Smart Stretching to Ease Low Back Pain
Low back pain is a common complaint for so many people—whether you are a serious athlete, a weekend warrior, or somewhere in between. If you've ever Googled "low back pain," you've probably seen "tight hip flexors" mentioned somewhere in the results. And you’ve probably spent a lot of time stretching and massaging your low back in hopes of getting some relief but that aching feeling never quite goes away. If this sounds like you, here’s a science-based protocol that will:
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Build your understanding of the relationship between low back pain and hip flexors
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Guide you through effective stretches that can relieve low back pain caused by tightness in the hip flexors
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Activate the supporting muscle groups to ease the tension in the low back
Your primary hip flexors are the iliacus and psoas that attach on both the right and left sides of the spine down to the respective right and left inside of the thigh bone. The iliacus is a short, broad muscle that runs from the inner border of your pelvis and passes through to connect on the inside of your femur (thigh bone). The psoas muscle runs from the vertebrae on your lumbar spine (low back) (L1–L5) and attaches to the inside of the femur (thigh bone). Because it originates on your spine, any excess tension or shortening in this muscle pulls directly on the lumbar vertebrae and can keep you feeling muscle tightness through the low back and in the front of the hip. The other culprit is the rectus femoris, the quadriceps muscle that crosses both the hip and knee.
Activities that stress flexion through the hip like running, hiking, rock climbing, long periods of sitting, or even those weekends of “catching up on your Netflix shows” can result in neurologically shortened or contracted muscles in the front of the hip. These shortened muscles can tip your pelvis into an anterior tilt and keep you feeling stuck in this position no matter how much you stretch your back. Think of this like a tug of war between your low back and the front of your hips, with the front of the hips on each side “winning” with a stronger tug!
Try these steps for more ease at the hips and low back:
1) Neurological stretching of Hip Flexors—Left hand holds onto something at shoulder height, Stand in a modified lunge with your L foot forward with bent knee, R leg extended behind you, both heels on the ground. Check that both hips are level, no hiking up of one side. Squeeze your R butt cheek and hold for 8-10 seconds then relax into a deeper hip flexor stretch. Repeat this butt activation 2-3 times. You may already feel a stretch in the front of the R hip. If not, begin to tuck your pelvis under (moving into a posterior pelvic tilt) and further lengthen out the front of the R hip. Keep your torso upright and find the alignment where you feel a stretch in the front of the R hip. Repeat the butt cheek activation 2-3 times. Next, lift your R arm up and overhead, reaching up and out of the R hip, increasing the stretch with a focus on the upper region of the hip flexors. Repeat the butt cheek activation and relaxation 2-3 times. Switch to the Left side.
2) Reciprocal Muscle Activation— Pelvic bridges to activate the gluteal muscles. Lie on your back, knees bent. Before you lift your pelvis into the bridge, press into your heels to connect through the back of the body and activate the gluteal muscles. You may find you need to actively squeeze your glutes as you get used to this exercise. If you feel your lower back taking over, drop the height. Three sets of 10–12 slow repetitions. This helps the brain recognize that the glute maximus is back “online” to do its job as the primary hip extensor.
3) Integration—Make sure to balance your hip flexion activities with extension using the standing lunge stretches, single or double leg pelvic bridges. You can also roll out the front of the hip and upper quadriceps muscle with a small ball or roller and then activate the gluteal muscles for especially tight feeling hip flexors.
It might seem counterintuitive to stretch out the hip flexors instead of where the pain is coming from, but once you understand the relationship between the front and back regions of the hip, it should clear up why stretching the back never offered any relief! This protocol helps the brain recognize that the glute maximus is back “online” to do its job as the primary hip extensor and that the neurologically shortened hip flexor is returned to its resting state. This protocol is a quick addition to your warm-up and/or recovery routine that can help you find greater ease in movement with science-based tools to end that painful “tug of war” between the low back and hip flexors.
@susanhainespilates
www.susanhainespilates.com
Susan Haines is a kinesiologist based in Bellingham, WA, bringing the latest research in fascia, biomechanics, and neuroscience into movement training and Pilates. Her research has been presented internationally and at universities and conferences around the US. Susan is a Level III NeuroKinetic Therapy practitioner, a sophisticated treatment modality that addresses the causes of dysfunctional movement in the motor control center. She has an MFA from UNCG-Greensboro where she studied with leaders in the field of Somatics and Kinesiology: Dr. Jill Green and B.J. Sullivan. She is nationally certified as a Pilates instructor with NCPT, Functional Range Systems, Yoga, IASTM, and helps clients from all walks of life improve their movement potential. She is on faculty at Western Washington University teaching dance, Pilates, and experiential anatomy in her Apolla Shocks.
