Is your Hip Pain being caused by your back….or vice versa?
7 min read
Today I want to talk to you about the Joint by Joint approach….which off the bat sounds like separating out each individual joint in isolation. It’s quite the opposite actually!
The Joint by Joint approach basically maps out the body from the bottom up as alternating Stable then Mobile joints.
Foot - Stable
Ankle - Mobile
Knee - Stable
Hip - Mobile
Low Back - Stable
Upper Back (Thoracic) - Mobile
Lower Cervical - Stable
Upper Cervical - Mobile
Shoulder - Mobile
Elbow - Stable
Wrist - Mobile
It simply states that mobile joints have a larger range of motion (usually your ball and socket joints like hip and shoulder)
And stable joints tend to have more supportive functions like the Knee or Lower back (though made up of several joints as a whole acts as a stable joint)
Why does this matter to you?
We are going to use the hip and low back in this example.
Your hip is the second most mobile joint in your body (shoulder is the first). It has a pretty wide range of motion.
Most of the muscles that attach the hip to you, are attached to the low back and pelvis as well.
How Tight Hips Can Create Low Back Pain
If you start to lose mobility in your hips for whatever reason, tight muscles/lack of use, a joint somewhere above or below the hip will need to be MORE mobile in order for you to continue to move. Usually it is the joint either just above (low back) or just below (knee) the joint (though it really can be anywhere like the foot)
From what I have seen over the years (especially during the COVID years) it is the low back that takes up the slack for this movement and starts to become more mobile.
The hips get tight, particularly the hip flexors and glutes from sitting a lot, this limits hip extension.
As you can see from the picture below these vertebrae aren’t designed for a lot of movement, particularly extension. So if they start trying to extend more a few different things can start to happen.
The spinous processes (the bone that sticks straight out, what you feel when you press on your spine) start to hit into one another. This can cause in extreme cases a stress fracture.
In order to get extension the actual body of the vertebrae needs to shift to make more room. This can cause increased pressure at the joints with the vertebrae above or below causing an inflammatory response (can lead to arthritis See my Blog Arthritis is it just inflammation)
Or this vertebrae then sits in an unaligned position and can put pressure on the nerves as they exit from the spinal cord (pinched nerve)
Your brain senses this excessive movement and tries to protect you by tightening everything around the area.
Tightness is the nervous system’s way of creating stability.
This is why many people tend to feel more back tightness than the actual hip tightness that is actually causing the pain/discomfort.
So I should stretch…..
Most people's first intuition when they have tightness is to stretch. While not completely wrong, not exactly correct either. First this tightness is the brain’s way of regulating you so it is controlled by the nervous system, so you need to change what your nervous system is perceiving, it’s part of the Hierarchy of Protection (Read about it HERE)
Also though to the brain tight is stable to our body and nervous system, STRENGTH is actually stable. So in order for it to feel stable again you need to build strength. And as you increase strength and stability, your brain feels safer and allows you more mobility again. You are basically reverse engineering your mobility back. You can’t force your body into positions it doesn’t feel safe in, so stretch though may FEEL like it is helping, it never really sticks and you regain your range of motion back.
Start with THIS
Hip Circles are my Go To movement to start helping decrease both hip tightness and back pain.
Though these look relatively easy….they are not! There is a lot going on here!
Your brain has a map of every joint in the body at every position. (think Google Maps in Satellite view) When there is pain in that joint that map gets blurry. The best way to clean the map is to use circular movements. It allows for the bones to touch and move in a smooth manner sending clearer info to your brain.
You are now using all the muscles in your hip to move it in that circle. Most people haven’t done this type of movement in quite some time, so now they are retraining the motor control of this movement (the one with your foot behind you gets everyone!)
This is also a nerve glide, which is super important. Your Sciatic nerve starts in your low back and branches and travels all the way down to you toes! This nerve (well all nerves) sit inside a tube. A lot of times when there is a lot of sitting or lack of movement, it gets sticking inside the tube and the nerve doesn’t glide through it as well….this can cause pain/discomfort anywhere along that nerve! So doing some light movement to get the nerve moving through the tube allows it to glide better!
Not only are the muscles of the hip doing the circle working, so is the hip that you are standing on. These muscles are now working hard to stabilize you while you are doing the circles! May even feel your core turn on to stabilize as well!
Now you can see why I love this one!
Next would be this self soft tissue release.
This is a tiny muscle that sits just below the crest of your pelvic bone. This is the TFL, Tensor Fascia Latae. The tendon of this is actually your ITBand, so it runs the entire length of your upper leg. This muscle also has very strong connection with your glutes. So if this muscle gets tight it can cause dysfunction anywhere from the hip down to the knee! Keep this muscle loose and happy is super important! For a while lacrosse balls were the go to for soft tissue release…but I have found better results using softer balls such as THIS ONE, for a couple reasons.
The lacrosse ball can be super painful! There are a lot of bones in the area and if you are directly over a bone this hurts….A LOT!
Also equal and opposite forces. Sir Isaac Newton discovered this and it applies here just as it does everywhere else. If I apply a strong force to your body it will response with and equal amount back towards me. So if something is hard and painful, your body is going to protect just as strongly. So using a softer ball allows the body to have more tolerance.
When to seek further help
If you are getting locking of the hip joint, a distinct click or clunk in the joint or pain that is waking you up at night please go see your orthopedic doctor. Further imaging and evaluation will be needed.
If you are in Redondo Beach or the South Bay and struggling with hip pain….
I help active people of all ages and abilities get out of pain and back to their favorite activities!
Usually within the first 1-3 sessions there is a change in your pain…and that is the most important piece. Once your pain has decreased then we can work on increasing mobility and strength and all the things to keep you moving and feeling better!
This is exactly what we do during one of my Orthopedic session.
If you would like to discuss how I can help you! You can click the button below and schedule a FREE Discovery call.
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