Got Low Back Pain? Check Your Hip Flexors.

When you walk, run, or climb stairs, you have to move your leg forward and bend it from the hip in order to make much progress. The same goes for your knees of course, but let’s save that for another day.

Muscles that flex your hip so that you can put your foot forward work together in many ways to get the job done. Some of these muscles run down the front and sides of your thighs.

But let’s go big for a minute. The biggest, thickest hip flexor is called the psoas, and runs from your low back vertebrae (L1-5 and sometimes T-12) to the top of your thigh bone, the femur. This is the good news. It is there to move your leg so you can do all the things we just mentioned, AND it helps to stabilize the vertebrae in your low back at the same time. You need stable vertebrae as your legs move beneath you so that you don’t get too much rotation in your spine or pelvis as you go.

So now you are probably already thinking…what’s the bad news? Right. Here it is. When your psoas gets tight, it can pull on your low back, make it have an excessive curve (called lordosis), and give you low back pain. That’s the short answer.

A longer answer is that a tight psoas also inhibits your glute maximus (large butt muscle), your lower abdominals, some of the muscles that help you keep your spine extended for good posture, and your hamstrings. The upshot from all that can be poor posture and alignment, and the overworking of some other muscles in your back and legs. In other words, many muscles need to be working together, and if things get out of whack, you may suffer.

But since we are homing in on the psoas, how does this specific muscle get tight? Two main ways. #1: sitting a lot, and #2: Not doing much movement that brings your leg behind your pelvis. #2 is where you may not walk or run much, and/or your stride is short. #1 is self-explanatory.

How can you tell if you need to work on this? One way is to check the curve in your low back. Check your posture in the mirror. If your low back is curved like a sway back, it can mean that you have the psoas pulling it towards the front. If you press your arms up from your shoulders and the curve stays or gets worse, then you can again suspect that this area is tight. For a more information on this, see my blog, “Truth or Consequences: Is Your Back Curved or Straight?”

The answer? Well, your psoas needs to be strong AND flexible in order to do its various jobs. This will save you from back pain or a host of other problems related to not being able to move your hips and legs well. (Sorry for the gloom and doom, but prevention can be a wonderful thing.)

One good idea is to walk. Make a conscious effort to walk tall, abs engaged, shoulders back, with a full stride.
Strengthen your glute muscles and your abdominals to bring them into synchrony with your psoas. This will help your psoas stop overworking and give it a chance to relax and stop being tight.
Introduce movements that get your psoas and other hip flexors going again. As an example, see the exercise below, Side-Lying Bicycles. Lay on your side, body in good alignment, legs extended. Activate your abdominals to help you stay in place and keep your spine in neutral as you do the exercise. Take the top leg and make a forward pedaling motion, using as big a motion as you can without compromising your alignment and set-up. Do this 10 times, and then reverse the motion 10 times. Do the other leg. You will probably notice that your abdominals and butt muscles are also participating, which gets the synchrony going that I was talking about.
Stretch your psoas. As in the stretch below, Hip-Flexor Stretch, place one leg ahead of the other in a staggered stance. The front leg should be far enough ahead of you so that your knee does not come out over your toes. Bring the other leg behind you as far as you can. Hang on to a chair or other sturdy object if you need to for stability. Activate your abdominals and press forward with your hips to stretch the front of your hip and thigh. Now, check the curve in your low back. You can place one hand on your low back and the other on our abs to help reinforce this. If, as you press forward the curve gets deeper, pull back off the stretch. Stay tall with your torso and use your abs to help keep your low back from going in to too much curve. Then, see if you can press forward again but keep your low back neutral and not moving into a bigger curve.
And, the last suggestion. Once again, it’s to get up and move! Be conscious of how much time you actually spend sitting, and try to find ways to reduce that time. Stand up more, walk more, find an active hobby, join an exercise class or hiking group. It all matters!

Cheers,
Kristen