Lower back pain is epidemic in our society. The fact of the matter is, we sit too much. Driving, at our computers all day long, most of us sit for many more hours than we stand. What happens from all of this sitting is that when we stand up, our hips stay semi-flexed, tilting the pelvis into forward inclination and increasing the curve in our lumbar spine (lower back). Given that we are thrown out of anatomical alignment, this creates undue stress on our lower backs that can become a chronic back issue, sometimes requiring surgery and accompanied by sciatica causing discomfort into the glutes and down the leg. Very painful.
Those of us who have had babies remember all too well the lower back pain from the added weight of the baby on the front of the body. Once again, this causes the pelvis to tip forward resulting in the painful over-arching of the lumbar spine. Not as much you can do about it during pregnancy except to make a concerted effort of use the lower abdominal muscles (Zip It!) to draw up on the pelvic rim and to feel the tailbone dropping and hanging heavy.
But the most effective thing you can do, and this should be done daily (gently during pregnancy too!), is to stretch the hip flexors to lengthen the muscles to counteract the foreshortening from sitting. We hear about hip flexors a lot, but understanding exactly where they are is key to visualizing their release. Remember, knowledge is power and the more mindful we are about How we are doing What we are doing, the more benefit we will derive from every activity in our lives.
What/where exactly are the hip flexors? First of all, the action of hip flexion is lessening the angle between the pelvis and the thigh or bringing the knee closer to the torso. One source of confusion in visualizing the hip flexors can be mistaking them with the hip socket more towards the side of the body; the ball and socket joint where the head (ball) of the leg bone (femur) fits into the hip socket (acetabulum) of the pelvis. The hip socket is made up of bones whereas the hip flexors are a group of muscles. Clearer?
So which muscles exactly are the hip flexors? We can all feel the thigh muscles as we lift our knee into hip flexion. Of the four muscles in the thigh (quadriceps), the most central thigh muscle is the major hip flexor of this group- the rectus femoris. Visualize this muscle running down the center of the thigh, flanked by the two vastus muscles and another one underneath the rectus femoris- the 4 quads. All work in hip flexion led by the rectus femoris. But the most important muscles in hip flexion that we rarely hear/talk about are the Iliopsoz (often referred to as the psoaz) that originate on the lumbar vertebrae, pass through the pelvis and attach on the upper, inner bone of the femur (the lesser trochanter). Sounds crazy I know, but this muscle group is actually what does the major work in lifting the leg up! Visualizing hip flexion as an action of the deep pelvis originating in the lower back can prevent the quads from getting as tight and promotes more muscular efficiency when lifting the leg in any activity.
So what are some strategies to release these key muscles called the hip flexors? The best stretch for the rectus femoris of the thigh is to step forward into a lunge with one foot, other knee on the floor (you may want to put a towel under the knee for cushion). Make sure the standing foot is directly under the knee (not behind it) for the health of the knee. Engage the lower abdominals (Zip It!) and tilt the pelvis under. You should already feel a pull on the thigh muscles. Then shift your weight forward to lengthen the hip flexors even more (fist into the glutes adds greater intensity to the stretch when you're ready), but make sure not to release into the lower back- hold the pelvic tuck. Also, watch the position of the heel under the knee as this may have changed. As with all stretches, breathe into the release of the muscles for at least 30 seconds. Upward facing dog from yoga (up dog) pictured below is another stretch for this as long as you maintain the pelvic tilt once again to protect the lower back from hyperextension (over-arching).
Accessing the psoaz is a little trickier. Since it is deep inside the pelvis it's important to visualize its release even more than in the thigh muscles. Simply lying with the feet flat, knees to the ceiling and consciously releasing the muscles inside of the pelvis is one way. It's also a nice opportunity to slow down the pace and practice diaphragmatic breathing (Umbrella Breathing). You can help it along even more if you lie with a rolled-up towel or even a foam roller under your hips. Bring both knees into your chest and gently extend one of your legs forward, holding on to the other knee. The foot may or may not touch the floor. You can also do this stretch lying on a bench at the gym with your sitz bones right at the edge. Hold and breathe into this stretch for at least 30 seconds and repeat on the other side.
The really interesting thing about the psoaz muscles is that it's another part of the body that is connected to the sympathetic nervous system. When we experience stress or anxiety, not only do the shoulders raise and breathing becomes shallow, but the psoaz muscles also contract. If this is a chronic state in our lives, it can impact our health in serious ways. The psoas muscle is intimately connected to our diaphragm, the main muscle of breathing. These two muscles are literally connected in all their functions, so stress can cause both to lose their ability to work in an optimal way. Another great reason to manage stress in our lives with deep, aware breathing (To Breathe Is To Live).
Who knew that hip flexors were so important to our health and wellbeing? For so many reasons including the condition of the lower back and managing the fight/flight response from stress, not to mention having the awareness of what hip flexion actually is to optimize the many activities that depend on this action including walking- let's make it a priority to stretch our hip flexors daily to Straighten Up And Fly Right.
#straightenupandflyright #chroniclowerbackpain #pregnancybackpain #stretchyourhipflexors #thepsoaz #psoazanddiaphragm #sympatheticnervoussystem #fightflightresponse
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