Low back pain is one of the biggest reasons patients come to my physical therapy practice. Most don’t realize what a big role their hip muscles play in causing their discomfort.
Here is a closer look at the important role your hips play in keeping you flexible and free from pain, from the lower back on down.
Weak Hip Muscles Cause Problems
There are two important muscles in the hip:
- Gluteus maximus
- Gluteus medius
When both are strong, they play a major role in preventing injuries in your back and legs. For example, if they are weak, you are at risk of knee pain if you run or walk regularly. The formal name is patellofermoral pain syndrome, or PFPS, but you might know it as runners knee.
Another common problem is ankle pain. Weak hip muscles make is difficult for ankles to absorb the force of the body in motion and safely redistribute it.
Do you get cramping in your hamstring? Blame weak hip muscles. Do you constantly feel pain in your lower back, especially after gardening or other functional-type movements? The reason is your hip muscles are simply not strong enough, lacking the needed stability, to support your actions. That causes the muscles in your lower back to try to compensate. The result is that nagging lower back pain.
Why Your Hip Muscles Aren’t Working
Many studies have looked at the cause of lower back pain. What they find is that when the ligaments enclosing the hip are tight, they send a message to the gluteal muscles to switch off.
The tightness is often a by-product of the fact that you are already in pain. Sensibly enough, you try different things to reduce the discomfort.
The most common is to move less. But you will probably also change your usual pattern of movement, trying to find something that doesn’t hurt as much. Your muscles get tighter, and you actually end up in greater pain.
How the Physical Therapist Can Help
That’s where the work of the physical therapist begins. For the long term, I can provide a set of exercises that train the muscles in your hip to stay switched on. In the short term, I need to use manual pressure to activate the muscles.
This hands-on approach is effective. According to one study, manual work on the front of the hip extends the force of a hip extension by 14 percent right after the patient is worked on. Physical therapy on the bottom of the hip can help the hip abduction by 17 percent.
What Happens at Your Physical Therapy Appointment
Do you have pain in your lower back, legs or feet? Expect your physical therapist to do a thorough, hands-on testing of your hip muscles. I need to do this to find out how strong and active they are, and how this is related to your pain.
The benefits are wide-ranging. Once I get your gluteal muscles active, your hip will be stronger and more stable. Your entire lower body benefits, and you will experience less pain.