Tuesday 12 November 2013

More on hip mobility and low back pain

I came across another interesting article about low back pain and hip mobility the other day. It came in an email about tennis coaching rather than a therapy newsletter. Written by Dr Josh Renkens, DC, MAT, ART, the article was titled "Is Your Limited Hip Mobility Causing Your Low Back Pain". Because it came in an email, there was no publication source, so I can't give you a reference to find it for yourself.

Anyway, he suggests that lack of internal (medial) hip rotation is a contributory factor in low back pain experienced by golfers and tennis players. Actually he refers to an imbalance in hip rotation rather than limited rotation in one direction. He says:

In one study, 48% of subjects with low back pain (LBP) had increased lateral rotation and a deficit in medial rotation of the hip (Ellison, JB).

Another interesting point he makes was that:

Researchers found that a statistically significant correlation was observed between a history of LBP and decreased lead hip internal rotation (Vad, Journal of Sports Medicine).

The obvious thing might be to assume that the limited medial rotation come from tight lateral rotators, and that can certainly be true. But don't ignore the possibility that it might be that the medial rotators are not engaging properly. I've certainly seen that with at least one recent client where medial rotation wasn't restricted, it just didn't happen readily.

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