Sunday, February 16, 2014

Back Pain Relief and Hip Stretches - What's the Connection?


I am a physical therapist and I regularly see back pain patients in my clinic who get lasting relief from stretching. Whether they are suffering from a simple case of low back pain or have a fully herniated disc, a key element of their treatment is often a rigorous hip stretching routine.

The Hamstrings get most of the attention when it comes to stretching for back pain relief. The connection between the Hamstrings and the back is that the Hamstrings attach to the pelvis at your sit bones and extend down the back of your leg to just below your knees. This allows them to control motion at the knee and the hip. When the Hamstrings are tight they do not allow sufficient motion at the hip. The hip doesn't rotate freely when we bend or twist. Because the hip is the first mobile joint below the vertebral joints in the low back, the spine must flex and twist more than it normally would to make up for the lack of motion in the hips. Therefore normal activities such as walking, sitting down, getting up and bending over will cause excessive motion in the low back which puts undue stress on the vertebra and surrounding tissues. This persistent stress can result in, or perpetuate chronic lower back pain. Also, an acute back injury such as a disc injury or a low back strain may not heal in a timely fashion due to this persistent stress.

The human body is an amazing self-healing system. However in some cases there may be some barriers to healing that need to be addressed before the body can heal itself. Most people come to physical therapy after about two weeks of pain that does not resolve on its own. When a patient arrives in the clinic, it is my job to find out why their system is not healing itself and what may have caused it to breakdown in the first place. A crucial part of my low back evaluation is the hip range of motion assessment. It is not uncommon to find limited hip motion in back pain patients. Fortunately, it is possible to stretch the hip muscles back to the proper length and restore normal hip motion, thereby alleviating a primary source of irritation to the low back.

Due to the limited movement patterns most people use in their jobs and the excessive amount of sitting that most people do during the day, it is not surprising that many people have some restriction in their hip motion. The Hamstrings get all the press when it comes to stretching, but there are other hip muscles that contribute to back pain when they are tight. These are the hip rotators, the hip flexors and the Quadriceps. These muscles all control some aspect of hip motion and are often as much of a contributor to pain in the low back, as the Hamstrings.

For many patients, Yoga, regular stretching classes or a home stretching program can be the key to back pain relief. For information about how to safely stretch your hips and other muscles related to low back pain, consult a physical therapist or if you don't have access to a therapist I recommend a book called the 7 Secrets of Back Pain Relief Guide.

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