The knee bone’s connected to the… hip bone. The hip bone’s connected to the…lower back pain that most people will experience at some point in their lives. Low back pain is second only to headaches as the most common neurological ailment affecting adults in the United States. You may wonder, what exactly is the perpetrator of this pervasive pain?
Most prominently, low back pain is caused by the sedentary lifestyle of working adults in an industrialized nation.1 However, there are myriad reasons for back pain, and only a qualified professional can assess each individual’s unique body structure. That being said, an often-overlooked source of low back pain is the hip region. Imbalances in the hips may actually cause your low back to suffer.
Back Pain Is Never One Solution Fits All
Because the spine is a complex region made up of four regions, more than thirty bones and intricate layers of muscle and other tissues, back pain can vary greatly from person to person. On average, low back pain mostly affects adults aged 30 to 50, the time when bone strength, spinal fluid and muscle elasticity aren’t what they used to be. Some of the most common causes of severe low back pain include a herniated disc, sciatica, spinal degeneration, spinal stenosis, osteoporosis, fibromyalgia, skeletal irregularities and inflammation.2 Severe or chronic back pain (lasting more than three months) requires professional medical attention. Yet, for anyone who wishes to understand the possible sources of back pain better, severe pain or not, read on: the hips could be an unlikely contributor.
Poor Hip Extension – The Spine Overcompensates
Because the hips are so intricately connected to the way we walk, and also connected to the base of the spine, when the hips are out of sync or the surrounding muscles are weak, the low back may be forced to compensate in order to allow for movement. You might not even know that the way you walk is causing your low back pain!
So what is healthy hip extension? Hip extensions happen in more places than the machine dedicated to it at the gym – in fact, every time we take a step forward, we are essentially making a hip extension with the opposite leg. Normal hip extension, from a neutral standing the low spine only provides support, not initiation of this movement.
However, the front muscles of the leg, the flexors, must be long enough and strong enough to make this movement easily. If not, the lumbar region of the spine will overcompensate for the muscles and overextend, causing continuous and unnecessary strain on the back.3 Luckily, it’s not too hard to start alleviating this common imbalance.
Don’t Let Your Spine Do All The Work
With the help of a trained kinesiology professional (physical therapist, chiropractor, massage therapist, corrective exercise coach) you can easily tell if your hips are causing your low back to suffer. While lying straight on a table, your kinesiology professional will ask you to raise your leg straight off the table about 10-15 degrees, the same arc of movement used for walking. Now, the muscles surrounding the hip, the hamstrings and the gluteus maximus, should be responsible for this movement. However, in a significant portion of the population, one or both of these muscles will not be strong enough to initiate the movement, and it will be the lower back taking on the strain of lifting the leg. Legs, by the way, generally account for 22-25% of total body weight,4 so you definitely don’t want your spine to do all this extra work!
Luckily, stretching and strengthening the hip flexors and gluteus maximus is a guaranteed way to improve hip functioning and reduce low back pain caused by this imbalance. The more balanced the hips, the more pain-free the back!
Assessment, Stretching and Exercise
In addition to this initial hip/back test, your kinesiology professional will perform a few more assessments to see how your unique body operates. Then, one of the most accessible prescriptions is regular, conscientious stretching. Some of the best generalized hip openers include (in yoga terms) the butterfly stretch, happy baby, pigeon and warrior lunge stances.5 If these names mean nothing to you, don’t fret! A kinesiology professional can walk you through healthy corrective stretches that are right for your body. Remember, the body is like a bicycle wheel where the spokes need to be balanced in tension (length AND strength ratios) on both sides of the wheel. Our bodies, being more complex than a bicycle wheel, need to be balanced left to right, front to back and up to down as a simple structure subjected to repetitive, complex movements that we initiate hour-to-hour to get though our daily activities.
Hip Openers Connect To… Reduced Back Pain!
Restoring normal functioning patterns in the hips can have far-reaching positive effects:
• Reduce low back pain caused by hip imbalances
• Avoid overextending the spine to compensate for the hips
• Correct an imbalanced gait
• Create a fuller, easier stride to walk more often and more painlessly
• Improve performance in activities like running and swimming
• Improve general flexibility and range of movement 6
Remember, your hip bones are connected to your back bones – and they could be causing a lot of unnecessary strain!
TAKING ACTION
Because so many people, in this 21st Century, spend so many hours in a day sitting at a desk, driving, eating, watching TV, etc,…one of the best ways to combat hip/back imbalances in daily life is to set your computer desk to a sit AND stand option. Until we have stand-up cars, or until you love standing up to watch your favorite TV shows and movies, standing for a few hours of the day at your desk can be the most functional way to make a big change. DO NOT invest in the expensive desk chair, instead, get an adjustable height drafter’s style chair and a desk that either adjusts in height with the touch of a button or set your workstation up to a standing level with the drafter’s chair set to this height for sitting. See what happens to your hip and postural functionality with this simple change! If you are wanting more information on this, contact me and I can even send you more information on desks, chairs and a DIY set-up that is cost and bio-mechanically effective. ; )
Written by Isaac Chenevey & Nancy Woo
References
1 National Institute of Neurological Disorders and Stroke. “Low Back Pain Fact Sheet”. National Institutes of Health. September 12, 2012. Web. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
2 Ibid.
3 Dianne Woodruff. “Hip Extension and Back Pain” PTontheNet. April 3, 2003. Web. http://www.ptonthenet.com/articles/Hip-Extension-and-Back-Pain-1958
4 Ibid.
5 Jenny Sugar. :Stretch Those Tight Hips and Lower Back.” FitSugar. January 12, 2013. Web. http://www.fitsugar.com/Stretches-Relieve-Lower-Back-Pain-Open-Tight-Hips-409369
6 Dianne Woodruff. “Hip Extension and Back Pain” PTontheNet. April 3, 2003. Web. http://www.ptonthenet.com/articles/Hip-Extension-and-Back-Pain-1958