There are many causes of lower back pain as we age, and tight hips are one of them. “Hips” is a combination term that includes the hip flexors (iliopsoas, rectus femoris, and tensor fascia latae) and the buttocks (gluteus maximus, gluteus medius, gluteus minimus, piriformis, and deeper hip rotators). Imbalances in these muscles can lead to sacrum dysfunction which can affect the lower back. Keeping these muscles strong and mobile help create a healthy lower back.
3 Types of Dysfunction
When the Hip Flexors are tight, especially the psoas, it pulls on the lower back. When we sit for long periods of time, the psoas is in a constant state of passive contraction (read more about the Psoas in “Muscles Involved in Lower Back Pain–Part 2.” ) When we stand up, we move the psoas attachments (femur and lumbar spine) away from each other. If it is tight, the muscle will pull at the attachments, often causing pain in the lower back.
If your Glutes are weak, your body relies on the hamstrings for hip extension (moving the thigh backward). Overuse of the hamstrings can tighten them, and pull on the base of the pelvis, moving the lower back into extension. Chronic extension of the lumbar spine can lead to strain and pain in the lower back. The hamstrings get tight from sitting as well, another passive contraction. The glutes are a powerful muscle group that when strong, keep the hamstrings from over working, thus allowing the pelvis and lumbar spine to stay neutral. This keeps the lower back stable and in alignment.
The Sciatic nerve runs down the body from the spine to the feet, usually traveling under the piriformis (15-20 percent of people it goes through the piriformis). A tight piriformis muscle (hip rotator) can squeeze the sciatic nerve as it travels through the buttock on it’s way down the leg, causing pain. The piriformis also attaches to the sacrum (triangular bone that makes up the back of the pelvis). If one side is tighter, the muscle can pull the sacrum to one side, affecting the way the pelvis moves. This causes dysfunction in movement of the lower back and can lead to lower back pain. Stretching (and rolling) the piriformis can help the SI Joint move more easily to free up the lower back. The SacroIliac (SI) joint is where the sacrum connects to the Iliac bones. It doesn’t move a lot, but it does move and can cause pain if it is not able to move properly.
Yoga Support for Lower Back Pain
Here is where having a yoga practice might help. There are certain yoga poses that strengthen the hips (glutes, hip flexors) and others that stretch them, helping the body feel more balanced. We don’t lead symmetrical lives, so sometimes one side is stronger, weaker, tighter, or looser than the other. Moving the body through a set of poses that you do on both sides, helps ameliorate the asymmetry, leaving you feeling strong, mobile, and in less pain. To learn more about strengthening the glutes, read my post “Love Your Butt! Why Strong Glutes Matter When it Comes to Lower Back Pain.” In it I include a short 15 minute yoga practice to both strengthen and stretch the glutes.
In this post I am focusing more on stretching. When it comes to stretching, it is always important to listen to your body. Forcing a stretch will only lead to injury. Get into the pose to the best of your ability, then relax and breathe, releasing tension as you hold the stretch. Over time, you will find more mobility and less struggle in the poses. Holding the stretch longer is not necessarily better. Rather than counting seconds, try counting breaths. This will drop you into your body a bit more, getting you in touch with how your body communicates–sensation.
These are the best poses (in my opinion) to stretch the hips to alleviate lower back pain.
This pose stretches the hip flexors and is the perfect pose to undo hours of sitting. Start on your hands and knees in Table. Step your right foot forward between your hands, aligning your right knee over your right ankle. Gently press your hips forward to feel the stretch in the left hip flexors, in front of your left hip. You can keep your hands on the floor or blocks next to your right foot, or you can bring your hands to your right thigh, pressing the chest away from the thigh. You can also raise your arms upward. Feel the tailbone dropping toward the floor as you engage your pelvic floor and lower abdominal muscles. Activate your left inner thigh to direct your left hip forward. Stay 3-5 breaths then repeat on the left.
This pose stretches the glutes and piriformis muscles and is a wonderful “hip opener.” This pose can help sciatic pain caused by a tight piriformis. If you have any knee or hip limitations, this pose can be done on your back which takes gravity out of the equation. If you have “bionic” knees or hips, please do modification on your back (see photos below). In the seated version, stack your right knee over your left knee and have both hips on the floor. If sitting on the floor isn’t possible, you can also sit on a block or rolled up towel to support under the hips. Stay seated vertically, or hinge forward from the pelvis with a flat back, aiming the navel toward the knees. Breathe there, or from the flat back, soften the spine forward and relax over your legs. Stay 3-5 breaths, then repeat with the left leg on top.
To modify this pose, lie on your back and cross your right knee over the left knee. Hold your shins and hug your knees toward your chest. You can stay with that, or flex your feet and grab your feet, gently pulling them to either side. Reach the tailbone toward the floor and lengthen your right sit bone toward the far end of your mat. Hold 3-5 breaths, then repeat to the other side.
Ankle to Knee pose
This pose can also be modified on your back if you need support for your knees or hips. I will discuss that in a moment. Ankle to Knee can be an intense hip opener for the glutes and whether you do it seated or on your back, remember not to force anything. Place your left shin in front of you, parallel to the front of your mat. Your shin should line up in front of your shoulders. Place your right shin either directly on top of or directly in front of your left shin so that the ankles and knees align with each other. They should either be arranged vertically or horizontally, depending on which variation you choose. Feel free to place blocks or rolled towels under your knees for support if you feel strain in either the knees or hip flexors. Keep your spine vertical, or hinge forward with a flat back. Stay with your flat back, or soften forward over the legs. Try to keep the buttocks relaxed, and stay 3-5 breaths. Repeat to the other side.
To modify further, lie on your back and cross your right ankle over your left knee. Pull your left knee toward your left shoulder. Feed your right hand through the hole made by your right leg, and with both hands, grasp behind your left thigh. Use the arms to bring the left knee toward the left shoulder. You can gently press your right elbow into your right thigh to move it away from your chest. Reach the tailbone toward the floor as a counter action. Breathe 3-5 breaths then repeat on the other side.
Half Seated Spinal Twist
This final pose stretches the outer glutes (gluteus minimus and medius) and you can modify the twisting aspect as necessary, or leave it out completely. Sit with your left leg either extended forward, foot flexed, or with your left leg bent, like in the photo below. Your pelvis and spine should be vertical with equal weight on your sit bones. Bend your right knee and place your right foot on the floor to the left of your left leg. If you can’t keep your right sit bone down with the left leg bent, straighten your left leg. Wrap your left arm around your right knee and gently pull it toward your chest. This alone should create the hip stretch. You can stay with that, or rotate your rib cage to the right, gently gazing over your right shoulder. Stay 3-5 breaths, then switch sides.
Click here to watch a short video where I guide you through each of the poses in a sequence!
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