these 10 Important Exercises for Lower Back and Hip Pain

In most cases, people who experience lower back pain usually have accompanying tightness and imbalances in the various muscles illustrated in Figures 6.1 and 6.2 below.  For example, it has been well established in both in the literature and among health professionals that tight hamstrings are one of the primary contributors to chronic lumbar pain.

Tight Hamstrings and Pelvic Tilt Pain

It is very rare to have chronically tight (or short) hamstring muscles and NOT suffer lumbar pain. The hamstring muscles are a group of very strong and large muscles which are often poorly maintained. It can be very challenging to keep them well conditioned, even under ideal situations.

Tight hamstrings and hip flexors will often occur together. The strong pull of tight hip flexors can lead to an anterior pelvic tilt.  This forward tilt of the pelvis causes an increased pull on the hamstrings which contributes to the tightness of the muscle group.  Another common contributor to this pelvic tilt and the related pain is the hip flexor muscle known as the psoas (pronounced “so-as”) muscle.
Pelvic Tilt and Lower Back Pain

Unlike the hamstrings, which are not connected to the lumbar vertebrae, the psoas is directly attached to each of the five lumbar vertebrae.  Please read on for further details.

To maintain the healthy and proper curvature of the spine, the muscles which are located in front and behind the pelvis must act and function in a balanced fashion throughout your daily activity.  In doing this, they keep the pelvis in a neutral and safe position.  This ’tilt’ is necessary to maintain evenly distributed pressure on the vertebral discs. 

Try This Exercise to Help Relieve Your Anterior Tilt Discomfort


Hip Flexors

The Hip Flexor Group

In figure 6.1, we see that the hip flexors perform various functions, especially where some muscles within the group cross over both the hip and knee joints.  The hip flexor group consists of the iliopsoas, rectus femoris, sartorius, tensor fasciae latae, pectineus, gracilis, adductors and a gluteal muscles.

the hip flexor group and back pain

It is the iliopsoas muscle which has the strongest pull on our spine.  It is attached to the L1-L5 and T1 vertebrae.  A tight psoas (the part of the iliopsoas that connects to the lumbar spine) can pull on the spine and compress the discs and vertebral joints associated.

Poor Conditioning and Lumbar Pain

This is a very strong muscle. If it is always tight, the compression is amplified along with pain.  Stretching of the psoas is vital to back health.

A chronic state of shortening can lead to an increased anterior pelvic tilt which is very harmful to the discs, especially within the L5-S1 region.   A tight iliacus muscle (part of the iliopsoas) also corresponds to a tight psoas.  The other hip flexor muscles mentioned above also influence the anterior pelvic tilt.

At the Workplace and Home

Most people do not have any serious conditions other than symptoms of fatigue in the lower back after extended times of sitting.   They can usually cope with this temporary discomfort and will recover quickly.  However, daily activities which involve extended and prolonged periods of inactivity or even over activity will cause muscle imbalances and chronic lower back pain.


Many symptoms of lower back pain can begin with tight hip flexors or hamstring muscles. It is rare to find a person who does not have tightness in these muscles, especially the hamstrings group.

When the hamstrings are too tight, they prevent the pelvis from tilting forward in a smooth manner, simultaneously with the back when bending forward to neutral.  As a result, you will mistakenly bend at the back, rather than at the pelvis to compensate for the lack of flexibility.

Tight hamstrings are often very uncomfortable to stretch, and we find ourselves trying to avoid it as much as possible.  We tend to favour bending the back rather than tilting our hips because of the discomfort we feel from tight hamstrings.

your hamstring group

The Hamstring Group

The three major hamstrings as seen in figure 6.2 are the biceps femoris, semitendinosus, and the semimembranosus muscles.  These muscles are very challenging to stretch and require sincere effort, time and patience to achieve long-term results.

The tightness of a muscle is usually the result of lifestyle but can sometimes be a natural condition in an individual.  The better solution, however, is always to lengthen the muscle with stretching.

How Lifestyle Worsens the Hamstring Group

Extended periods of sitting, as in the cases of driving, office work, sitting in front of the TV or even extended periods of studying will cause tightness in the hip flexors and hamstrings.

During these activities, the muscles are in their shortened positions, with blood circulation and nerve activity within the tissue also being compromised.  This not only produces a tight and shortened muscle but also contributes to overall weakness and decreased responsiveness in that muscle.

During upright and active periods, these tight and weak muscles are sometimes required to perform the job of stronger and more lengthened muscles.

This is likened to using a stiff, old rubber band instead of a new, more elastic one.  When these muscles are required to perform daily work in the upright position, they will do so, but with added strain on the lumbar spine and discs.

Poorly Conditioned Hamstrings Lead to Spinal and Muscular Issues

A lengthened and stronger muscle can extend and flex the legs with minimum effect on the normal curvature of the spine during activity.

Short, tight and weak muscles will exhibit much more pull, tension and fatigue on the lumbar spine and pelvis as they are no longer as efficient at relaxing and lengthening at times needed during exertion.

When hip flexors and hamstrings pull on the spine and pelvis with increased force and tension, the pressure on different sides on the discs increases dramatically and causes degeneration.

This causes too much movement and compression on your spine and discs.  They become progressively worn over time and may lead to disc and vertebral problems.

The Connection Between Healthy Hip Activity and Lumbar Safety   

The fact that we must ‘keep our back straight and bend at the hips and knees’ is not really news to us at all, especially for back pain sufferers.  

What we must understand is that there is a direct relationship and correlation with your lumbar spine and your hips that cannot be overemphasized.  The more that you use your hips and legs, the less work your spine must perform.

Remember this One Simple Rule to Use Your Hips More and Reduce Lumbar Pain

It is through the combined action of maintaining strong and supportive back and abdominal muscles to control neutral posture (that ensure minimal bend in the lumbar spine) together with the hip flexors and hamstrings that lower back pain is reduced or minimized.

Getting the Right Help for Hip Flexor and Hamstring Pain


To reduce the discomfort of lower back pain, your hip flexors and hamstrings should be exercised in many different ways.  This requires several different positions, stretches and movements.  It is usually insufficient to perform basic, standard stretch and strengthening methods since they don’t necessarily target ALL of the muscles of concern.

Try this Hamstring Stretch to Help With Stubborn, Tight Hamstrings

Follow this stretch technique for healthier hamstrings

The Low Back Pain Program eBook teaches specific lower back exercises that specifically target the hip flexors and hamstrings among other muscles groups involved. The exercises help the muscles and joints to move in a multitude of directions and positions. These methods teach you how to SAFELY stretch your hip flexor and hamstrings muscle without risk to your spine.

You can learn better methods of safer hamstring stretching than the standard “toe touching” way that is, unfortunately, harmful to your back.


This variation is key to progress out of back pain.  The Instructional Guide provides careful and progressive methods which allow them to function more effectively and help to reduce the unnecessary stress and burden on the lumbar spine.


“I wanted to let you know that your program has made me have unbelievable breakthroughs and in only two days. I now realize that my pelvis has been tilting back and up as well as to the right side. Your hip unlocking exercises in particular made me feel something I forgot I could feel. I’m 22 and was having a lot of spinal issues and joint pain which was causing immobilizing suffering but this has already made me have unbelievable relief and hope. You’re a real life saver” 

“This book is a lifesaver for anybody with chronic lower back pain. I have suffered from lower back pain for 6-7 years and nothing I tried (physical therapy, yoga, swimming) provides any meaningful lasting relief. Found this book about 10 days ago and have been following the exercises in this book; it is like magic and I have been pain-free for the last week. After many years, I am sleeping well at night and wake up energized and ready to take on the day.”




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how the exercises help to relieve your pain

Excellent for Hip Flexor and Hamstring Pain


Get more help here:


  1. Treat Your Own Back – 2011. Robin McKenzie.  Gordon Soules Publishers. 9th Edition.
  2. Strength Training Anatomy – Frederic Delavier. 2006. QM151.D454. 2nd edition. Human Kinetics Publishing.
  3. (The National Institutes of Health)
  4. Lower back pain – Eric R. Castillo Daniel E. Lieberman Evol Med Public Health (2015) 2015 (1): 2-3. DOI: Published: 10 January 2015

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