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hip flexor

Check your hips for back pain

Your low back pain may be coming from your hips

Having back pain is miserable, and not knowing why you might have back pain can be frustrating.  Often in treatment people focus purely on the back muscles, and getting very little relief.  This may be because they are focusing on the wrong muscle groups that may be causing your lower back pain.  In some cases the hip flexors may be causing your low back pain (see diagram below).

hip flexor

The hip flexors include the Psoas muscle which is a large muscle that originates at the lower levels of the lumbar spine and attaches to the femur.  Because the Psoas muscle originates at the lumbar spine, it can often be the root cause of your low back pain.

How do the hip flexors and more specifically your Psoas muscle cause low back pain?

Consider this, you spend most of your day with your hips in a flexed position, from sitting, sleeping (when side-lying), and even in exercising.  By putting your hip flexor muscles in a shortened position for long periods of time you eventually tighten this muscle so when you are standing or laying flat on your back with legs fully extended, you may experience back pain.

How to test if your Psoas muscle is tight

A simple test anyone can do is to lay flat on your back with legs fully extended.  How does this position feel?  Now, while laying flat on your back raise your knees while keeping your feet flat on the surface you are lying on.  Does this position feel better?  If so, this is a good sign that your Psoas muscle is tight.

How to stretch the Psoas muscle

Because the Psoas muscle is so deep it is very difficult to get to and isolate when stretching.  If you try these stretches and don’t get relief, seek a physical therapist.

Try the following stretches based on tolerance:

Supine single knee to chest – Keep one leg straight, while laying on your back, and pull the opposite knee to your chest. Do not let the straight leg flex at the hip.  Stretch should be mild.  Hold for 30 seconds for 3 repetitions.  This is a good stretch to start with for the hip flexors.  Once you feel that you can tolerate easily, progress to supine leg drop.






Supine leg drop – Laying at the edge of a table or bed, drop one leg over the edge so your hip is able to extend.  Pull the opposite knee to your chest. Stretch should be moderate.  Hold for 30 seconds for 3 repetitions.  Once you feel that you can tolerate easily, progress to kneeling hip flexor stretch.








Kneeling hip flexor stretch – From a kneeling position, place one foot flat on the ground directly ahead of you.  Keep your other knee on the floor and press your hips forward. Stretch should be moderate to significant.  Hold for 30 seconds for 3 repetitions.  The stretch intensity can be controlled by adjusting how much you lean forward into the stretch.

Are Ankle Braces Bad For You?

Are ankle braces bad for you?

We often get asked, should I wear an ankle brace?  So, are ankle braces bad for you or good for you?  The right answer is that “It depends”. It depends on the history of your ankle, the type of activity you are doing, the type of terrain you are on, and the type of shoe wear.

For years ankle braces were provided to athletes and people who had pre-existing ankle sprains to help provide for the support that has been lost.  Recently a study from the University of Wisconsin School of Medicine and Public Health showed that high school basketball players who wore stabilizing lace-up ankle braces had 68 percent fewer injuries than athletes who did not.  This group included athletes that had both pre-existing ankle injuries and athletes that did not.  Evidence supports that a healthy un-injured ankle can benefit from ankle bracing.

When it comes to activity, you need to consider if you even need to brace.  Going for a walk on flat pavement, riding a bike, working out in the gym, are not activities that an ankle brace would necessarily be needed.  Sports and activities that require quick lateral movements, the ankle brace can help provide more support and help prevent injuries.

Walking on flat pavement the foot has good contact with the ground.  Trail hiking often exposes you to very unstable and uneven surfaces where an ankle brace can help protect you from injury.  Consider this also when playing field sports.  Often there are hidden holes and loose ground that your foot might come in contact with, so brace accordingly.

Wearing proper footwear is important for ankle to do its job.  Proper grip in shoe wear helps establish the proper base for the ankle to support the body.  Like, wearing an ankle brace while wearing flat bottom tennis shoes on a wet field.  You are still going to slip and lose balance putting extra strain on your ankle, that even the brace may not be able to support.

Ankle bracing is a very good preventative accessory to many people who are active.  Overuse of an ankle brace can be bad for you because it can affect your ankle strength and balance.  If the ankle doesn’t have to do the work for balance and support, then it gets weaker, increasing the risk of injury.   Make sure that when there is minimal risk of injury to your ankle that you allow the ankle to do the work without the support so that you have strong supportive ankles for a lifetime.