The source for back pain can commonly be found at the hips; more specifically, lack of complete hip extension. One of the byproducts of tight, weak hips is an anteriorly tilted pelvis, aka lumbar lordosis. Now, the pelvis may orient itself that way in static postures, but I’m typically more concerned if the person has the wherewithal to be able to move OUT of that position. If it cannot, chances are your lumbar spine ain’t liking it that much, and it’s certainly not conducive with long term back health.
One of the main issues involved with tight, weak hips is excessive compression of the lumbar facets, discs, nerves, fascia, musculature, etc., due to the position that the pelvis is in relative to the anatomical structures above and below it (in this case, the femur/lower leg and thoracic spine). So what can you do about it? Well, there are many variables to consider, including but not limited to:
– Length of time the body has been exposed to the dysfunctional movement pattern
– Relative tri-planar range of motion/stability of surrounding joints/musculature
– Current level of trunk stability
While many kinesiologists, strength coaches, physical therapists, personal trainers, chiropractors, etc. may have different methods of getting after low back problems, most effective programs are going to tackle these critical steps:
1) Soft Tissue work (Self Myofacial Release, or SMR for short),
2) Activation Drills
3) Dynamic Stretching/Joint Mobilization
4) Integration Exercises.
First thing’s first though, we gotta get that stubborn, tight, tender tissue of the “Front Butt” ( or Hip Flexor Complex – Tensor Fascia Latea, IT Band, Rectus Femoris, Illiopsoas) to stop being just what it is; stubborn and tight! We need to increase soft tissue extensibility, temperature, elasticity, and turn on some proprioceptors in the area so that we can get the hips and the back to start communicating with each in a healthy way again!
Hence, foam rolling and stretching the Front Butt is an excellent start for this!
My recommendation: spend at least 30 seconds in the most tender areas around the front and side of the hips, and just sit there for 30 seconds… You can either hold it on tender spots, or gently kneed back and forth. I find that 2-5 minutes on especially sensitive areas is a great strategy. Here are a couple videos performing SMR on the Front Butt:
Then, you can follow this with some dynamic stretching. here are a couple more you can try:
My recommendation: get at least 2 sets of 10-15 “rocks” back and forth just before the point of discomfort (only slight discomfort!), being sure to drive in from the hips FIRST!
Then, it becomes important to activate the muscles that have been “turned off”, or even “turned down”, due to the synergistic dominance of the overly tight Front Butt. I like doing Wall marching drills, as this teaches the back leg several important things, when done correctly:
– Increases glute activation in the presence of end range of hip extension (via Reciprocal Inhibition, a topic for another day in and of itself!)
– Increases core activation due to the mass and momentum of the driving leg
– Reinforces a concept of “forward lean”, which is necessary for proper running/sprinting mechanics
My Recommendation: Perform 2 sets of 10 reps, each leg.
Finally, we need to integrate, which must involve the body moving through space as a whole. Here’s a great video to demonstrate this:
My Recommendation: Perform 2 sets of 8 lunges (1 rep = the same leg going forward and backward)
So there you have it, a 4 step approach to help increase range of motion and strength in the hips, therefore taking much unneeded stress off of the low back. My question for you – what have you found that works to help out your low back pain? Tell me in the comments section, I’d love to hear about it!