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Supercharged

Therapist TM

For today’s article, “Hips and Backs NEED these TWO Stretches to Resolve Hip and Back Pains“, we talk about all things hips. Particularly interesting are the two stretches that help resolve the common hip and back pains.  This is especially advantageous to those who constantly sit for long periods of hours who may occasionally experience lower back and hip pain.

And this is quite true also for people with occupations that require them to stay in a variety of uncomfortable positions for any length of time. Plumbers are a PERFECT example of having an occupation that leaves them flexed, rotated, side bent, back bent, crouching, and all manner of odd positions. When I see these clients, they almost ALL present with lower back pain especially in the morning.

Which Occupations Mostly Suffer from Hip and Back Pains?

So if you think about your clientele who you treat for back and hip pain, how many fit this demographic?? Occupations that put them in tight and awkward body positions will undoubtedly increase the risks of having them experience lower back and hip pain. These include plumbers, carpenters, electricians, mechanics not to mention those who sit for hours each day.

The mechanism of injury is extended periods of forwarding flexion which loads the posterior chain of the body – excessive glute contraction, and also hamstring and the erector spinae fatigue. Our contralateral muscles often co-contract leading to tight hip flexors, tight adductors, and a restricted capsular hip joint.

The Two Powerful and Effective Stretch Techniques

Let’s address both lower back and hip pain using two powerful and effective stretch techniques.

  • Let’s start with the client supine.
  • Take the affected leg into hip flexion.
  • Now externally rotate their leg until you get the end feel of the tissues in the gluteal region. This can include glute Maximus, minimus and minimus, deep rotators, and/or piriformis. You may also feel the end of the range in the actual joint. Depending on the flexibility of your client, you should be able to externally rotate their leg till the ankle nears their opposite hip.
  • Then you apply a little bit of pressure using your body weight by leaning forward into the client’s raised leg while holding the adjacent hip using your other hand. Fixating the hip stops the pelvis from moving into counternutation or rotation.
  • While in this position, try to flex, externally rotate. Abduct the leg as far as they can manage while stabilizing yourself using your client’s opposite hip. Make sure that the stretch is deep but comfortable. They should be able to breathe through it.

  • You should ask your client for feedback, where they feel the stretch. Any pain felt is usually in the socket and the deeper hip rotators i.e. obturators and Gemelli.
  • Now reposition yourself into a position where you can grasp the full thigh with both your arms. Take the femur into a supportive hug and keep the external rotation and abduction.
  • From there, lean backward away from the table, distract the thigh putting the abductors under stretch. You hold each of these positions for 20 – 30 seconds to allow for some soft tissue ‘creep’.
  • Repeat these two manoeuvers twice more each time going much deeper into the stretches and distractions and leaning more of your body weight.

Watch out for Compressive Groin Pain

  • Now, this stretch is not applicable if your client complains of compressive groin pain. This can be a multitude of reasons including:
    • arthritis,
    • bony spurs,
    • bursitis in the lessor trochanter trochanteric tendonitis, etc.
  • We can address this by getting a pillow slip or hand towel, put it at the proximal medial region of the thigh i.e. the groin or crotch area. Further, distract the femur with the material. You are creating a wedge to encourage the head of the femur further into the posterior lateral region within the acetabulum. This should reduce pain when the client’s leg is taken into flexion/adduction/external rotation.
  • Repeat the steps with the other leg and see the difference in the range in motion as you rotate the legs forward and backward.

Now that’s a stretch!!! It focuses on abduction and adduction restrictions, gluteal hypertonicity, tight hip flexors. It can give your clients great relief for both lower back and hip pain.

That’s just about it for now with “Hips and Backs NEED these TWO Stretches to Resolve Hip and Back Pains“. See you in the next article!

Paula Nutting Director Your Musculoskeletal Specialist
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