hip flexors and their role in back pain

This article has been adapted from "Dynamic Fitness' Blog:

"A client will come to me and complain of back pain. The pain is worst, they explain, when they lie on their stomachs, and virtually disappears when they lie on their sides and draw the knees towards the chest.

Your hip flexors are the muscles that attach the front of your thighs to your pelvis and spine (called the 'psoas' and the 'iliopsoas' muscles). They're a series of tough, stringy muscles responsible for swinging your legs forward and up. If you stand, balance on your right foot, draw your left knee up towards your chest, and dig your fingers into the crease formed between your left thigh and hipbone, you'll feel your left hip flexor muscles doing their thing.

On any given day, whether you're active or not, your hip flexors take a pretty good pounding. If you walk, run, play football, or do virtually anything athletic, your hip flexors are working pretty hard to pull your legs forward every time you take a step. If, on the other hand, you're sitting down all day, the hip flexors remain shortened the entire time you're sitting there driving or typing or watching TV. And chances are that unless you already know the kneeling hip flexor stretch, you're not getting much flexibility work in this area either.

Combine the overstimulation from athletic endeavors, the shortened resting position, and the lack of flexibility in the area and you get a recipe for short, tight hip flexors, and -- you guessed it -- back pain.

You see, the hip flexors, naturally, connect to the hips. When they get tight, they pull the front edge of your pelvis down and forward when you stand, resulting in a rodeo-rider like, butt-sticking-out posture. With the pelvis tipped forward like this, it becomes impossible to stand straight without straining the lower back -- which, over time, can lead to chronic LBP. This is another example of the Tall Ship image from a few weeks ago: do anything often enough and the body starts to conform to that shape -- healthy or not. So if you sit a lot, which all of us do, you get short hip flexors and, sooner or later, a greater or lesser degree of lower back pain.

So instead of spending all your time stretching the low back (most peoples' immediate impulse when the back gives them trouble), give the Kneeling Hip Flexor Stretch a try:
(1) Kneel down with your right foot behind you.
2) Step your left foot out in front of you.
3) Place your hands on your left knee.
4) Lunge forward onto your left foot so that your hips sink towards the floor.
5) Continue lunging forward until you feel a comfortable stretch in the front of your right hip. Press the top of your right foot into the floor. Hold for 10-20 seconds.
6) Stretch the right hand above your head and hold for another 20 seconds (optional).
7) Repeat stretch with your left foot back.

This is the most effective hip flexor stretch I know -- it's easy, quick, and a heck of a lot cheaper than surgery and six months of physical therapy. I'm not saying it'll cure every case of low back pain, but it's definitely worth a try before you go under the knife".