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Exercising Before Bed: Impact on Your Sleep Cycle

What type of exercise is recommended for individuals who want to exercise before bed?

Exercising Before Bed

Exercising sounds like a good way to tire the mind and body before bed. However, research shows that moderate to vigorous exercise later in the day can negatively impact sleep quality. (Alkhaldi E. H. et al., 2023)

  • To improve sleep, it is recommended that you exercise in the morning or earlier in the day, at least four hours before bed.
  • Individuals who exercise later should aim for lighter activities, such as non-strenuous walking or gentle, restorative yoga.
  • Light physical activity, like a slow walk after dinner, is OK.

Advantages

Daily exercise improves sleep quality. (Johns Hopkins Medicine, 2025) Mild exercise before bed and engaging in light activities like walking or stretching can positively affect health (Hijikata Y, Yamada S. 2011). These include:

  • Decrease muscle tension
  • Improve digestion
  • Improve blood sugar regulation
  • Relax the mind and body

Disadvantages

The nervous system naturally switches between active and calm. It is ready to work and engage in physical activities when it is active. When it is resting, sleep occurs. Activating the nervous system before bed can affect sleep, and exercising can affect body temperature, producing sleep challenges. Typically, body temperature decreases as the body prepares for sleep. Exercising before bed can increase core temperature and disrupt the process. (Szymusiak R. 2018) Moderate or vigorous physical activity close to going to sleep can: (Alkhaldi E. H. et al., 2023)

  • Make it more difficult to fall asleep
  • This leads to more waking up during the night.
  • Decrease sleep quality

Recommended Types of Exercise

Pre-bedtime activities should not be vigorous or engaging enough to make the body and mind more alert. Some exercises to calm the body and mind before bed include: (Sleep Foundation, 2023)

Restorative Yoga

  • Yoga Nidra and other low-intensity yoga can help promote sleep.
  • More intense forms of yoga, such as vinyasa/flow, should be done earlier.

Tai Chi

  • A Chinese practice that incorporates slow, gentle movements and focuses on breathing to promote peace and relaxation.

Slow Walking

  • Walking at a leisurely pace can help the body unwind and relax.

A slow heart rate and breathing indicate that the activity is calming and not stimulating.

Exercises to Avoid

Moderate to high-intensity workouts before bed that increase breathing and heart rate can disrupt sleep. Individuals who struggle to fall asleep or get restful sleep should try reducing the intensity of certain exercises or avoiding them one to two hours before bed. Examples of moderate to vigorous exercises include: (American Heart Association, 2024)

  • Gardening or heavy yard work
  • Running
  • Brisk walking
  • Cycling
  • Dancing
  • Sports activities

Working Out In The Evening

Sometimes, exercising later in the day or close to bedtime is the only time to get physical activity. If this is the case, late exercise is better than no exercise at all, but there are ways to lessen its impact on sleep, including:

  • Light physical activity, like walking, can be done up to an hour before bed.
  • Do more intense exercises at the beginning of the workout.
  • End the workout with a cooldown, like walking or stretching, to relax the mind and body.
  • Know how your workout schedule impacts your sleep, and adjust as necessary.

How Long After Working Out to Go To Sleep?

For individuals who want restful and uninterrupted sleep, experts recommend waiting one to two hours after a moderate or vigorous workout to go to bed. (Harvard Health Publishing, 2024) (Johns Hopkins Medicine, 2025)

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Optimizing Your Wellness


References

Alkhaldi, E. H., Battar, S., Alsuwailem, S. I., Almutairi, K. S., Alshamari, W. K., & Alkhaldi, A. H. (2023). Effect of Nighttime Exercise on Sleep Quality Among the General Population in Riyadh, Saudi Arabia: A Cross-Sectional Study. Cureus, 15(7), e41638. https://doi.org/10.7759/cureus.41638

Johns Hopkins Medicine. (2025). Exercising for better sleep. https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep

Hijikata, Y., & Yamada, S. (2011). Walking just after a meal seems to be more effective for weight loss than waiting for one hour to walk after a meal. International journal of general medicine, 4, 447–450. https://doi.org/10.2147/IJGM.S18837

Szymusiak R. (2018). Body temperature and sleep. Handbook of clinical neurology, 156, 341–351. https://doi.org/10.1016/B978-0-444-63912-7.00020-5

Sleep Foundation. (2023). Bedtime routines for adults. https://www.sleepfoundation.org/sleep-hygiene/bedtime-routine-for-adults

American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Harvard Health Publishing. (2024). Does exercising at night affect sleep? https://www.health.harvard.edu/staying-healthy/does-exercising-at-night-affect-sleep

Hula Hoop Workouts and Their Health Benefits

Can hula hooping be an option for individuals and athletes needing an effective, light, fun workout?

Hula Hoop Benefits for Core and Full Body Fitness

Hula Hoop Workout

A hula hoop workout is a low-impact exercise that involves spinning a hula hoop around your body. It can help improve balance, core strength, and aerobic fitness. Hula hooping is a great aerobic exercise that raises the heart rate and engages the whole body. Exercises can be done with a weighted or non-weighted hula hoop. A standard hoop will increase heart rate after about three minutes. A weighted hula hoop can target and build important core and lower body muscles, including the hamstrings, calves, quadriceps, and glutes. Lifting the weighted hula hoop also works the upper body muscles, giving the all-over body workout.

Weighted Hula Hoop

A weighted hula hoop can offer several health benefits.

Burns Calories

According to a research study, hula hooping can burn an average of 200 calories during a 30-minute workout. Researchers found that hooping is comparable in calories burned to boot camp-style fitness classes, kickboxing, and step aerobics. The average heart rate of the study participants was 151 beats per minute, equal to 84% of the age-predicted heart rate maximum. This can result in improved cardiovascular health and muscle conditioning. (American Council on Exercise, 2011)

Helps Build Muscle Mass

A study found that hula hooping increased trunk muscle mass and decreased waist circumference more than walking alone. Participants hula hooped an average of 12.8 minutes daily and walked almost 10,000 steps daily. The results showed more benefits to the core with hula hooping. The body fat percentage in the core region decreased significantly with hula hooping compared to walking. (Lahelma M. et al., 2019)

Lowers LDL Cholesterol

  • In the same study, researchers found that hula hooping can reduce LDL cholesterol more than walking. The results demonstrated an LDL-lowering effect similar to what resistance training does for cholesterol levels. Hula hooping for 13 minutes daily could benefit anyone with elevated cholesterol levels. (Lahelma M. et al., 2019)

Fun Workout

  • Weighted hula hooping can help individuals get out of a workout rut if they’re bored with a routine. It is recommended as either a warmup or a full workout.

Allows for Multitasking

  • If time to work out is limited, you can multitask using a hula hoop, easily add it to an exercise routine, and get moving while speaking on the phone, during breaks, or watching TV.

Benefits

  • Core strength: The exercise requires core strength to keep the hoop spinning.
  • Balance: Helps improve balance.
  • Aerobic fitness: Hooping can be used as a primary cardio routine.
  • Weight loss: Hooping can help burn calories and contribute to weight loss.

Hula Hoop Workout

  • Stand with a straight spine and feet shoulder-width apart.
  • Draw your abdomen in to engage your core.
  • Place the hoop around your waist, just above your hips.
  • Hold the hoop with both hands and toss it to one side.
  • Keep your back straight and move forward and back as fast as you can.
  • Pulse your hips and feet in a rocking motion.
  • Keep your arms out to the side or above your head.
  • Be mindful of posture, which will help you hoop better.

Weighted Workout

A full-weighted hula hoop workout. Start with a warmup for 5 minutes with a light jog or running in place. Then, perform three sets of the following:

Minute 1

  • 50 seconds of a hula hoop halo with the right arm – swinging the hoop around your arm
  • 10 seconds of rest

Minute 2

  • 50 seconds of a hula hoop halo with the left arm
  • 10 seconds of rest

Minute 3

  • 50 seconds around the waist, hula hooping
  • 10 seconds of rest

Minute 4

  • 50 seconds of hula hoop squats, keeping the hoop around the legs and not dropping it
  • 10 seconds of rest

Minute 5

  • 50 seconds of hula hoop sit-ups, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

Minute 6

  • 0 seconds of hula jumping front to back, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

How long you hula hoop each day is a matter of personal preference. To gain cardiovascular benefits, it is recommended that adults engage in at least 150 minutes per week of moderate-intensity aerobic activity. Spreading out the exercise throughout the week is preferable. (American Heart Association, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Can Core Exercises Help With Back Pain?


References

American Council on Exercise. (2011). ACE-sponsored research: Hooping—Effective workout or child’s play? https://www.acefitness.org/certifiednewsarticle/1094/ace-sponsored-research-hooping-effective-workout-or-child-s-play/

Lahelma, M., Sädevirta, S., Lallukka-Brück, S., Sevastianova, K., Mustelin, L., Gylling, H., Rockette-Wagner, B., Kriska, A. M., & Yki-Järvinen, H. (2019). Effects of Weighted Hula-Hooping Compared to Walking on Abdominal Fat, Trunk Muscularity, and Metabolic Parameters in Overweight Subjects: A Randomized Controlled Study. Obesity facts, 12(4), 385–396. https://doi.org/10.1159/000500572

American Heart Association. (2024). American Heart Association Recommendations for Physical Activity in Adults and Kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Bicycle Stationary Conversion for Home Workouts

Can converting a bicycle into a stationary bike be a way for individuals to exercise more while still enjoying cycling?

Bicycle Stationary Conversion

Is your bike collecting dust in the garage? Do you miss riding, but the weather or temperatures keep you indoors?  Why not quickly and painlessly turn your bike into a stationary bike? An indoor stationary bike is a great way to maintain physical activity while avoiding inclement weather and outdoor elements. Plus, bicycle stationary conversion in your home, office, or garage is quick and straightforward. A bike trainer or roller is needed to convert a bicycle into a stationary bike. The bike is mounted onto the trainer stand, and its rear axle is replaced with a special axle provided with the trainer kit to secure it and hold the wheel in place while allowing you to pedal, creating resistance for indoor cycling.

Cycling

Bicycle stationary conversion isn’t only for die-hard cyclists. Research shows indoor cycling is a great way to stay healthy and consistent with your workouts. One study showed that indoor cycling improves aerobic capacity, blood pressure, lipid profile, and body composition. (Chavarrias, M. et al., 2019)

Stationary Bikes Types

For those who don’t have the space or know that they won’t regularly use a stationary bike, indoor bike trainers and rollers can provide convenient, economical, and compact options. Whether individuals want to exercise more, maintain a riding schedule, or train for an event, trainers and rollers can be highly effective tools for any cyclist. However, choosing between a bike trainer and rollers varies depending on the pros and cons. Selecting the right equipment depends on several factors, including:

  • Personal needs
  • Space – indoor or garage.
  • Cycling experience

Most cyclists, even hobbyists, prefer indoor cycling bikes over traditional stationary bikes because they are riding a real bicycle, including the positioning and pedaling, compared to upright, air, or recumbent bikes.

Trainer

A bike trainer is a stand that lets an individual ride a regular bicycle while stationary. Cyclists often use it to warm up before races, and it comes in handy when weather conditions or time constraints prevent riding outdoors. Most trainer stands can accommodate bicycles. Trainers are suitable for beginners and professional riders. There are two types of indoor bike trainers.

Direct-drive

  • Direct-drive trainers attach to the bike’s rear dropouts, replacing the wheel and providing a direct connection to the resistance unit.
  • These can cost more, but they’re worth the investment because they’re more accurate and deliver the highest resistance levels.

Friction

  • A small roller is installed against the rear wheel with friction trainers, which use magnetic or fluid resistance.
  • These are typically lighter and easier to transport than direct-drive trainers but are less accurate and provide less resistance.

Rollers

Rollers are the most basic type of indoor stationary bike but may not be the best option for individuals new to indoor cycling. This is because it requires advanced cycling techniques, such as balancing and keeping the front tire straight while riding. The cycle is on rollers instead of being fixed, allowing the resistance to range from zero to the equivalent of a direct-drive trainer. Rollers help refine pedaling technique and improve cycling form because you balance and stabilize while riding.

Conversion – What Is Needed

The most important equipment needed to convert the cycle is a bike stand, which will be the foundation of the stationary bike setup. (Bike To Work Day, 2025) There are two-piece stands and one-piece stands. (Bike To Work Day, 2025) Tools like an Allen wrench may be needed. Various bike trainer kits contain all the parts needed for this conversion, but extra standard tools may be required to remove the back wheel and replace the axle.

  • Choose the right trainer: Consider your bike type, desired resistance levels, and budget.
  • Install the trainer: Follow the manufacturer’s instructions to position and secure the trainer properly.
  • Mount the bike: Remove the rear wheel quick release, insert the trainer’s axle, and tighten it securely.
  • Adjust resistance: Most trainers have a knob or lever to control the difficulty level.
  • If you are uncertain whether your bike stand is set up correctly or having issues with the installation, contact a professional bike mechanic. They can help get the stationary bike up and running properly.

Considerations

  • Tire wear: Using a dedicated trainer tire for the rear wheel can minimize wear and tear.
  • Noise level: Some trainers can be noisy, especially wheel-on types.
  • Stability: Ensure the bike is properly secured on the trainer and your training area is stable.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Body In Balance: Chiropractic, Fitness, and Nutrition


References

Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Pérez-Gómez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8), 452. https://doi.org/10.3390/medicina55080452

Bike To Work Day. (2025). How to turn a bike into a stationary bike: Things to know. https://biketoworkday.us/turn-a-bike-into-a-stationary-bike/#Setting_up_Your_Stationary_Bike

Weight Resistance Training and Its Impact on Sleep Quality

For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?

Weight Resistance Training

Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.

Resistance Training and Improved Sleep

Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:

  • Your body weight
  • Resistance bands
  • Free weights
  • Weight-lifting machines

The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.

Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)

How Much Resistance Training Is Needed?

Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.

  • General guidelines from the American Heart Association recommend strength training at least twice a week.
  • The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
  • The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
  • They added that higher intensity and frequency of training could have a greater effect on sleep.

In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)

Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.

Strength Workouts

Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including: 

  • Leg presses
  • Chest presses
  • Lat pulldowns
  • Bicep curls
  • Abdominal crunches 
  • Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
  • One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)

However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.

Other Ways to Improve Sleep Without Meds

Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Weight Loss Techniques


References

Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. https://doi.org/10.1371/journal.pone.0301616

Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. https://doi.org/10.1016/j.jpsychores.2017.12.012

Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. https://doi.org/10.3390/ijerph20054431

Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. https://doi.org/10.1519/JSC.0000000000000750

Iowa State University. (2022). Pumping iron may improve sleep more than cardio workouts. https://www.news.iastate.edu/news/2022/03/03/resistance-exercise-sleep

Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. https://doi.org/10.1249/JES.0000000000000273

American Heart Association. (2022). Resistance exercise may improve sleep more than aerobic exercise. https://www.heart.org/en/news/2022/03/03/resistance-exercise-may-improve-sleep-more-than-aerobic-exercise#:~:text=The%20results%20are%20considered%20preliminary,at%20night%2C%22%20Brellenthin%20said.

Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. https://doi.org/10.1016/j.smrv.2017.07.002

The Benefits of Standing Lower Back Flexion for Pain Management

Could incorporating standing lumbar flexion exercise into a daily routine help decrease pain and improve overall spinal mobility for individuals with low back pain?

Standing Lower Back Flexion Exercise

A chiropractic physical therapy team visit can help determine which exercises are best for an individual’s injury or condition and teach them what to stop doing if they have low back pain. Exercise and proper posture can decrease discomfort and improve mobility for individuals with low back pain. (Suh, J. H. et al., 2019) Sometimes, exercises that bend backward are recommended, while other times, flexion or forward bending movements are the best way to manage lower back pain. Many find the standing Williams lumbar flexion exercises maneuver helpful for low back pain. (Amila A, Syapitri H, Sembiring E. 2021)

Benefits

Individuals with certain diagnoses may benefit from spinal flexion. These diagnoses include:

Be sure to speak with a healthcare provider to understand the diagnosis and low back symptoms, and work with a physical therapist to be sure that forward flexion of the spine is the correct exercise for your back.

When To Avoid Lumbar Flexion

Some should avoid excessive forward bending, which could cause further damage or injury to the spine. Reasons to avoid flexion include:

Before starting this or any other exercise program for your spine, check with a healthcare provider or physical therapist.

How to Perform

Gradually progressing with other gentle lumbar flexion exercises before full-standing lumbar flexion is recommended. These include performing a week or two of lumbar flexion lying down, followed by a couple weeks of lumbar flexion seated. Once these exercises are easy to perform and pain-free, progress with lumbar flexion standing postures.​To perform, follow these steps:

  • Stand with your feet shoulder-width apart.
  • Slowly bend forward by sliding your hands down the front of your thighs.
  • Reach down as far as possible and let your lower back bend forward.
  • Grab your ankles and gently pull into more forward flexion to increase the backstretch.
  • Hold the end position for a second or two, then slowly return to the starting position.

As you exercise, be sure to monitor changes in symptoms. Pain worsening in the back or traveling down your leg indicates that you should stop the exercise (Spine-health, 2017). If the pain decreases in your leg or centralizes to your back, continue the exercise. Standing lumbar flexion can be repeated for 10 repetitions a couple of times daily. It can help decrease low back or leg pain symptoms and stretch tight hamstrings and back muscles. (Montefiore Pediatric Orthopedic and Scoliosis Center, 2003)

Injury Medical Chiropractic and Functional Medicine Clinic

Exercise can also prevent future lower back problems. Standing back flexion, postural correction, regular physical activity, and exercise are tools for keeping the spine healthy. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


What Causes Disc Herniation?


References

Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173

Amila A, Syapitri H, Sembiring E. (2021). The effect of William Flexion Exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv., 4(1), 28-36. https://doi.org/https://doi.org/10.35654/ijnhs.v4i1.374

Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. https://doi.org/10.1136/bmj.h6234

Sfeir, J. G., Drake, M. T., Sonawane, V. J., & Sinaki, M. (2018). Vertebral compression fractures associated with yoga: a case series. European journal of physical and rehabilitation medicine, 54(6), 947–951. https://doi.org/10.23736/S1973-9087.18.05034-7

Howell E. R. (2012). Conservative management of a 31 year old male with left sided low back and leg pain: a case report. The Journal of the Canadian Chiropractic Association, 56(3), 225–232.

Spine-health. (2017). Exercise with lower back pain: Should you work through the pain? Spine-health
Knowledge from Veritas. https://www.spine-health.com/blog/exercising-lower-back-pain-should-you-work-through-pain

Montefiore Pediatric Orthopedic and Scoliosis Center. Center, M. P. O. a. S. (2003). Low Back Strain. https://www.cham.org/File%20Library/Global%20Navigation/Expertise%20And%20Programs/Pediatric%20Expertise/Orthopedics/Monte-LOW-BACK-STRAIN-WITH-EXERCISES.pdf

How to Properly Warm Up Before Running

Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?

Warming Up, Cooling Down

Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.

Steps for a Running Warmup

  • Do five to 10 minutes of light aerobic exercise to loosen up muscles.
  • Walk briskly, march, jog slowly, or cycle on a stationary bike.
  • Don’t rush.
  • Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
  • Begin the run with a slow jog and gradually increase speed.
  • Slow down if you run out of breath.
  • This is part of knowing how fast you should run; starting too fast is a common mistake.
  • Pay attention to posture and form.
  • Ensure you are using the best technique before speeding up.

Warm Up Benefits

When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)

Properly Cooling Down

At the end of the run:

  • Cool down by walking or slowly jogging for five to 10 minutes.
  • Breathing and heart rate should gradually return to normal.
  • Drink water or an electrolyte-infused drink to rehydrate the body.

Benefits of a Cooldown

The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.

Before or After Stretching 

Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)

Stretching After Running

Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:

Don’t Bounce

  • Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
  • Hold the stretch for 15 to 30 seconds.

Don’t Stretch Through Pain

  • Don’t stretch beyond the point where tightness is felt in the muscle.
  • Do not push through muscle resistance.
  • Never stretch to the point of pain.

Stretch Whole Body

  • Don’t just stretch the areas with tightness and/or soreness.
  • Stretch the whole body equally to prevent injury.

Don’t Hold Your Breath

  • Take deep breaths during the stretch.
  • Stay relaxed and breathe in and out slowly.

If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises. 

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Science of Motion


References

The American Heart Association. (2024). Warm up, cool down. https://www.heart.org/en/healthy-living/fitness/fitness-basics/warm-up-cool-down

Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. https://doi.org/10.1002/14651858.CD004577.pub3

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. https://doi.org/10.1007/s40279-018-0916-2

Key Exercises in the Treatment of Achilles Tendonitis: A Protocol

Can incorporating an exercise program like the Alfredson Protocol help athletes and individuals who have hurt their Achilles tendon find pain relief and healing so they can return to regular physical activities?

Exercise Protocol Achilles Tendonitis

Achilles tendonitis occurs when the tendon at the back of the ankle gets injured. It is common in runners. For individuals who have Achilles tendonitis, walking and running can be painful. You might have to stop engaging in exercise and physical activities like sports. Depending on your job, having the condition may make working harder. Here are a few of the signs and symptoms of the condition:

  • Pain in the back of the lower leg, just above the heel.
  • Pain with running, jumping, or pointing the toes.
  • A small lump on the Achilles tendon just above the heel.

The first line of treatment is to rest and ice the tendon. Anti-inflammatory medications can help reduce pain. (American Academy of Orthopaedic Surgeons, 2022) Physical therapy can include strengthening exercises, ultrasound heat therapy, and deep massage. Exercises stretching the nearby muscles will help gradually increase the stress the tendon can handle, eventually reducing inflammation and swelling. Stretching and flexibility exercises will help an Achilles tendon heal. (University of Michigan, 2023)

The only way to determine if an individual has injured their Achilles tendon is to see a doctor. If the injury is Achilles tendonitis, a physical therapist may be recommended. A physical therapist can train individuals on the Alfredson protocol, an exercise protocol program for those with Achilles tendonitis (tendinopathy) that research has shown is helpful for those with the condition. The therapist will train on how to exercise to strengthen the tendon. The exercises stretch the Achilles tendon to help it handle forces and stress, known as eccentric loading. (Stevens M., & Tan C. W. 2014)

Inflammation

Tendonitis is inflammation of a tendon. However, studies have shown that the tendon might not be inflamed in those with the condition. When an area of the body is inflamed, inflammatory cells are present. Individuals usually feel pain in the inflamed area. For those with Achilles tendonitis, the tendon will present with pain, but not necessarily because the tendon is inflamed. Under a microscope, researchers examined tissue from the tendons of those with Achilles tendonitis. They did not find inflammatory cells in the tissue. (Stevens M., & Tan C. W. 2014) This means that although individuals felt pain, they were not inflamed. If there are no inflammatory cells in the tendon, this could explain why those with Achilles tendonitis often do not find relief from the anti-inflammatory treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Studies have shown that gentle exercise protocols for the tendon are more helpful. However, researchers are not sure why these exercises are so beneficial. (O’Neill S., Watson P. J., & Barry S. 2015)

Eccentric Exercise

A chiropractic physical therapy team can help individuals heal the injury with eccentric loading exercises. Eccentric loading exercises work the muscles and tendons to help them get stronger. Once healing has begun, they can help strengthen the tendon. Individuals start slowly with easy exercises and then work up to harder ones. They will have the patient lengthen or stretch out the muscle. As the patient moves, the muscles and tendons contract or shorten. The Alfredson protocol consists of eccentric loading exercises for the Achilles and the muscles that support it.

Alfredson Protocol

Before exercising, talk to a doctor or physical therapist to know if it’s safe. How to do the Alfredson protocol:

  1. First, stand on a small step or curb.
  2. Stand with the balls of your feet on the edge.
  3. Your heels should hang over the edge.
  4. Hold onto something for balance.
  5. Keep the knees straight.
  6. This will load a muscle part of the Achilles tendon called the gastrocnemius.
  7. Using both feet, lift the heels and rise onto the balls of the feet.
  8. Keep the foot with the painful Achilles tendon on the step.
  9. Lift the non-injured foot off the step.
  10. Slowly lower down using the injured ankle.
  11. The heel should move towards the floor.
  12. The ball of the foot should remain in contact with the edge of the step.
  13. Return the non-injured foot to the step.
  14. Repeat the exercise.

Do three sets of 15 reps with the knees straight. Then, do the Alfredson protocol again with the knees slightly bent. This will work a muscle called the soleus, which connects to the gastrocnemius. Perform three sets of 15 repetitions. Perform both exercises twice a day. This could be in the morning and the evening. The Alfredson protocol is most beneficial when done for about 12 weeks. (Stevens M., & Tan C. W. 2014)

Injury Medical Chiropractic and Functional Medicine Clinic

The Alfredson exercise protocol can be done at home with a step or raised platform to put the feet on safely. Individuals should consider working with a personal trainer to ensure safety and get the most out of the workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Functional Foot Orthotics Achieve Optimal Performance


References

American Academy of Orthopaedic Surgeons. OrthoInfo. (2022). Achilles Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

University of Michigan. (2023). Achilles Tendon Injury: Physical Therapy and Rehab. https://www.uofmhealth.org/health-library/tr2261

Stevens, M., & Tan, C. W. (2014). Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial. The Journal of orthopaedic and sports physical therapy, 44(2), 59–67. https://doi.org/10.2519/jospt.2014.4720

O’Neill, S., Watson, P. J., & Barry, S. (2015). WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY?. International journal of sports physical therapy, 10(4), 552–562.

Enhance Your Fitness Journey: Kettlebell Training for All Ages

For older individuals looking for a workout that can help improve overall fitness, can kettlebell training help achieve health goals?

Kettlebell Training At Any Age

Previous research found that training with a kettlebell can improve aerobic capacity, balance, and core strength. New research suggests that kettlebell training is beneficial at any age (American Physiological Society, 2024). Compared to dumbbells or barbells, the kettlebell’s specific shape—a sphere on the bottom and a handle that can be grabbed by one or both hands—better emulates how the body moves through daily tasks and activities. When isolating a muscle, like a bicep, only that muscle is getting worked out. But in everyday life, a lot of what the body does is lifting and moving things. A kettlebell allows those muscle groups to connect in a stronger and more efficient movement.

Benefits At Any Age

A research study examined how using kettlebells impacted the health of individuals from different backgrounds without prior exposure to resistance training between the ages of 60 and 80. The participants enrolled in a twice-a-week exercise program using kettlebells to improve fitness. At the end of six months, the researchers found the participants had increased muscle mass and grip strength. At the end of the year, the participants had lower inflammation markers in their blood and had met other fitness goals, including climbing stairs faster and making multiple chair stands/standing from a seated position. The researchers say the findings show how effective kettlebells can be for all ages and demonstrate that the kettlebell training program leads to benefits even in older individuals just starting. (American Physiological Society, 2024) The kettlebell’s unique shape allows for an offset center of gravity from the handle, encouraging increased engagement of stabilizing muscles. This combination of strength and functional movement patterns helps to improve the following:

  • Balance
  • Coordination
  • Core stability

This makes it a versatile tool for older adults.

Getting Started

For individuals just starting kettlebell training, it is recommended that they work with a certified instructor or find a beginner’s class. Guided training ensures proper technique and form and reduces the risk of injury. To avoid common kettlebell mistakes when lifting weights for the first time, start with lighter kettlebells to master form and focus on slow, controlled movements. When lifting weight from the ground to the chest, don’t pull with the shoulder muscles. Instead, start in the legs and let the energy move up through the body, known as the kinetic chain. When exercising, spend only 20 to 30 seconds on a rep before resting for 30 seconds, and don’t spend more than five minutes on a single exercise. (American Council on Exercise, 2015)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who want to start an exercise routine should consider kettlebell training. Following basic tips and training slowly, kettlebells can be an option for anyone looking to improve their fitness and overall health. Consider working with a personal trainer to ensure safety and get the most out of workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Transform Your Body


References

American Physiological Society. (2024). Kettlebell training may help maintain muscle strength in older adults. https://www.physiology.org/detail/news/2024/11/21/kettlebell-training-may-help-maintain-muscle-strength-in-older-adults?SSO=Y

American Council on Exercise. Wall, A. J. (2015). How to get started with kettlebells. https://www.acefitness.org/resources/pros/expert-articles/5269/how-to-get-started-with-kettlebells/?srsltid=AfmBOor4x0yZwrHzGRccSA2uYMQtS3PX-vRC03eVwQoGX6_6B5wryAAi

Exploring the Importance of Planes of Motion

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane.  Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint
  • Extension – An extending movement that increases the angle at a joint
  • Hyperextension – Extending the angle at a joint beyond neutral
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin
  • Plantarflexion – Pushing the foot down and away from the body

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Difference of Using Custom Foot Orthotics


References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. https://blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000

Mastering the Hip Hinge: A Key Movement for Back Health

Can performing the hip hinge exercise movement help individuals with lower back pain?

Hip Hinge Exercise

A hip hinge is a controlled movement that involves bending forward from the hips while keeping the spine neutral. The thoracic, lumbar, and pelvis stay neutral while bending forward. The movement comes from the hips, preventing the thoracic and lumbar spine from flexing or rounding. It is a fundamental movement that helps prevent back injuries and strengthens the glutes. It’s used in everyday activities, like picking up objects and sitting down.

The hip hinge exercise targets the posterior chain or back muscles, including the lower back, the glutes, and the hamstrings. It also strengthens the core or abdominal muscles to assist in the movement. When the body hinges at the hips, the bend occurs at the hips, and the spine stays neutral. When the lower back hinges or bends, this causes pain and reduces the range of motion.

Performing the Movement

A wooden dowel, broom handle, or PVC pipe can be used as a guide to help achieve the proper positioning and learn the correct form. Place the dowel or pipe vertically on your back, anchoring it to the head, shoulder blades, and tailbone.

Grasp one end with your right hand in the natural curve of your neck and the other with your left hand in the small of your back. Ensure the dowel touches the back of your head, upper back, and the area where the lower back meets the sacrum. To perform the hip hinge:

  • Stand with your feet shoulder-width apart
  • Shift your weight to your heels and
  • Push your hips back while hinging your torso forward
  • Keep your chest open and back flat
  • Slightly bend your knees
  • Visualize sticking the butt out
  • The dowel should not lose contact with the three points as you hinge. If it does, the movement is incorrect.
  • Lower your torso until it’s midway between vertical and parallel to the floor.
  • Pause when your torso is about 45 degrees
  • Keep a slight bend in your knees during the downward and upward phases.
  • Reverse the movement by contracting your glutes and pushing your hips forward and upward to return to the starting position.
  • Repeat

Benefits

The hip hinge is a fundamental movement pattern that helps the body perform essential tasks such as bending over and picking things up without worry of pain or injury. It’s also required in strength training exercises like the deadlift, kettlebell swing, power clean, and more. The exercise can help strengthen the core, reduce back pain, improve balance, and improve flexion, extension, and trunk rotation. (Michaud F. et al., 2021) Stronger core muscles can increase fitness and athletic performance. (Clark D. R. et al., 2018)

Variations

It is a challenging movement that requires plenty of practice. Individuals who can’t perform it correctly after a few tries may need to modify the movement.

Wall Variation

  • Using a wall as a guide is an easy way to make the movement easier.
  • To do this, stand with your back to a wall, about three inches away.
  • Start hinging at the hips by sticking your butt out touching the wall.
  • Keep a neutral spine and a flat back.

Once you can do this several times, try stepping out another inch or two and perform the same modified motion. Stick with this until you are away from the wall and can do a full hinge without the wall.

With A Kettlebell

  • Once you master the basic hinge, you can elevate it using a kettlebell to make this move more difficult.
  • Start with the kettlebell swing exercise and progress to more challenging moves with the kettlebell.

Common Mistakes

Be aware of common mistakes to keep the move effective and reduce the risk of injury.

Treating the Move Like a Squat

  • The hip hinge is not the same as a squat.
  • This is a common misconception. When squatting, the knee joint determines the movement pattern.
  • But when hip hinging, the movement starts at the hips.

Not Engaging the Core Muscles

  • This exercise requires core engagement throughout the entire movement.
  • If these muscles relax, there is an increased risk of dipping the hips during the hinge, which can cause the lower back to dip and cause pain.

Using the Lower Back

  • Bending or hinging with the lower back rather than letting the hips generate the movement.
  • Using the wall as a guide can help reduce and eliminate excessive bending at the waist.

Lost Dowel Contact 

  • If the dowel loses contact with one or more set-up positions on the back, the hinge is not being executed correctly.
  • If your head loses contact with the dowel, the neck is flexing too far forward.
  • If you lose contact with the sacrum or lower back area, the spine is flexing too much.
  • If you lose contact with the mid-back, the knees are bending rather than the hips.

Safety

Stop and check your form if you feel back pain during any part of the movement. The movement may need to be modified further or decrease how far the hinge is at the hips. If the pain continues, discontinue the exercise and talk with a doctor or a physical therapist before reattempting the exercise. The dowel is a great tool to help maintain a neutral spine. If you cannot perform the hip hinge while keeping the dowel in contact with the body, you might benefit from working with a personal trainer or physical therapist who can walk you through the steps with the correct form.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Chiropractic: The Secret to Unlocking Mobility 


References

Michaud, F., Pérez Soto, M., Lugrís, U., & Cuadrado, J. (2021). Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises. Sensors (Basel, Switzerland), 21(16), 5487. https://doi.org/10.3390/s21165487

Clark, D. R., Lambert, M. I., & Hunter, A. M. (2018). Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners. Sports medicine – open, 4(1), 32. https://doi.org/10.1186/s40798-018-0150-3