BACK PAIN? THE HIPS DON’T LIE!

Written By Alan English

A great mentor of mine, Andrew Lock, said NEVER assess lower back pain clients without assessing a hip & quality of movement. Mentors who have also taught me the essentials of program design hammer home how important quality movement is & that the proverbial saying that you can’t “shoot a cannon out of a canoe” (just ain’t stable enough for those that were wondering) stands the test of time again & again. Quality movement and exercise is a must! Chronic Lower Back pain (pain > 3 months) sadly is on the rise & is the #1 contributor to years lost with disability (YLD). In 2007 when I started working as a PT the #1 injury I encountered was lower back pain. Since leaving Uni in 2022 it is THE #1 injury I help clients with & from my clinical experience it’s only getting worse. There’s many reasons but one that sticks out is that we’re simply not exercising enough or doing any sort of strength or aerobic training. We sit for hours on end, each day, each week, each month year after year but eventually that will catch up on us, our bodies keep score!  

 

HIP ANATOMY

When it comes assessing clients with lower back pain assessing hip mobility & movement is so important! Why? Because our anatomy links the two areas together. Muscles around the hip are major supporters of quality movement and posture. When these muscles are not used enough, challenged enough or exercised at all some other muscle groups or areas of the body have to pick up that slack & often its areas around the lower back! So when assessing the back pain client or your own back pain THE HIPS DON’T LIE as Shakira put it (sorry I had to!!)! So the hips & the muscles around there is probably one of the areas that needs to be addressed in your training to help relieve your back pain.

 

 




 

STABILITY, QUALITY MOVEMENT & STRENGTH IS THE KEY!!

PAIN TRIGGERING HIP HINGE

PAIN FREE HIP HINGE

Of course, there are many other factors involved as to why a person may have back pain but I feel this is a HUGELY overlooked area. Simply put, we don’t spend enough time improving our hip mobility or perform much focused movement at all. I’m guilty as charged, I’ve been there! I used to get into the gym & get out. When I played sports we had no coaches guiding us, we did a few hammy stretches, quad stretches & we played! I didn’t pay any attention to any mobility stuff. But…..over the past 10 years or so I’ve added more hip mobility & stability work into my training week. I’ve added hip focused work into clients programs & the impact & results have been profound! Both normal Joe soaps & athletes have eliminated their back pain by adding in some hip mobility & stability work. However, caution must be exercised among clients who have more severe lower back injuries, the right exercise for the right person at the right time applies hugely here. But… even when the time is right for those client’s with more severe lower back injures better movement about the hips can vastly reduce the risk of reinjury & also take training quality up a few levels.

 

TRAINING & EXERCISE TIPS

Keep it simple, get the hip muscles involved (use isometric contractions, isotonics) & practice movement fundamentals (hip hinge, squats, lateral lunges, single leg stability work like kettlebell RDL’s).

  • Practice 3-5 movements daily for 10-15mins covering multiple directions.

  • Strength train 2-3x p/wk

  • Target stability with exercises like Kettlebell Around The Worlds

  • Target major muscles of the hip, glutes, hip flexors, hip stabilisers (glute med/min) & adductors.

  • Include the bread & butter movements like squats, deadlifts/deadlifts/deadlift variations, thrusts, bridges

  • Increase your core endurance – front planks, side planks (min of 45-60secs to start ) & include rotational movements like woodchoppers

  • Increase your aerobic health, start by walking, cycling, rowing or even try a jog for 500m-1km to start.

Try this approach & your back pain may just disappear altogether! For more exercises you can view them on my Instagram post @alanenglish_ep & here:

 

https://www.instagram.com/p/DMMFh9TTNWJ/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==

 

Alan English
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