Unlocking the Hips: One Essential to Preventing Back Pain

Welcome back to the MoveMed blog! Today, let’s dive into a frequently overlooked but critical aspect of back pain prevention: the role of your hips. In our modern world, we spend a significant amount of time sitting—whether at our desks, in cars, on public transport, or on the couch. Unfortunately, this sedentary lifestyle can lead to a range of musculoskeletal issues, particularly in the hips and lower back. Understanding how your hip flexors function and making simple adjustments to your daily routine can make a significant difference in your spinal health.

The Hidden Culprits: Tight Hip Flexors

Many of us recognise that prolonged sitting isn’t ideal, but few realise its impact on the deep muscles within the pelvis and lower back, particularly the hip flexors. The primary muscles at play are the psoas and the iliacus, which together form the iliopsoas. These muscles are responsible for lifting your knee toward your chest, stabilising your pelvis, and maintaining the natural curve of your lower back.

Psoas

This unique muscle originates from the lumbar spine and attaches to the thigh bone. Often overlooked, the psoas is essentially a back muscle that functions as a hip flexor, playing a key role in connecting the upper and lower body.

Iliacus

Situated inside the pelvic bone, the iliacus works alongside the psoas to facilitate hip flexion, crucial for basic movements like walking, running, and bending.

Prolonged sitting keeps these muscles in a shortened position, leading to tightness, muscular imbalances, and lower back pain over time.

Sitting: The Modern Epidemic

You may have heard the phrase “sitting is the new smoking,” and while it might seem dramatic, it highlights the serious health implications of a sedentary lifestyle. Studies found that prolonged sitting is linked to musculoskeletal disorders, particularly lower back pain, due to the sustained shortening and weakening of the hip flexors. The study also noted that incorporating frequent, low-intensity movement breaks throughout the day can significantly reduce these risks .

The Psoas: A Major Player in Lower Back Pain

The psoas muscle’s unique connection to the spine means that when it becomes tight, it can pull on the lumbar vertebrae, disrupting posture and contributing to discomfort. This makes the psoas a focal point for both the prevention and treatment of lower back pain. Addressing psoas tightness isn’t just about feeling looser; it’s about re-establishing balance in your entire musculoskeletal system, which is crucial for effective back pain management.

Small Movements, Big Impact: The Power of Micro-Stretches

One of the first steps I emphasise in my clinic is that back pain prevention starts with daily habits, not just exercise routines. Before we even consider strengthening and conditioning the back, we need to counteract the effects of sitting by creating an “even playing field” for your muscles. This process begins with integrating gentle, repetitive stretches throughout your day.

Research supports this approach, demonstrating that periodic stretching of the hip flexors reduces muscle tightness, improves flexibility, and can significantly lower the risk of developing lower back pain . These micro-stretches don’t need to be time-consuming but can make a substantial difference when performed consistently.

Easy Hip Flexor Stretches You Can Do Anywhere

Standing Hip Flexor Stretch

Stand upright, take a step back with one leg, and bend your front knee slightly. Push your hips forward gently until you feel a stretch in the front of your hip. Hold for 20-30 seconds, then switch sides.

Kneeling Hip Flexor Stretch

Kneel on one knee with the other foot in front of you, knee bent at 90 degrees. Tuck your pelvis under and gently push your hips forward. You should feel a stretch in the hip flexor of the leg that’s on the ground. Hold for 20-30 seconds.

Seated Figure-Four Stretch

Sit on the edge of a chair, place your ankle on the opposite knee, and gently press down on the bent knee. This stretch opens up the hip flexors and helps alleviate tension.

These stretches can be performed at any time during the day. Just a few moments of stretching each hour can help reset your muscles and counterbalance the impact of prolonged sitting.

Moving Forward: Strengthening from a Balanced Foundation

Once we’ve addressed the tightness in your hip flexors, we can begin to strengthen your back and core, improve posture, and enhance overall mobility. This balanced approach ensures that your muscles work harmoniously rather than compensating for one another. Prevention of back pain is an ongoing process, and keeping your hips mobile is an essential first step.

Conclusion: Your Hips Can Be the Gateway to a Healthy Back

While sitting may be unavoidable, understanding how it affects your body empowers you to take proactive steps toward better spinal health. By unlocking your hips through regular stretching and mindful movement, you can make significant strides in preventing back pain.

Take those few minutes to stand, stretch, and move - it’s a small investment that yields substantial benefits.

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References

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2. Zhao R, Bu W, Chen Y, Chen X. The Dose-Response Associations of Sedentary Time with Chronic Diseases and the Risk for All-Cause Mortality Affected by Different Health Status: A Systematic Review and Meta-Analysis. J Nutr Health Aging. 2020;24(1):63-70. doi: 10.1007/s12603-019-1298-3. PMID: 31886810. https://pubmed.ncbi.nlm.nih.gov/31886810/

3. Konrad A, Močnik R, Titze S, Nakamura M, Tilp M. The Influence of Stretching the Hip Flexor Muscles on Performance Parameters. A Systematic Review with Meta-Analysis. Int J Environ Res Public Health. 2021 Feb 17;18(4):1936. doi: 10.3390/ijerph18041936. PMID: 33671271; PMCID: PMC7922112. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922112/

4. Hatefi M, Babakhani F, Ashrafizadeh M. The effect of static stretching exercises on hip range of motion, pain, and disability in patients with non-specific low back pain. J Exp Orthop. 2021 Jul 27;8(1):55. doi: 10.1186/s40634-021-00371-w. PMID: 34318348; PMCID: PMC8316530. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316530/

5. Wyon M, Felton L, Galloway S. A comparison of two stretching modalities on lower-limb range of motion measurements in recreational dancers. J Strength Cond Res. 2009 Oct;23(7):2144-8. doi: 10.1519/JSC.0b013e3181b3e198. PMID: 19855344. https://pubmed.ncbi.nlm.nih.gov/19855344/