Is Your Lower Back Pain Caused by a Tight Hip Flexor?

The iliopsoas muscle known as the hip flexor can be a huge culprate to why your lower back hurts. I can think of many lower back pain patients that I have had in the past that were tight in these muscles. The muscles have attachments to your lower back and pelvis and then extends downward and attaches to the top part of your thigh bone.

As the muscle is named, it flexes the hip or marches the leg up. It also imparts actions at the pelvis and lower back. It tilts the pelvis forward called an anterior tilt and it bends the spine to the side. If you are tight in the hip flexor it can tilt your pelvis forward and put your spine into excessive lordosis; or too much arch in your lower spine. When this happens the spine becomes out of alignment and unstable and abnormal pressure is consistently applied to the spine. This position can put too much stress to the facet joints in the spine and lead to degeneration and eventually nerve compression called stenosis.

Prolonged sitting is the greatest cause to a tight hip flexor; this is just one reason why prolonged sitting and being sedentary is harmful to your spine and health as a whole.

It's a good practice to routinely stretch the hip flexor to prevent if from getting tight. It also helps significantly to train the gluteus maximus, which opposes the hip flexor. It is very common for people to be tight in their hip flexors and weak in their glutes. In a study published by the International Journal of Sports Physical Therapy by Matthew Mills, et al. Individuals with restricted hip flexor muscle length demonstrated less gluteus maximus activation.

The gluteus maximus is a key muscle in providing stability to the hip, pelvis and spine. There are many studies which directly correlate lower back pain to weakness in the gluteus maximus. One such study in Plos One by Amy Amabille, et al. states that the mean normalized cross-sectional area of the gluteus maximus was significantly smaller in the lower back pain group than in the control group. Meaning the gluteal muscle was weaker and smaller in people with lower back pain; especially in people with chronic lower back pain.

How to assess your hip flexor flexibility:

Pull one leg up and let the other one drop down, if the thigh is not parallel to the floor then you have a tight hip flexor; in this picture the tight hip flexor is on his right side.

Here is a good way to stretch and lengthen your hip flexor:

Start in a half knee position and draw your weight forward onto your front leg keeping the trailing knee on the ground. Squeeze the gluteus maximus and further try and extend your hip back. For added stretch try and lean to the opposite side. Hold this position for 20-30 seconds and perform 3x.

Here is an exercise to isolate the gluteus maximus:

It's called a donkey kick. Start in a quadruped position on your hands and knees. Hands directly beneath shoulders and knees directly beneath hips. Keep your back still and in a neutral position. Squeeze your gluteus maximus and lift your leg up as if driving your heel to the ceiling. Try and do this exercise slow and controlled and hold the leg up for a second or two during each repetition. Do 10 repetitions and 2-3 sets a day.

Hope these exercises help in achieving a healthier back! Get ahold of us if you need further consultation regarding your back. We offer many individualized exercises to meet your specific needs and also offer deep tissue massage to isolate and release the hip flexor.

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