As a society we spend most of our life sitting – at school, at work, at home. Most of our day is spent on our bottoms. As a result, the muscles in the front of our hips, our hip flexors, get tight. Unfortunately, tight hip flexors can lead to low back pain.
The psoas is one of the body’s main hip flexors. It attaches into the lower lumbar vertebrae, winds through the pelvis, and then attaches to the front of the femur (thigh bone). Normally, the action of this muscle is to lift your leg up. However, it can also bring your body closer to your legs, such as when doing a sit-up.
When a person’s psoas and hip flexors are tight, one of two things will happen. First, their hip will not stretch behind them, which can limit walking. It will be harder for a person to propel themselves forward as they take each step. And second, the psoas will pull on the lower spine causing the spine to arch. Over time, a person can develop low back pain because this arching can cause increased stress on the joints of the back.
What can we do to help prevent low back pain due to tight hip flexors? Number one is stretch. To stretch the psoas you can bring your hip into extension or put your leg behind you.
The most gentle stretch is one where you lay on a table. Bring one leg into your chest and let the other leg hang of the table. The more of your thigh that is off the table, the more stretch you should feel.
For a more advanced stretch, you can do a kneeling or standing hip flexor stretch. The kneeling stretch requires you to be on one knee. While keeping your stomach tight you can lunge forward until a stretch is felt in the front of the down leg (back leg). The standing stretch uses a similar concept. One leg is behind the other in a lunge. While squeezing your stomach you can lunge forward until a stretch is felt.
Another way to help offset tight hip flexors is having a strong core and hamstrings. The action of the abdominals and hamstrings counteracts the natural pull of the hip flexors on the lower spine. Sit-ups are not the best exercise for abdominals because it is possible to cheat and use your hip flexors. The best exercises to focus on are ones that involve abdominal stabilization, such as planks. This involves not only strength, but increased coordination and body awareness.
The combination of stretching and strengthening can help prevent most chronic back pain. For more information you can always contact your physical therapist or physician.