Back & Neck Pain Exercise Back and Butt Fitness Tips for Your Backache By Anne Asher, CPT Anne Asher, CPT Facebook LinkedIn Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial process Updated on March 19, 2021 Medically reviewed by Mohamad Hassan, PT Medically reviewed by Mohamad Hassan, PT LinkedIn Mohamad Hassan, PT, DPT, diagnoses neuromuscular and orthopedic conditions, including sprains, strains, and post-operation fractures and tears. Learn about our Medical Expert Board Print Most people who have tight low back muscles — or pain in their low back that's due to muscle spasm, misalignment, or posture problems — spend a lot of time doing back stretches. What they don't know is that both tension and weakness in the muscles that surround the hips and buttocks likely play a big role in their pain. Condition Your Hip Muscles to Relieve Your Lower Back Pain Hip muscles are those located on or near the pelvis and butt, and they cross over the hip joint. In this way, they power the movement of the thigh, relative to the hip, or conversely, the pelvis relative to the thigh. Because the pelvis is located below the low back, and because the spine is wedged between the two hip bones in back, these muscles, when they work, provide support for your low back. When they get too tight, and especially when some are tighter than others, it can create pain or chronic discomfort. It's a similar story for weakness in hip muscles. 1 Tight Quads and the Culture of the Sedentary Science Photo Library / Science Photo Library / Getty Images Let's start with the quadriceps, that big muscle group located at the front of your thigh. Most people's quads are much tighter than their hamstrings (hamstrings are quads’ opposing muscles and are located at the back of your thigh/bottom of your butt.) And this is especially true in our sedentary culture, since, when you're sitting, your hips are flexed. The muscles at the front of your thigh that flex your hip, called the hip flexors, are therefore in a shortened position for all of the time that you're remaining seated. Both the quads and hamstrings are two-joint muscles, which means they affect movement at both your hip and your knee. For the purposes of relieving muscle or posture related to low back pain, the effect these muscles have at the hip is our key concern. When the quads contract (and overpower the work of the hamstrings), they can pull your pelvis forward and flex your hips, which may accentuate the curve in your low back. This may be one reason why your back muscles are tight. How to Remedy Tight Quads There are two approaches to decreasing the forward tilt of your pelvis—and the excessive curve in your low back. They both involve releasing tight quads. I suggest combining the approaches as they complement one another nicely. Stretch your quads. Stretching your quads is the most direct way to counter the effects of sitting or other types of quad muscle overuse.Strengthen your hamstrings. Working your hamstrings brings the bottom of your pelvis back closer to the back of your thigh. In turn, this extends your hip, which will give an extra stretch in the front, where the quadriceps are. Weak quads (relative to the opposing hamstring muscle group) may lead you to flat low back posture. 2 Condition Your Hamstring Muscles When the quadriceps muscle contracts, the hamstrings stretch, and vice versa. While most people have a combination of tight quads and weak hamstrings, overly tight hamstrings are also common and can lead to a posture problem called flat low back. This occurs because the tight hamstrings bring the back of the lower part of the pelvis and the back of the thigh closer together. This, in turn, reduces the degree of lordosis in your lumbar spine. When the low back curve is reduced past normal, the result may be flat low back posture. As with a tight quadriceps muscle, there are two ways to approach relaxing tight hamstrings Stretch your hamstringsStrengthen your quadriceps Weak Hamstring Muscles and Your Lower Back When your hamstrings are weak, it can lead to a misalignment of your pelvis such that it gets “stuck” in an anterior tilt. This happens a lot in people who sit on the job, discussed above. Hamstring strength is quite helpful, for example, when you climb stairs or get into or out of a chair or car. One great exercise to help strengthen hamstrings is yoga's bridge pose, but you can really approach this using a number of strategies. 3 Condition Your Outer Hips Now let’s talk about your outer thigh muscles. This muscle group plays a big role in keeping you from toppling over sideways, as well as stabilizing your hip when you’re standing on one leg. (Think about what happens when you walk or run, and when you do balance exercises. The outer hip muscles are hard at work during these activities.) When abductors get overly tight, they may tilt the pelvis towards the outside of the thigh (on the same side.) This, in turn, may change the mechanics of your pelvis and low back such that the pelvis is down on one side and up on the other. This is often referred to as "hip-hiking." To adapt to hip-hiking, the spine may curve sideways. When your right hip hikes up (and your outer hip muscles are on a stretch, relative to the left side), the right side of your spine curves outward, which may tighten or overwork the muscles on that side. This means that in our example the muscles on the left side of your lumbar spine will likely be weaker than the right. This muscle imbalance is not only related to tight outer thigh muscles but is often seen in cases of scoliosis, as well. Either way, you may experience pain in the hip, pain in the back or both. Your hip motion may diminish and you may become stiff. How to Fix Tight Outer Thigh Muscles and Oblique Pelvic Tilt As with quads and hamstrings, there are two approaches to release the outer thigh. For the best results, I suggest using them in combination. Stretch your outer hipStrengthen your inner thigh, aka groin muscles. One way to do this is to work on your one-legged balance. Learn more about how the outer hip muscles, also known as the hip abductors, move the hip and thigh with the gluteus medius muscle. 4 Condition Your Inner Hips Your inner thigh or groin muscles, also known as adductors, play a role in pelvic positioning, and therefore the sideways tilt described above. Adductor action opposes that of the outer hips, so when the outer hip muscles contract or get tight, the adductors may become stretched, or vice versa. When they are working properly, adductors help you balance when you're standing. They also bring the thigh (and lower extremity) across the midline of your body. But when they get tight, they may alter your pelvic position and overstretch the abductors, leading to a sideways pelvic tilt that affects the spine (including the muscles around the spine) that is similar to the one described for the outer hip muscle imbalance in "Condition Your Outer Hips" above. Many people have weak adductors, even though they are tight. In this case, add some inner thigh strengthening to your mix, but don't forget to stretch, as well. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. How to Identify and Correct Tight Hip Flexors. International Sports Sciences Association. Are your hamstrings working double duty?. Harvard Medical School. January 2019. Czaprowski D, Stoliński Ł, Tyrakowski M, Kozinoga M, Kotwicki T. Non-structural misalignments of body posture in the sagittal plane. Scoliosis Spinal Disord. 2018;13:6.doi:10.1186/s13013-018-0151-5 Jandre reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015;9(4):535-40. doi:10.4184/asj.2015.9.4.535 McColl P. Muscle Imbalance: 6 Things to Know About Muscle Imbalances. American Council on Exercise. 2016. Ross J. 5 Exercises to Train Balance in Motion. American Council on Exercise. August 2017. Tyler TF, Silvers HJ, Gerhardt MB, Nicholas SJ. Groin injuries in sports medicine. Sports Health. 2010;2(3):231-6. doi:10.1177/1941738110366820 Additional Reading Source: Boachie-Adjei, O. MD, Adult Scoliosis with Low Lumbar Degenerative Disease and Spinal Stenosis. An interview with Dr. Oheneba Boachie-Adjei Orthopedic Surgeon Emeritus, Hospital for Special Surgery. https://www.hss.edu/professional-conditions_adult-scoliosis-low-lumbar-degenerative-disease-spinal-stenosis.asp By Anne Asher, CPT Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit