24 Jan Lesser Well Known Risk Factors for Back Pain: Hip Mobility and Strength
Some lesser well-know risk factors associated with developing back pain: Hip Mobility & Strength
I. Impaired Hip Mobility and/Or Strength
I often say to my patients that the body is the great compensator. When a problem exists in a specific region, we immediately (and subconciously) switch on mechanisms for compensating for this problem in order to carry on with our routine. A good example to illustrate this is considering someone with a shoulder problem. For the sake of understanding, let's call it a shoulder mobility problem. When this individual attempts to reach overhead, they are observed to hike their entire shoulder. It's not as if they had to tell their shoulder blade to move more than it's naturally designed to, or that otherwise normally quiet muscles in the neck now have to pitch in just to complete the task. It just happens! If allowed to continue, this individual will very likely begin having not only an increase in their shoulder pain, but also the start of muscular neck pain as well.
Returning to the back, stiffness in the hips will eventually cause compensations to occur in the lower back, specifically causing it to move more than it is designed to for a given task. This leads to instability, and an unstable joint is guaranteed to eventually become a painful joint. A good way to summarize this point is to picture the natural flow of water down a hillside. The stream will always follow the path of least resistance until it reaches a point where gravity no longer has influence on it. If the hips are too tight, and we continue to go about our day, these forces will be transferred to the lower back causing eventual instability and PAIN. Furthermore, tight hips are something I commonly find in patients, especially in individuals who spend much of their day behind a desk. By taking some time to stretch your tight hips, you are indirectly reducing stress to your lower back. Illustrated below are some hip stretches that I commonly prescribe for my patients. While there are many more, these represent the most common "trouble areas". **PAIN MUST BE AVOIDED WHILE STRETCHING. HOLD FOR 20-30 SECONDS AND REPEAT 3-5 TIMES.**
Another very common finding I discover in patients is hip muscle weakness. There is a multitude of existing research which identifies a connection between individuals with back pain and hip weakness. Just as in my previous point, this weakness will, given sufficient time, cause compensations to arise in the back. Two hip muscle groups in particular have been implicated in this affected population: the gluteus maximus and the gluteus medius. Below are some basic strengthening exercises to target these 2 muscle groups. **PAIN MUST BE AVOIDED WHILE PERFORMING THESE EXERCISES.**