Tight, overused hip flexors and back pain

Sheltering for COVID has motivated people to work out at home. But jumping into a challenging new workout can sometimes have unintended obstacles. Here’s a recent experience we had involving tough new core and hip exercises and back pain.

Exercises that are too challenging cause unwanted compensations

A young patient had started a new workout program to improve her core strength. But 2 weeks into it she started getting low back pain when she did her squats. We reviewed the workout program she’s been following and it’s full of great stuff: planks, squats, sit-ups and more. But when we assessed her muscle strength, we found the issue.

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Despite her workout’s emphasis on hip strength, her gluteus maximus muscle did not turn on to do the intended work. Overly challenging exercises resulted in compensation with her back and psoas major hip flexor muscles. Overuse of back and psoas caused her pain. Furthermore, her overused psoas hip flexors became tight and is what prevents her gluteus maximus from working. So until she breaks this cycle, her workout won't work for strengthening her glutes.

Secondarily, her abdominals also showed a imbalance: her rectus abdominis (the six pack) was extremely strong, but the transversus abdominis (deep abdominals) were overshadowed.

Gentle exercises to get back on track

Photo by i yunmai on Unsplash

Photo by i yunmai on Unsplash

Proper performance of squats uses a balance of engaging the deep abdominals & back muscles, moderating the tension of hip flexors, and engaging the gluteus maximus. Preparing her busy for that was her home treatment program:

  • release the psoas hip flexor with gentle self massage and yoga stretch

  • gentle and easy activation of gluteus maximus

  • avoiding sit-ups, which emphasizes the rectus abdominis

  • strengthening her transversus abdominis

She was a little disappointed that her core strengthening program will have to wait. But within 2 weeks of her new PT exercises her back pain was much better. With her improved muscle control and balance, she was able to resume her original workout program without pain.

Sometimes our best intentions get ahead of our body. Taking a step back and reassessing can help optimize your journey towards your goal!