Hip Flexor Mobility: The Key to Solving Low Back Pain

This post was written by Chase Besuden, who ran the Wholesale Division at Paleo Treats during most of 2015.  Chase has moved on from Paleo Treats since then, but is still active and focused on healthy living.

“I have a bad back!” is a common excuse I often hear from friends as a cop-out to why they can no longer do certain physical activities such as surfing, basketball, golf, indoor soccer, and lifting.

Many people I know under the age of 30 have resigned themselves to simply not being able to enjoy physical activity because of a “bad” back. After experiencing my own SI (sacro-illiac aka "hip" for you non-science-y types) joint injury after a couple years of thinking I was going to be the next Pyrros Dimas, I became fanatical about fixing my injury without surgery, which led me to the KEY to solving low back and hip pain; HIP FLEXOR(s).

Talking to my friends and acquaintances at the gym and elsewhere, very quickly I noticed a common theme among these “bad backers” (myself formerly included).

First, they all spent the majority of their time at work/school/home sitting with no awareness of their posture.

Second, they were all incapable of doing even a half-assed couch stretch (see below) without excruciating pain.

In short, I’ve seen the tight hip flexors=low back pain situation repeated over and over. The awesome thing is that the majority of the time this low back pain can be remedied without doctor visits, surgery, medication, acupuncture, and/or chiropractic. Keeping mobile hip flexors is also a great preventative way to avoid low back pain and injuries.

All it takes is diligent stretching, a foam roller, and slightly more walking/standing.

Seems simple enough right? 

The Stretches

There are numerous stretches for the hip flexors and related areas. The ones included below are simply the most popular and useful in my opinion so by no means consider this an exhaustive list and feel free to search for more!!!  Also, with all of these stretches it is important to keep your hips square with each other. In other words, don’t allow your pelvis to overly twist laterally.

Couch Stretch

Kelly Starret of MobilityWOD demonstrates the couch stretch.

The couch stretch is the easiest way to find out how tight your hip flexors are (and of course to stretch them!) If you can’t get into a position like the one above without pain/discomfort in your hip/quad, you likely have a lot of work to do. To get into this position, start with both knees on the ground on all fours, put one leg up behind you against a wall/box/couch and then step your other leg out forward in front of you. Then slowly raise your torso and lean into your front knee. For video explanation of how to get into this position, see this and this.   

 Samson Stretch

The Samson Stretch is another great stretch for the hip flexors. It is very similar to couch stretch but without the wall/box/couch behind you. To get into this position, simply step forward from standing into a lunge and let your back knee drop near the floor. Then lean into your front leg. You can also raise your arms above your head to get a deeper stretch. Here's a quick video link.

Banded Samson Stretch

Banded Samson Stretch is the same stretch but uses a band to pull your hip deeper into the stretch. This is a great stretch to do once you get comfortable with both the Samson and Couch Stretch. And remember to keep your hips square!

Pigeon

All of the Yogis reading will be very familiar with this stretch. This one is pretty self-explanatory from the picture. Lay one leg across your body like above and let your other leg lay straight back. This is a great stretch for your hip flexors as well as glutes, medius, piriformis, etc. Quick Video Explanation 

And Finally….. SQUAT!!! (Not really a stretch but equally important)

The final way to improve lower back pain after stretching your hip flexors is to sit in the bottom of a squat for extended periods of time. I personally think it is awesome to alternate the stretches above with sitting in the bottom of a squat.

If you’re curious how it should look, a great place to start is look at your young child, sibling, cousin, or nephews and nieces. Before years of sitting down in chairs and logging 100s of hours on the couch, the human body is surprisingly good at naturally maintaining a perfect squat.

Sitting in a squat is great for restoring and improving motion in the lumbar spine as well as promoting ankle/hip flexibility. Without going in depth into squat mechanics and individual anthropometry, there are a few important cues to remember.

1. Keep a neutral spine (i.e don’t tilt your pelvis forward (anteriorly) or back (posteriorly))
2. Keep knees in line with your toes
3. Keep heels on the ground
4. Keep torso as upright as possible
5. Get your hips below your knees
6. Stay engaged

Once you’re in a natural bottom position like our baby friend pictured above, see how long you can hold it.

An attainable daily goal that will improve hip/ankle mobility and back pain is 10 cumulative minutes and eventually 10 continuous minutes. Combine this with the hip flexor stretches above and you’re on your way to low back pain relief and a generally healthier life!

For more on not just solving low back pain but becoming more flexible and stronger throughout your body, check out Kelly Starrett's excellent book "Becoming a Supple Leopard".

If you want to check out the 10 min squat test take a look at Kelly Starrett’s Mobility WOD here and check out this video

Foam Rolling

At this point, most everyone is familiar with foam rolling or at least aware of what a foam roller is. While you can certainly get most of the benefit with a garden variety foam roller (or even a length of PVC), we've recently found (and LOVE) the Backmate vibrating foam roller.

However, many still underestimate the benefits of foam rolling. The technical term is self-myofascial release or SMR. Similar to benefits of massage, SMR loosens muscle adhesions and scar tissue throughout the body and can be very beneficial to helping with low back pain and tight hip flexors when done correctly.  

Beyond Stretching + Rolling

While unfortunately the great majority of Americans are forced to sit at their desk at work for 8+ hours after sitting in their car while they commute to work before finally commuting home to sit on the couch, there is a very easy way to combat this epidemic of sitting.

 STAND UP AND WALK AROUND!

Take a break as often as you can and walk around the office. Stand up when you’re on phone calls. Stand up while you eat lunch. Or maybe even get a standing desk and stand up all the time! 

NOW GO GET 'EM!

Ok, now you have no excuse for holding on to back pain, or from welching out on going surfing, lifting, running, or even (yes, it's a sport) golfing.  

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