Master Class: The Hip and Lumbar Spine
The notes below are from Ellie’s workshop series, Master Class: The Hip and Lumbar Spine, on October 28. Check out our Events page to register for Ellie’s next Master Class: The Knee, on Monday, November 4 at 3pm at EHP South Slope on 8th Ave and 13th St.
The Hip and Lumbar Spine
The lumbar spine can move in all directions but because it lives in extension. It has more range of motion (ROM) in this direction and a limited range of motion in every other direction. The lumbar spine is more rigid than the thoracic and cervical because of the ratio of the thickness of the vertebrae and the discs.
CURVES BEGET CURVES AND FLATNESS BEGETS FLATNESS
Curves of the spine are thought to absorb shock. A flattened lumbar curve can be part of a picture of flattened curves in general throughout the spine, with a flat thoracic and cervical curve, potentially causing neck pain and vulnerability for disc dysfunction in both lumbar and cervical spine. Ramrod spine I call it. Tight hamstrings and glutes can cause Posterior Pelvic Tilt which contributes to a flattened lumbar curve.
Another common picture is lordosis/kyphosis which is too much curvature throughout the spine.
The lumbar spine takes a huge load throughout life and therefore a common place to get herniations and disc dysfunction. Avoid loaded flexion and rotation with disc problems. Neutral spine and mild extension are indicated. Avoid any extreme movements in any direction, and of course, any movement which triggers pain.
The lumbar spine is continuous with the pelvis and hip joints as it is continuous with the thoracic and cervical spine. The curvature and mobility of the lumbar spine will affect structures above and below. As we age we tend to lose some of our lumbar curve.
And vice versa….
Hip movement and lack of movement affects the lumbar spine mightily, as will it affect the knee functionality.
It’s extremely important that the hip joints have a full range of motion in every direction to avoid excess stress on the lumbar spine.
Always consider what is limiting a particular hip movement. If its not a structural issue it will most likely be the oppositional muscle group. Arthritis is the most common reason for decreased range of motion in the hip.
THE PSOAS AND THE QUADRATUS LUMBORUM: THE YIN AND YANG OF THE LUMBAR SPINE
Both muscles contract in lumbar extension. Both muscles will be tight in lordosis. Psoas is an anterior back muscle, QL is the deepest posterior back muscle. They sandwich the kidneys. Psoas can be the cause of menstrual pain.
QL is the keystone of the pelvis and can be seen on both views of posture: both rearview and side views. The QL will be affected by both a hip hike and anterior pelvic tilt and pelvic rotation to one side.
Unilateral hip flexor tightness may cause pelvic rotation to that side and same side QL tightness.
Bilateral hip flexor tightness causes anterior pelvic tilt (usually rectus femoris most responsible)
Bilateral psoas tightness causes lordosis.
HIP FLEXION
Most important hip movement as we need to bend forward in order to live life.
90% of lumbar pain is due to a lack of hip flexion. Why? Because if the hip doesn’t flex easily the spine will flex when bending forward. Flexion is the movement that will damage the disc. That is why the squat is such an essential exercise!
What limits hip flexion? Hamstring tightness is the most common culprit, but also glute and deep rotator tightness can limit hip flexion.
With corrective exercise always start with releasing tightness in an oppositional muscle group, if tight. Sometimes releasing the synergist can help since the synergist can compensate when a stabilizing muscle is weak.