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Dublin: 12 °C Wednesday 15 July, 2020

Watch and learn: Four simple hip mobility drills to reduce low back pain

Personal trainer Sarah Cremen shares, and demonstrates, her advice.

Image: Shutterstock/Albina Glisic

TIGHTNESS, STIFFNESS, IMMOBILITY in the hips – it’s one of the most common dysfunctions I see in clients on a daily basis and can be a relatively common cause of sacroiliac joint pain, knee, ankle and most importantly low back pain.

The days of heat packs, ultrasound and ESTIM as a means of treating low back pain are thankfully over as the importance of addressing the biomechanical factors associated with pathology is better understood.

There’s plenty of new research that indicates a relationship between low back pain and hip pain secondary to limited range of motion in the hips (namely deficits in hip rotation) and the fitness world has now come a long way in understanding the importance of mobility work and its influence on pain, performance and training.

When it comes to the hips, ensuring we have good ranges in flexion, extension, internal and external rotation and abduction is vital to reducing the stresses and strains placed on the lower back and other area of the kinetic chain that can compensate.

Below are a few of my go-to drills for trying to improve hip mobility, but it’s worth remembering that they are simply part of a bigger picture. All the stretching and mobilising in the world won’t necessarily improve your motor control, pain and movement abilities without stability and neutral positioning of the pelvis and spine… but more on that another day!

90/90 hip stretch

A nice drill that addresses multiple areas — external rotation on the lead hip and internal rotation and adduction on the trail leg.

Source: SarahCremenPersonalTraining/YouTube

To position – place the lead leg directly in front of you, bent at 90 degrees and with the shin lined up with your heel. Your trail leg should be to the side, also bent at 90 degrees. Try to maintain a neutral spine and breathe deeply as you move into the lead and back again, allowing for relaxation in the soft tissue tone and your body to get accustomed to new ranges.

If you’re feeling adventurous, try a few transfers, ending up in the same position on the opposite side.

Half kneeling couch stretch

So often performed with poor technique, but when done correctly, this is a really effective drill for addressing mobility issues with hip extension.

Source: SarahCremenPersonalTraining/YouTube

Neutral spine alignment is key here; think about ‘tucking’ your tailbone, avoid hyper-extension at your lower back or excessively lunging forward over the lead leg.

Activate your glute max on the back leg (i.e. squeeze your butt) to place the pelvis in a neutral position and allow for a greater stretch on the anterior muscles of the hip and thigh.

Switching on your glute max will also induce what is known as reciprocal inhibition – whereby the activation of one muscle decreases the activity in the opposing muscle/muscles. In this case, squeezing your butt helps to decrease the activation in the anterior hip musculature.

Deep squat hold

Basically an isometric or static hold at the bottom position of a squat.

Source: SarahCremenPersonalTraining/YouTube

Get into the deep squat while holding a moderately heavy weight (kettlebell) to provide a counterbalance. Position the elbows just inside the knees, resting on the inside of your quad. Keep your toes tracking forward and use your elbows to drive your knees outwards to increase the stretch on your inner thighs.

Again, use deep breathing to enhance the stretch — deep inhale and forceful exhale for 8-10 breaths should suffice.

Alternating spidermans

Bringing it all home with a big bang for your buck drill that I use with the majority of my clients.

It manages to hit both hips simultaneously; incorporating hip flexors, adductors, internal and external rotators. Stay active with this one by alternating your legs, your spine neutral and contract the glutes of the trail leg with each rep.

Source: SarahCremenPersonalTraining/YouTube

Give these a try and assess how you feel after — more mobile? Less pain? If so, it’s probably a good sign to start incorporating them into your training regime. Hopefully it goes without saying that if you experience pain and/or a deep pinching in your hips with any of the above…stop!

Sarah Cremen is a personal trainer and physiotherapist based in David Lloyd Riverview in Dublin. For more health and fitness advice and tips, you can follow her on Facebook and Instagram, and you can find her website here.

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