A Non-Negotiable Step in Treating Back Pain or Sciatica: Check the Hips

The following is a transcript of the video above

In this video, I'm going to talk about why it is nonnegotiable to check the hips when you're trying to treat somebody with back pain or sciatica. So many people are allowed to continue having chronic back issues because of a problem with their hips. So I'm going to go into what to look for in the hips, what we check in clinic, and then how we use what we find in that check to make decisions about either exercises, mobility work, or how to help somebody move around with less pain or without aggravating those symptoms on a daily basis.

So why do the hips matter so much for the spine? It's really quite simple. If I don't have enough hip motion, when I'm trying to move about the hips and I run out of space, then my spine is next in line to take up the remainder of that motion. If we already have some damage or an issue in the spine, we need to stop it from moving for a time to allow it to heal, but not having enough hip motion isn't going to allow you the ability to do that because your spine's going to continue to make up for that lack of motion. So in order to allow the spine to heal, we first have to get that mobility from the hips.

It's important to understand the difference between spine movement and hip movement, to understand this concept. So briefly, I'm going to show you the difference in this video. That would be hip motion from the front again, hip motion from the front, that would be hip motion from the side, once more hip motion from the side. And then we have spine motion from the side. So spine motion here. (this paragraph will only make sense in tandem with the video)

A great example of the importance of hip mobility as it pertains to back pain and sciatica would be during sitting to standing. Now for most people with back pain and sciatica, you don't want to allow the spine to move while you're under load, but that becomes a problem when I'm sitting and standing from the surface that I need to have more hip depth from, like a toilet seat or a lower chair. If I don't have enough hip mobility, my hips will stop here, and then I have to find other means to get into and out of the chair, which becomes a problem constantly moving that spine while loaded.

So getting into the passive hip exam, we're going to check out hip flexion or like a squatting position. I'm going to put my hand under her spine to see if it moves while I go into hip flexion, because that's common. It did not. Then we're going to go into some external rotation and internal rotation. It's important to check from this position because this is how our hips would do in a squatted position or a seated position. And then we're going to flip over and we're going to check from more of like a standing position, internal and external rotation, as well as some hip extension (this paragraph will only make sense in tandem with the video)

Quadruped is another way we can check on hip mobility and also keep an eye on the spine and making sure that spine can stay neutral while we move through that hip range of motion. So Candace is going to sit back with a relatively closed off hip position. You can see her spine rounds out almost immediately. That's not what we want to keep the spine safe. So I'm going to widen out her stance a little bit, get that external rotation in her hips. And then as she goes back, you'll be able to tell she gets way deeper almost ass-to-grass without rounding out, which is a much better position if she were going to go sit/stand out of a toilet seat, in her office chair, or even squat. (this paragraph will only make sense in tandem with the video)

Okay, so we just went through a ton of information. Now it's time to decipher it. Really, we're looking for one of two things when we go through the hip exam that I just showed you. The first thing was really positional. If you looked at Candace in quadruped, as we went back and forth, we noticed that her ability to drop deeper into a squat changed as her hip position changed. So with a more narrow base, she had more trouble keeping a neutral spine, and with a wider base she was able to move a lot more freely. You might be thinking, come on, it's never that easy. But sometimes it is that easy. I have seen people with chronic bulging discs who just a simple change in their hip position was all they needed. It's not always the case, but it is absolutely possible that that is the case.

The other thing that we looked at was hip mobility. When I had her on her back and on her stomach, we looked through to see how well her hips move. Again, we're just checking to see, do we have any restrictions? If so, where, what, why, when, how?

That isn't even getting into the balance side of things, the stability side of things, which is a whole other video unto itself that needs to be made eventually. But I want this video to serve as a public service announcement that the hips are so, so very important. And my hope for this video is it highlights just a couple of the many aspects of the hips that pertain to your spinal health and your ability to recover from something like back pain or sciatica.

Obviously I would be more than happy to help you out with this. And I would love it if you would hit the button below and schedule a phone call with us.

But I hope if nothing else that this video serves as a way to show you that your hips are very important for your spinal health. And they're absolutely 100% involved in the process in one way, shape, or form for most people.