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Self Treatment Techniques for the Low Back and Hip

Posted by [email protected] on April 21, 2014 at 1:25 AM

Self Treatment Techniques for the Low Back and Hips

Below are some stretches and muscle release techniques for hip, abs, and low back pain that I have personally used with good results. Feel free to share and try these techniques, but keep in mind that they might not work for you and are not a substitute for medical treatment. If you feel any sharp pain or your problem gets worse or fails to improve, stop the activity! For more details on my favorite way to stretch or loosen my own muscles, review my Self Treatment page.

Hip Flexors

Your hip flexors lift your legs, and are thus some of the strongest and most-used muscles in your body. They pull the legs up from the inside top of the femur, and are anchored to the inside of your spine & pelvis; if they are tight, they pull your spine & hips forward, which can cause low back and hip pain. The more you sit or sleep with your knees pulled up, the shorter and tighter the muscles get. While it is hard to massage your own hip flexors, stretching them often relieves the pain. There are several hip flexor stretches on the Internet; they can be tricky to do properly and require performing a pelvic tilt (using your abs to pull the pelvic bone upward).

 

My favorite stretch for the hip flexors is easy to perform without much chance of straining your low back. Lie with your butt either on an elevated platform (i.e., foam roller) or at the edge of a bed. Before starting the stretch, pull one knee toward your chest to flatten and rotect your lower back. Then extend the other leg and let it hang for at least 2 min. Repeat with the other leg. Another easy hip flexor stretch is to bend one leg at the waist and knee and rest your lower leg on a chair, while allowing the straight leg to gently stretch for 20 min. on each side.


Glutes

The gluteal muscles (i.e., your butt!) both extend and rotate your hip. Quite often, the outer glutes are sore not from being too tight, but from being too weak and being over-powered by tight hip flexors. To reduce pain in your glutes, lay on a tennis ball, bend your knee, and move your knee back and forth (with your heel staying still- see Left).

 

To strengthen the gluteus medius, lay on your side as straight as possible, point the toes of your upper leg to the ground, and repeatedly lift your leg (see Right). You can also do "clam shells" by bending at the waist and knees, keeping your heels together and on the ground, and raising your top knee. In either case, try to relax everything except for your butt. To strengthen the gluteus maximus, lay on your back with your knees up, contract your butt, and raise your butt off the floor and hold 5 seconds (see Left).

 

To stretch your glutes, pull your foot toward your chest (or rest your leg on a bed and move your chest towards your foot, see Right).

 

Low Back

Many times, low back pain is caused by tight hip flexors either pulling directly o the front of the spine (psoas) or pulling one or both of the hips forward (iliacus), either or which causes strain on the low back. For hip flexor stretches, see my Upper Leg section.

 

Low back spasms can also be massaged directly by lying on your side with a rolling pin or pool noodle between your ribs and pelvis (don't put direct pressure on your ribs!) and doing slow pelvic tilts or bringing your bottom knee to your chest and back down. If you have some help, you can lie on your side with a partner's elbow between your ribs and pelvis, and do pelvic tilts and raising the upper knee toward your chest (direct your partner's elbow to the sore spot with the amount of pressure that feels effective- they are there only to do as you direct, and NOT try to play massage therapist!).


Proper Spine Curvature: Whether you are sitting, standing, walking, or running, having the proper curvature to your low back will improve your overall posture and reduce low back pain. Most people can easily determine their optimal curvature by doing the following exercise.

 

During whatever activity you are engaged in (standing, sitting, walking, running), stick out your butt and put too much curve into your low back. Then slowly flatten your back as much as possible by tucking your lower pelvis forward. Go back and forth between these extremes while imagining someone standing on your shoulders. The spot where it feels like you could best support the weight is likely your optimal curvature! Try to maintain this curvature as you stand, walk, sit, or run (with most people, this will involve teaching yourself to hold a little bit of tension in your ab muscles).

Strengthening Your Abs: I've had many Physical Therapists tell me they hate sit-ups! Many over-zealous pursuers of better fitness focus in sit-ups and push-ups, which tighten and shorten muscles that already tend to be short, strong, and tight (and are thus causing pain in the opposing muscles that are smaller and have to work too hard in a never-ending tug of war!).

 

The rectus abdominus (6-pack) is usually strong enough, but the deeper core ab muscles (transverse abdominus and obliques) often need strengthening. An easy way to do so is to sit upright and to lean backwards about 6 inches (only as far as you can go while maintaining the correct spinal curve- see above). Hold 5-10 seconds, and then "pull" yourself back upright using the front muscles below your ribs. Do 10 sets periodically during the day.


Loosening The Pelvis & Low Back: Lay on your back with your knees bent and your feet flat on the floor, and do the following exercises. This routine will stretch and loosen the low back-sacrum-pelvis, strengthen the core muscles you need to maintain proper posture, and neurologically train your core muscles to operate independently without co-contracting hip, leg, and other muscles.

Tilt/tuck your pelvis and flatten your back against the floor by only using your core ab muscles. Relax your butt, quads, and the rest of your body. Hold 3-5 seconds and relax; repeat 10X.

Push your tail bone down into the floor (curving the low back) by contracting the muscles in your low back, relaxing your butt, hamstrings, and everything else. Hold 3-5 seconds and relax; repeat 10X.

Pull your left hip up towards your left ear by contracting your side muscles between your ribs and pelvis. Hold 3-5 seconds and relax; repeat 10X. Repeat on the opposite side.

After performing the exercises independently in all 4 directions, slowly make circles with your pelvis ("hula" and Figure 8s). Keep all other muscles relaxed, and spend more time moving in directions that feel stiff or sore.

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