Increase Your Hip Range of Motion and Reduce Lower Back Pain

Jun 25th, 2012

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Category: Functional Training

Increase Your Hip Range of Motion and Reduce Lower Back Pain

Range Of Motion and Lower Back Pain

By, Mark Wine CSCS; USAW; NASM PT, CES, PES
Creator of The 12 Pack Abs Program

Range of motion (ROM) limitations within the hip region is a precursor for lower back pain (LBP), lack of gluteal musculature development and altered lumbar spine kinematics (1). The most common train of thought is to simply prescribe a comprehensive stretching routine. However, there are multiple forms of stretching, as well as flexibility techniques; for example there are active, dynamic and static flexibility. Dynamic flexibility is more commonly used in athletic training because it is more related to dynamic athletic movements. Static flexibility, which is yoga or pose stretching, is the most known form of stretching. Individuals with an overall goal of increasing hip joint ROM, as well as overall flexibility, must incorporate both dynamic and static forms of flexibility, core stabilization and eccentric resistance training (2, 3, 5).turkish get ups

Core stabilization training should focus on multi-joint complex exercises (i.e. squats, deadlifts, etc…). These movements require multiple joints working in concert while placing heavy resistance on the core. Individuals with insufficient core strength are leading candidates to suffer from LBP, which leads to altered lumbar spine kinematics. Altered lumbar spine kinematics results in poor movement mechanics during multi-joint complex movements, which impedes the results of any resistance training program. LBP athletes, fitness enthusiasts and persons alike typically round their spine at the end of hip rotation during prone hip rotational activities (full ROM squats, lunges, etc…). Core stabilization, strength increases, local muscular endurance, motor control and spine/hip positioning during squat movements should be the focus of any musculature correction program.

Flexibility impingements within the lower extremities results in altered kinematics within the hip and spine, which will surely lead to LBP or other injury. For example, participants who are unable to perform full ROM squats often perform parallel squats. Parallel squats result in decreased flexibility of the lower body while continually tightening up the hip region (6). For athletes with tight hips who participate in a sport that requires hip flexibility, such as football or Rugby, often leads to increased risk of head injury due to an inability to efficiently squat while coming into contact with an opponent. Fitness enthusiasts or lifters alike run into issues with being able to maintain posture and technique during squats, deadlifts, lunges, etc… Strength & Conditioning (strength) coaches and personal trainers should immediately remove their clients and/or athletes from movements that require full ROM until they can correct their musculature imbalances and weaknesses. Through comprehensive musculature correction programs strength coaches can save their clients from LBP and further injury. Once corrected, strength coaches should re-incorporate full ROM movements back into their clients program because of their superior results in fat loss, muscle growth, injury prevention and athletic performance.

The following four tips are efficient in maintaining and increasing hip ROM, which leads to reduced LBP and more efficient movement patterns / exercise technique.

1) Overhead Squats…

Overhead squats are one of the most utilized total body flexibility exercises by strength coaches. Overhead squats have been shown to increase core strength, hip joint elasticity, latissimus dorsi flexibility and improved strength and power within the lower limb musculature. Overhead squats should first be performed with an empty barbell, or even better, a broom stick or PVC pipe. Place your hands wider than shoulder width apart with your arms fully extended; place your feet shoulder width apart with your feet slightly angled out; hold the broom stick or empty bar fully above your head with your arms lined up with your ears or slightly behind; lastly, shift your hips back and squat. As you squat, retract your shoulders backwards (posterior) while keeping your chest and eyes up. This exercise is extremely challenging and will highlight any musculature tightness, weakness and asymmetry. If you cannot perform a full ROM overhead squat try sitting to a chair or a bench first. If this doesn’t work select other forms of assistance to perform the exercise, such as a stability ball against the wall. I find that utilizing this exercise before and after each workout, with a prescription of two sets for 8 repetitions, to be very beneficial in increasing neurological efficiency and total body flexibility.

2) Stability Ball Wall Squats…

Stability Ball Wall Squats are great for beginners because it restricts the spine during movement and can decrease the pressure on the hip joint. The restriction of the spine during movement allows for active utilization of the hip joint axes, thus resulting in elastic symmetry of the joints involved. Symmetry within the joints involved during squatting will result in greater ROM within the hips and less rounding of the spine at the bottom. This exercise can be performed holding dumbbells to the sides; a PVC or empty bar overhead; and/or dumbbells racked in the front. Regardless of the technique that is performed stability ball squats allow for increased hip ROM without the risk of altered spine kinematics that places beginners or inflexible athletes at high injury risk. 

3) Core exercises…

The core is the center of all movement. Therefore, the benefit of core strength and stability goes beyond simple improvements in hip ROM. A stronger core allows for efficient kinematics with little to no pain, as well as increased athletic performance and health. Here are 5 exercises that are beneficial for aiding in increased core strength and stabilization (they are in no particular order):

1)    Hip Rolls

2)    Turkish Get Ups

3)    Farmers Walking

4)    Blood Hounds

5)    Oblique Twists

To see examples of these exercises visit www.functionalmusclefitness.com and visit our YouTube channel.

Incorporate these exercises at the end and/or beginning of your workouts (i.e. a warm up or warm down). The exercises Turkish Get Ups and Farmers Walks are better served being incorporated into the main workout. Turkish Get Ups work multiple joints and require a high level of mastery, including strength, which means greater lean muscle and performance gains. Farmers walks work your traps, forearms and obliques. This is a great exercise to help with rotational power (i.e. hitting, swinging, etc…) as well as overall strength.

4) Self-Myofascial Release & Static Stretching…

There are numerous methodologies that can be prescribed to stretch the soft tissue. The most common form of stretching, due to its simplicity, is static stretching. Static stretching is holding a pose for greater than two seconds. Although static stretching is limited in its results, it can and should still be utilized. There are various other and more efficient forms of flexibility techniques that aid in tissue elasticity. Recent research has looked into the fascia tissue and how it affects adjacent musculotendinous structures (3). A link between myofascial tissue connections and the coordinated transmission of force into those adjacent musculotendinous structures were found. Findings, such as the aforementioned, have resulted in an increasing popularity in the practice of foam rolling. A prescription of foam rolling, followed by static stretching, is far more efficient than static stretching alone.

Foam rolling, or SMR, requires application of near maximal tension to the fascia tissue (soft tissue) with the foam roller or an even harder plastic roller. To specifically increase flexibility surrounding the hip region focus on the IT bands (sides of the legs); the quadriceps group (front of the leg) to hip flexors; the gluteal musculature group (butt); and lastly the erector spinae / trapezius muscles (muscles that start at the lower back and continue to run along the spine). Once near maximal tension has been placed upon these muscle groups and held for 15-20 seconds at each spot of tenderness, perform static stretching.

I have found that participants who stay consistent with the aforementioned techniques have increased hip ROM and reduced LBP; some have even experienced these results within the first couple weeks.

In Summary: perform 8-12 overhead squats before and after each workout. Utilize stability ball wall squats as needed (a great warm up or teaching exercise for beginners). Incorporate the five core exercises weekly. Perform foam rolling and static stretching after every workout or at least 4-5 times per week.

 

Functional Muscle Fitness LLC © 2012

 

SOURCES

1. Barbee Ellison, JB, Rose, SJ, and Sahrmann, S. Pattern of hip rotation range of motion: A comparison between healthy subjects and patients with low back pain. Phys Ther 70: 540-541, 1990.

2. Offierski, CM and Macnab, I. Hip-Spine syndrome. Spine 8: 316-318, 1983

3. Huijing, PA and Baan, GC. Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles. Cells Tissues Organs 188: 405-410, 2008.

4. Myer, GD, Chu, DA, Brent, JL, and Hewett, TE. Trunk and Hip Control Neuromuscular Training for the Prevention of Knee Joint Injury. Clin Sports Med 27: 430-440, ix, 2008

5. Mark A Wine. Eccentric Training for Athletic Performance. www.functionalmusclefitness.com: 2012

6. Mark A Wine. Squats for Performance: Range of Motion Squats vs. Parallel Squats. http://functionalmusclefitness.com/squats-for-performance-range-of-motion-squats-vs-parallel-squats-part-i/: 2012

 

Learn More About Functional Training and Improving Your Range of Motion

SOURCES
1. Barbee Ellison, JB, Rose, SJ, and Sahrmann, S. Pattern of hip rotation range of motion: A comparison between healthy subjects and patients with low back pain. Phys Ther 70: 540-541, 1990.

2. Offierski, CM and Macnab, I. Hip-Spine syndrome. Spine 8: 316-318, 1983

3. Huijing, PA and Baan, GC. Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles. Cells Tissues Organs 188: 405-410, 2008.

4. Myer, GD, Chu, DA, Brent, JL, and Hewett, TE. Trunk and Hip Control Neuromuscular Training for the Prevention of Knee Joint Injury. Clin Sports Med 27: 430-440, ix, 2008

5. Mark A Wine. Eccentric Training for Athletic Performance. www.functionalmusclefitness.com: 2012

6. Mark A Wine. Squats for Performance: Range of Motion Squats vs. Parallel Squats. http://functionalmusclefitness.com/squats-for-performance-range-of-motion-squats-vs-parallel-squats-part-i/: 2012


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