Updated September, 2016
Back pain? Maybe it’s from your tight hip flexors.
For the millions of us suffering from lower Back Pain (LBP), most do not realize the contribution that tight hip flexors may have. It is not very common to have both LBP and healthy, conditioned hip flexors, except in instances of disease or injury. In cases of chronic LBP (which involve muscular imbalance), tight hip flexors are often among the causes of this condition.
Lower back pain is a common problem which affects most people at some time in their life. The statistics range from 1-2 adults for every 5 when asked if they have experienced pain within the last month with repeated episodes. In studies in the United States, up to 85% of people with lower back pain have required consultationwith their healthcare provider.
Tight hip flexors are generally not suspected until significant alterations in mobility and injury are found. Some of these muscles, which include the psoas major, iliacus and tensor fasciae latae are difficult to target physically. Most of us do not even realize the significance of these muscles until they are deficient in their operation. When they do not function well, they become weaker and tighter from lack of use. This results in a significant shortening which reduces the mobility of the joints they operate.
Reduced mobility also leads to reduced use and increased strain on the joint
It also results in overcompensation of other joints and areas. This includes the lumbar spine. This reduction in mobility can have a serious effect on the lower back and knees. When patients report issues with lower back symptoms, a limited hip extension range of motion (ROM) with hip flexor muscle tightness is associated. These patients also present with ‘lower quarter’ and functional limitations. Often when a patient complains of tight hip muscle symptoms experienced with pain, they most likely have lower back symptoms as well.
Unfortunately, our typical lifestyles directly affect the hip flexors negatively. The average person spends an extensive amount of time in a sitting position throughout the day. This adversely affects the health of your hip flexor muscles and surrounding joints. Whether seated at work, during your commute or at home, your hip flexors are in a constant state of contraction, shortening and exert minimal energy.
Over the years, these muscle groups become weakened and easily fatigued.
They diminish in tone and conditioning is reduced. Even when in a standing position, these muscles exert little effort and movement necessary to their well being.
As a result, it becomes progressively easy to develop tight hip flexors. Most of us are not aware of what to do to correct it. Also, the average persons’ sedentary lifestyle, encourages one to remain in a seated position with little opportunity for exercise. This directly contributes to the shortening and weakening of the hips flexors. In fact, sitting would be the ideal method in which to put your hip flexors in a shortened position.
When you are experiencing symptoms of lower back pain, your first reaction is to try to adjust your back rest, seat cushion or mattress. This may help to adjust your position to alter your comfort level but it rarely addresses the root cause.
These methods provide a short term fix for a long term problem. For example, if you are feeling symptoms of lower back pain while reading this page, you may feel that by standing or massaging your lower back, or by simply arching or twisting your body, you will have some needed relief. This is certainly true but if you find yourself relying on this habit repeatedly, then there is a much deeper issue.
Try this stretch for your tight hip flexors
Part of the solution is not simply to stand, but to lower one leg beside our seat and then to stretch it back behind. This stretches the psoas major, a major culprit for lower back pain. This exercise can be found in thesitting pain page. This stretch should be performed often and even when pain or tightness is not present. This helps to relieve symptoms of discomfort but will stretch a key hip flexor. This stretch helps to also readjust your pelvic tilt from one of a posterior tilt, towards anterior in order to become neutral. This helps to prevents lumbar disc bulge and also alleviates soreness found among the muscles of the lower back.
Most of us do not complain of having sore hip flexors unless we have overused them from exercise. Rather, we complain of the other areas of the body that the hip flexors affect. Some of these areas are the lower back and lumbar vertebrae. If your hip flexors are shortened and weak, you may experience a dull, aching sensation of pain in your lower back throughout your day and particularly as you are in a standing position. This is because of the psoas major attaches from the femur to your lumbar vertebrae. (This muscle is illustrated in figure 6.1 as part of the iliopsoas). This allows this muscle to flex the hip joint upon contraction thereby raising your lower legs. This action is required everyday, ranging from kicking a ball, to walking upstairs.
When standing, there is a pull on the lumbar vertebrae, resulting in discomfort due to an over arched lower back. This becomes more evident if you were to lie flat on the floor and observe whether or not your lower back arched or lifted off of the floor. This is also true of another key hip flexor called the rectus femoris (fig. 6.1). A loose, well stretched psoas major would allow your lower back to rest closer or fully with the floor. As a rule, if you can slip your entire hand behind your lumbar spine while lying down, your hip flexors may be too tight. You may likely experience discomfort in the lower back while performing this test.
Without addressing the hip flexors, the effort that we put in to relieving our back pain is lost. Our best attempts to solve LBP are temporary at the most. Hip flexors require a specific treatment plan in which they are both lengthened and strengthened for optimal conditioning.
Most of us already know that stretching and strengthening is key.
We can readily go online and find countless images of perfectly healthy individuals demonstrating for us how to perform these movements. We can copy their movements or videos and begin a routine.
Massage and massage therapy is often a very common method in which to attend to hip flexor pain. It certainly has its benefits. Pain is effectively reduced but frequent visits are generally required.
Some methods to address tight hip flexor muscle include techniques which apply different ways in which to stretch. Passive, ballistic and proprioceptive (PNF) stretching are among them. These methods can be very effective if done correctly and routinely. Some studies indicate that subjects with lumbar or lower back pain symptoms who performed either passive or active stretching for tight hip flexors improved the range of motion of their hips over a 3-6 week period. Either method was found to be equally beneficial.
It should be noted that passive stretching increases a muscles’ viscoelastic ability. Here, when a muscle is stretched over a constant period of time, initially it will resist the stretch. After a short time, it will gradually relax and lengthen. When this is done routinely, the muscles then learn to relax and lengthen in a more efficient manner. This will allow the stretch to facilitate faster and more effectively when performed as a routine.
Most of us can become successful with alleviating pain.
However, for the rest of us that do not find relief, we need to try a different strategy which does not allow us to fail and later struggle to find another. Stretching programs are frequently used by physical therapist for their patients.
This website is geared for those of us who need a structured, safe, easy and effective method to address tight hip flexors. There are many exercises that can be learned throughout this site. For are more comprehensive and effective program, please read the program page. It offers a real alternate to simply copying the movement of models and athletes or other professionals who merely study pain and have yet to struggle and overcome it.
Spend the time to go through the many pages and informative suggestions to address both your tight hip flexors and lower back pain. Here you can find numerous pages and illustrations available to provide much needed help. It is worth the investment.