Low back pain is an extremely common ailment. Because it’s a symptom rather than a diagnosis, there isn’t a one-size-fits-all treatment. But I still find myself routinely recommending certain things to lower back pain patients. One is the hip hinge.
The stresses we place on our spine can be crucial in developing lower back pain. The most important among these are activities that require spinal flexion, which is the position our spines adopt when we bend forward and sit slouched. Research indicates that we flex our spines to some degree thousands of times per day, making it a direction of excessive mechanical stress for most people.
When patients are vulnerable to spinal flexion, I will usually teach them how to hip hinge. When we bend forward at the waist, whether to pick something up off the floor, open the bottom drawer, or pet a cat, we typically achieve that through the movement of the spine and hip joints. Hip hinging transfers motion from the spine to the hips, which helps maintain a neutral spine posture while bending forward. Moving that way decreases the flexion stress on the spine, making the hinge a powerful spine-sparing movement pattern.
You want the hip hinge to become your default movement pattern so you don’t have to think about it when bending or lifting. That can be achieved by practicing a simple exercise requiring a dowel, broomstick, PVC pipe or something similar. You would perform it as follows.
· While standing, orient the dowel vertically along the center of your back.
· Hold the dowel in place using one hand behind your neck and the other behind your lower back.
· The dowel should contact the back of your head, your mid back and the back of your pelvis.
· While keeping the dowel in place, move your hips back and your torso forward (hinging at your hips) with a slight knee bend.
· Hip hinge as far as you comfortably can while keeping the dowel in contact with all three points (the back of your head, mid-back and pelvis).
· Return to the starting position.
· Do 10-15 repetitions.
If the dowel remains on all three contact points throughout the movement, it means your spine is in a neutral posture. If you lose contact between the dowel and the back of your pelvis, it means you are bending at your spine rather than hinging from your hips. You also know you are achieving the proper hip hinge motion if you feel tension in your hamstrings.
Once the hip hinge becomes second nature, maintaining a neutral spine posture will be much easier when lifting or bending forward. Moving that way will spare your spine from excessive flexion stress and likely decrease your incidence of lower back pain.
Dr. Jordan Duncan is from Kitsap County and writes a monthly online health column for the Kitsap News Group. He is owner of Silverdale Sport & Spine.