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Be hip to source of back, knee pain

Have knee or back injury? Some athletic trainers say you should look your hips for relief.

Have a knee or back injury? Some athletic trainers say you should look to your hips for relief.

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Updated: October 14, 2012 12:19PM

You stand up from your chair at work and your lower back starts grumbling. You decide to take a walk down the hall and before you know it, your knees ache, too. What gives?

The answer might have little to do with your back or knees. The pain could be linked to your hips, in particular a group of muscles called the hip flexors that are in use when we climb stairs, run, dance and play soccer and even do resistance training. Also known as the iliopsoas, they help the leg move up and down and stabilize the spine. They are in your abdomen and upper thigh and are among the strongest in the body.

“When we sit all day, the hip flexors shorten,” says Jim Thornton, president of the National Athletic Trainers’ Association and head athletic trainer at Clarion University in Clarion, Pa. “When they’re shortened, it impacts how we perform and can cause all kinds of problems, from our lower backs down to our feet.”

The older you are, the more they shorten, and it’s not just sitting that leads to problems. Lie in a fetal position at night or when napping? That also shortens them.

Unfortunately, Thornton says, many training programs overlook the hip flexors and focus on the hamstrings and quadriceps. But tight flexors will prevent the rest of the body’s flow from working properly, he adds.

Here’s one example of what can misfire:

“Let’s say you’re going for a walk or jog and your hips are tight,” he says. “When you strike your heel on the ground, the muscles that control the arch of the foot are going to be inhibited because the hips are tight. As your foot rolls forward, it will pronate (roll inward). That can cause shin splints and plantar fasciitis (inflammation in the arch). If you get that, you feel like and walk like a 99-year-old person.”

Chances are many of us probably have tight hip flexors. Government statistics suggest that almost half of us report sitting more than six hours a day; 65 percent say they spend more than two hours a day watching TV.

“There’s all kind of exercises people can do to get a workout in,” Thornton says. But “the most important thing is you actually get up off the couch and do something.”

It’s important to warm up first. “Don’t go right into a class,” he says, or start a program on a DVD cold. “One of the biggest problems is people will go and get injured in the first couple visits and get discouraged.”

When it comes to warming up the hips, he recommends gentle stretches such as lunges with one knee bent in front and the other leg straightened behind you.

He also suggests using a foam roller, which sells for about $15. They come in different sizes, but a good one for the legs and hips need only be 24 inches long by 6 inches in diameter.

In The Athlete’s Book of Home Remedies, author and sports medicine physician Jordan Metzl recommends warming up the hip flexors by lying face down on the floor with the foam roller positioned above your knees and your elbows on the floor for support. Roll back and forth toward your hips. When you’re comfortable with that move, cross one leg over your other leg and rest it behind the ankle. Roll back and forth on the straight leg. You might have to tilt inward onto the flexor.

“They’re seriously underrated muscles,” Metzl says. “But they’re very important in everyday movement as well as explosive athletic movements.”

Gannett News Service

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