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Low Back Pain - Understanding What It Needs To Improve, Part 2

back pain dr. marcus Aug 18, 2021

Part 2: The Hip’s Role in Low Back Function

A car needs a good road to function at its best. A house needs a good foundation to stay strong. A tree needs solid roots to stand tall. 

By only focusing on the low back you are having low back pain, you are missing the big picture! 

The hips play an absolutely crucial role in low back pain. If they are weak or stiff (or both!), the foundation of your house has major issues in providing your low back what it needs to function pain-free. 

This is very much supported by the literature. Two major reviews found that in patients with low back pain, there was a high prevalence of weak hips (1) and that by strengthening those weak hips, you can improve your back pain (2)! Furthermore, a lack of hip internal rotation has been found to be correlated with low back pain as well (3). 

So, if hip strength is found to be directly associated with low back pain, we’ve gotta strengthen our hips! If I were to choose two exercises for you to try for hip strength that can help with low back pain, here’s the two I would choose to target these potential impairments.

Single Leg Hip Thrust:


Keeping your core tight, squeeze your butt as you push your hips up to the sky. Try to not let your spine move. Let your hips do all the movement (no arching your back!). Try 2-3 sets to moderate levels of fatigue. If this is too hard or too uncomfortable, regress to trying these on the ground without your back elevated. 
Clamshells and/or Side Plank Clamshells:



Clamshells are often looked down on as easy basic exercises (which they can be). However, if you know how to progress them, they can be downright challenging! These are two variations I enjoy in the clinic and both involve a band. Try 2-3 sets on each side to mild to moderate levels of fatigue.

Both exercises should have discomfort levels below 2/10. More is not better with these!

By combining a healthy lumbar spine and hip complex, you have the best chance to improve your low back pain for the long run. If you still feel like you’re getting stuck, feel free to reach out to us and we can get you the care you need to get your back to the place you want it to be!

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โ€‹Thanks for reading,

Dr. Marcus, PT, DPT, CF-L2

  1. โ€‹de Sousa CS, de Jesus FLA, Machado MB, Ferreira G, Ayres IGT, de Aquino LM, Fukuda TY, Gomes-Neto M. Lower limb muscle strength in patients with low back pain: a systematic review and meta-analysis. J Musculoskelet Neuronal Interact. 2019 Mar 1;19(1):69-78. PMID: 30839305; PMCID: PMC6454257.
  2. Tataryn N, Simas V, Catterall T, Furness J, Keogh JWL. Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis. Sports Med Open. 2021 Mar 8;7(1):17. doi: 10.1186/s40798-021-00306-w. PMID: 33683497; PMCID: PMC7940464.
  3. Sadeghisani M, Manshadi FD, Kalantari KK, Rahimi A, Namnik N, Karimi MT, Oskouei AE. Correlation between Hip Rotation Range-of-Motion Impairment and Low Back Pain. A Literature Review. Ortop Traumatol Rehabil. 2015 Oct;17(5):455-62. doi: 10.5604/15093492.1186813. PMID: 26751745.

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