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6 Ways to Test Hip Mobility as a Cause of Low Back Pain

Posted on December 28, 2022

To watch the full video, click here: https://youtu.be/ahvWLPzHD3U

We need to have an assessment that helps us figure out where it starting from where are some of those culprits or some of those suspects of that low back pain might be coming from. And so we have below the lumbar spine is our hips, our pelvis, and above our lumbar spine is up in our thoracic spine. So those are two typical big rocks. And there’s something either lacking mobility or lacking strength, and one of those two areas or both that are contributing to more work happening at the lower back, either more emotion happening from the lumbar spine, or more muscle effort from those lower back muscles. So how do we figure it out? Well, there’s two little assessments that we do that are pretty quick to kind of show us where we need to go first. And it’s the hip assessment and set thoracic spine assessment in our previous video chatted a little bit more about flexion, extension, lateral motion, rotation, and then combinations of type one and type two spine, so feel free to reference that and just use it for your lower back pain assessment. Today, we’re gonna talk more about the hips and how to figure out where we need to go first, either with some soft tissue techniques, maybe just some stretching techniques and the true stretch or the mobility stick. Or maybe it’s just moving those areas that haven’t been taught in motion before. So we have to think about our front hip, we got to think about our posterior hip that I think about medial gotta think about lateral, and then also our rotational dynamics. And that’s typically where we’re most limited, or where most of that dysfunction lies. Now we’re going to think the lumbar spine, we have our so as that attaches down into our femur, and up into t 12, all the way through L five. So that can typically be a big culprit, especially if someone’s got a lifestyle of sitting, flexing, traveling or pulls their their core forward, or to more flexion. So we’re gonna look at so as we’ve also got to take a look at our abductors that also come up into the pelvic bowl and down into the legs. And we’re going to think about the TFL, we’ve got to think about the glutes, especially those muscles that are helping in rotation, they’re not helping in rotation, typically, the lower back or the knees are going to be asked a lot more. So for front hip, if we just go into a stride stance into a call into a left stride, we’re looking at doing the right hips ability to extend, right, we’re going into a typical lunch, you might see somebody dropped the knee down, not a horrible movement. But it might not give us enough information about how the anterior hip is loading, how much extension doesn’t have the ability to essentially load or decelerate. So if we take a left foot for lunch, we’re looking at the lengthening of this right front hip, and also its ability to contract back home from that load. Same thing, when you take your right foot forward, we’re looking at the left anterior hip. And typically if there’s some kind of dysfunction at the anterior hip, what you’re going to find is either a foot bail out in rotation, you’re going to find a knee flexed out of the ground, or instead of both of those, the hips will stop and you’ll see a ton of extension, aka more muscle effort at the lumbar spine. So it’s usually a quick hitter, seeing if that back foot turns out, as opposed to keeping them in that extension, internal rotation, they’ll typically bail to external rotation and a bit of flexion forward, as opposed to that inter rotation and extension, that’s telling, you probably need to go after the front thighs either with some soft tissue work, maybe just some other cueing or adding some stability with moshtix, a wall or a chair, just to allow them to go through that extension to the hip. Right, we don’t have to do a ton of soft tissue work, if we just need to teach the body teach their body how to go through the extension. Sometimes the access isn’t there. We can even take this up into a box. So not even going into this strike stance. But maybe something more into just this extension. And typically what we will find if there’s limitation at this front hip or even in the posterior hip, is will compress forward and put a lot of pressure and compression into the front side of our spine, making our low back start to ache quite a bit, right because now to come out of this, we’ve got to use those low back muscles versus being strong and allowing the Senate

to get that posterior tilt. Now for the posterior chain more than looking at the hamstrings, the loading through the upper hammy and the lower hamstring number attaches at the knee and up in the hip. And what most individuals will do in a hamstring load, right if you go through a posterior stretch, as they’ll try to lock out this portion of the leg lock out the knee. That’s not a bad thing. But typically we’re going to get so much motion from that lower portion of the hammer During that we have done nothing to give them the upper. So for example, we step our left foot that lock into that hamstring stretch, yes, a ton of load, but we may not get the full anterior tilt of the pelvis to load the upper section of the hamstrings. So if we just emphasize a slight event, as we take this posterior launch, now we can see if the pelvis can access into your tilt to load the upper hamstrings, if you’re finding that they can’t quite till they just kind of bail, the hip stopped tilting, and it’s off to the lower back, that’s probably a sign that we need to work on their hip hinging, especially in the upper section, that goes for both sides too, right, we can go with the leg straight leg a little bit bent. But each of those are going to give you some different insight into how they load their posterior chain. Something a bit simpler is to put them up on a chair a box that toe up, and then drop in and seeing if they have the ability to post your anteriorly tilted the pelvis. Or if they just use their back to get there. It’s so subtle, so you need to be very aware, you can place the hands on hips, seeing if you can guide them into that anterior tilt, they may just know they might just not know how that feels, how to create that motion, because they’re so focused on keeping their leg locked out, there’s times we want that leg straight. Other times we want to stay a little bit bit to load upper portion of the hamstring. We’ve got our medial chain. And this is what we see so much dysfunction, especially for those desk sitters or travelers on planes, or in their car driving for hours at a time, they’re flexing the pelvis, they’re not using any stabilizer muscles on the inner thigh. And so when they go to stand up and walk those muscles, typically state doormen, they may be used a bit a percentage, but maybe not the whole adductor tissue, that old medial line. So we can start with this a wide foot position, just slide to our left and to our right. And what we’re looking at is not just the translation of the pelvis, the shifting of the pelvis to the right and left side in space, but actually the tilting or the rotation of the pelvis in reference to the femur and our spine. So we love to our left lateral, we want to fill out a right hip drop and the pelvis tilt to the right side loading those deeper adductors. Many people keep their pelvis flat and slide and they create this big gunky sensation up in the hip. And their back starts to compress and hold and squeeze because we don’t want to go much deeper. But if we can start to access this till now we’re giving more love to the inner thighs and hips, rather than to our lumbar spine trying to create that lateral flexion. Right, the difference of this where my spine is really straight, relatively in the pelvis, versus the pelvis is flat and we bend at our lumbar spine. And that’s going to create more compression, that’s not necessary because our hips have the access as long as we’re training them to do that till.

So maybe foam rolling inner thighs, upper groin getting in there with an elbow, or going up into that trough, stretch leg is up, hands can hold on. So you got four points of contact, and we start to tilt our pelvis and drop our shoulder, feeling that upper inner thigh and sometimes it takes some time just to rest here, that tissue can start to separate like taffy. Now we’re starting to feel like oh my gosh, it’s sharp, it’s a bit of a tug, but avoiding the pinch on the outside. If we come back and retest, typically we’ll find that there’s quite a bit more tilt. And now the spine doesn’t have to do it, the hips can do it. Then we’ve got our lateral line, we got three left here, super important on these, we’ve got our uncommon frontal plane stances, like as we like to call it, which is simply an opposite side lateral step, which is going to give us an adducted hip position relatively, right, so we’re loading our AB doctors. And what we’ll tend to find is if someone’s got lower back dysfunction, and this is the cause of their pain, they’re not going to be able to slide or translate their pelvis to the side, those try to go, but they’ll lose their balance, they’ll step and then as soon as their hips start to slide, they can’t quite go any further, they hit a barrier hit a wall, as opposed to getting a nice slide to one side, you wouldn’t find one side limited, other side ease. And that might be why they have this asymmetric pain, it’s only on one side of their back, because we’re only accessing one translation, or one way to laterally tilt their pelvis. You can take that up into the thoracic spine as well. But again, if we want to keep it more so in the hips, we’re looking at the right femurs ability to add to or get into the adjunct position passively, right, I’m not forcing my leg to add that it’s planted, my left leg comes across and now we’re seeing that eccentric load of the AB doctors. So if you’re not seeing that load, sometimes TfL. Sometimes the vastus lateralis, sometimes more open to the oblique that’s compressed down in the connective tissue that we just need to start to prime that tissue before we go into a workout squats or an event involves lateral motion in the hips. You can take them up into a platform as well onto a chair and just see if they can slide their hips while maintaining stability here Great way to start to access more that range that over time, just two feet on the ground, they can get into that position where we’re going to look at our hips ability to externally and internally rotate. When we walk, our pelvis is actually twisting right and left, we had a top down view of this, you’re gonna see my pelvis twist, and my torso rotate, opposite, we don’t walk in sync without drastic spine and hips, we walk out of sync, and it creates this nice spiral and diagonal load through our front core and our backside. And sometimes that towards net twisting, is too aggressive, we don’t have more than we can access this is as far as we can get. That means we’re going to be straining some of the tissues to the thoracic and lumbar spine and down into the pelvis. And so what we’ve got to do is see, do we have access into actual rotation, and we have access into internal rotation on this relative on this passive leg here, this stance foot, or taking that femur into extra rotation of the pelvis, and then taking that leg into internal rotation. If your client doesn’t have access tipic, which your mind is a bailout either in the knee that needs to start to cave in and create tension here or the low back, or the low to keep the leg straight, and it’s compressing the outer hip, because they’re not allowing the tension to load on the inner thigh. And vice versa, when they come across. They might not feel the outer hip loading or might not have access to their foot pivots, or they stretch and compress down. If you’re not seeing a smooth transition in that rotation, that’s a good sign that you’ve found a place to go target, go do soft tissue techniques, go stretch it, go move it around a little bit and then come back and reassess. Do they still have that compression? Do they still have that bail out in the New York now they’re able to cue more successful, more efficient loading through the hips. So I should give you a good baseline 3d maps through gaze to assessment of the full lunge matrix of anterior posterior same side lateral opposite side lateral, same side rotation, opposite side rotation. We’re gonna keep diving deeper into this and even some techniques on okay, you found that the knee bailed, or the foot turned, or that they couldn’t quite extend their knee flex. So what do we do about it? Go check out Gymnazo easy to use Instagram and that’s we’ll be breaking down some more of those techniques. You’ve been checking out our multi dimensional movement coach certification to be able to apply these techniques to your clients. Good luck and enjoy.

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