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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

Sleeping with Lower Back Pain and Sciatica: Finding Relief 

Sleeping with lower back pain and sciatica can be difficult and frustrating. What are ways to get more comfortable sleep?

Sleeping With Lower Back Pain and Sciatica

Various factors can affect sleeping with lower back pain and sciatica, including age, injury and medical history, the mattress (e.g., soft vs. firm mattress), and sleep positions. Unfortunately, there’s no one-cure-all solution for this problem, and depending on the underlying cause/s, they can worsen the pain and cause sleep problems. For example, if a herniated disc places added pressure on the nerves in the lower back, twisting the spine can worsen the lower back pain, and sleeping in a fetal position can exacerbate the nerve pain. (UCF Health, N.D.)

Lower-Back Pain

Low-back pain can be activity-related, intermittent, or constant. (American Association of Neurological Surgeons, 2024) For some, it only occurs occasionally, such as when performing specific movements. For others, it can be excruciating, chronic, and disabling. Low-back pain is unique for everybody and can differ depending on the cause. Some low-back pain symptom descriptions include (Förster M. et al., 2013)

  • Aching pain deep in the back
  • Shooting pain flare-ups
  • Pain caused by slight pressure
  • Burning
  • Tingling

Sciatica Not Present

For some, low-back pain may be confined to a specific area known as axial back pain. (Förster M. et al., 2013) The pain may be felt in a band along the lower back and does not radiate down the legs or anywhere else.

Sciatica Present

Low-back pain with sciatica pain that radiates from the lower back or hip down the leg is the most common symptom of lumbar radiculopathy (compression of spinal nerve roots). (North American Spine Society, 2020) Sciatica symptoms include: (American Academy of Orthopaedic Surgeons, 2021)

  • Shooting pain from the lower back down the leg
  • Feeling like a bad leg cramp
  • Leg weakness
  • Sensory changes radiating down the leg – numbness, burning, and or tingling

Sleep Tools

Consider changing the mattress to improve sleeping with lower back pain and sciatica. For the best spinal support, choose a medium to firm mattress. Pillows, wedges, and other tools can also help improve sleep. (UCF Health, N.D.) It is recommended that individuals who sleep on their backs place a small pillow under their knees to reduce pressure on their lower backs. For those who sleep on their side, placing a pillow between the knees can keep the spine in a neutral/straight position. To relieve lower back pain, consider sleeping in a reclined, angled position with the head and shoulders higher than the hips. This can be accomplished with an adjustable bed or a wedge to prop the body in a regular bed.

Back Sleeping

Easing back pain while sleeping involves maintaining the body in a neutral or straight position. Extending the muscles, tendons, and ligaments too far in any one direction while sleeping with lower back pain and sciatica can cause stiffness, muscle spasms, and pain. Sleeping on the back puts the spine in neutral alignment with the least stress on the neck and back. It evenly distributes body weight to avoid exerting pressure on the joints and prevent backaches. In addition, a supine position allows outstretched ligaments to shrink and recover to their normal positions. (Keck Medicine of USC, 2019)

Chiropractic Assessment

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team may be best for individuals with acute back, neck, and musculoskeletal pain and discomfort symptoms. A chiropractor can quickly 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.


Sciatica, Causes, Symptoms and Tips


References

UCF Health. (N.D.). The best sleeping position for lower back pain (and the worst). https://ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

American Association of Neurological Surgeons. (2024). Low back pain. https://www.aans.org/patients/conditions-treatments/low-back-pain/

Förster, M., Mahn, F., Gockel, U., Brosz, M., Freynhagen, R., Tölle, T. R., & Baron, R. (2013). Axial low back pain: one painful area–many perceptions and mechanisms. PloS one, 8(7), e68273. https://doi.org/10.1371/journal.pone.0068273

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of low back pain. North American Spine Society. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica

Keck Medicine of USC. (2019). The best -and worst – sleep positions for back pain. Keck Medicine of USC Blog. https://www.keckmedicine.org/blog/the-best-and-worst-sleep-positions-for-back-pain/

The Importance of a Supportive Mattress for Arthritis

Getting a good night’s sleep can be difficult for individuals suffering from arthritis. Can finding a mattress that fits an individual’s needs help relieve aches and pains and provide restful sleep?

Mattress For Arthritis

Quality sleep can be difficult for those managing arthritis. Joint pain, stiffness, and tenderness can make falling and staying asleep feel impossible. A mattress for arthritis should be firm, provide comfortable support, and relieve joint pressure. (Sleep Foundation, 2024)

How Mattresses Affect Arthritis?

  • Not adequate support or cushioning can exacerbate arthritis pain and stiffness.
  • Individuals not sleeping well at night can experience significant physical and mental fatigue, increase the risk of injury, and perceive a higher level of pain.
  • Zoned mattresses provide targeted pressure relief to areas of arthritis pain, like the neck and lower back.
  • Mattresses that don’t support the body are more likely to disrupt sleep and exacerbate nighttime and daytime pain symptoms.
  • The body needs time to recover and repair during sleep, so the right mattress for arthritis will allow sound rest throughout the night.
  • A joint-supporting mattress can alleviate pain and stiffness.

What to Look For Mattress Types

Mattresses fall into three basic categories.

Foam or Latex

  • These mattresses are often recommended for individuals with chronic pain because they conform to the body and alleviate pressure points without being too firm that they aggravate existing injuries or inflammation.
  • Not all foam is the same; some mattresses are too soft to support someone with arthritis.
  • Latex is a more reliable material for support and durability, but it’s also more expensive than memory foam.

Innerspring

  • Innerspring mattresses are often long-lasting and provide firm support.
  • However, they are not recommended for individuals with arthritis because they can be hard on joints and pressure points.
  • The innerspring system doesn’t mold or conform to the body, so getting and staying comfortable can be difficult, if not impossible.
  • They’re not as heat-retaining as foam mattresses so that hot sleepers may prefer them.

Hybrid

  • A hybrid mattress typically consists of individually wrapped springs topped with one or more layers of memory foam.
  • Hybrid mattresses are often recommended for arthritis patients because they meet the expert-recommended balance between support and cushioning.

Firmness Levels

Mattress firmness is rated on a scale of 1 to 10, with firmer mattresses scoring higher, often 6 or 7 and above. However, no one firmness rating works for all individuals with arthritis. Finding the right firmness for arthritis symptoms is highly individualized. For some, a super firm sleep surface can aggravate symptoms. In determining what firmness number is needed, consider weight. For example, a person weighing 400 pounds will have a different experience on a soft mattress than a person weighing 150 pounds. Typically, larger bodies need a firmer mattress to avoid sinking too far into the mattress’s core. Petite individuals may be perfectly supported on a mattress rated 5 or 6 for firmness, but taller or heavier individuals should look for a mattress rated seven or eight.

Support and Pressure Relief

Individuals will want to look for a mattress that targets specific areas for relieving aches and pains, such as the shoulders, hips, and lower back. Foam helps relieve pressure points in the body without feeling too soft, which is helpful when managing joint pain. There is debate over whether latex or memory foam is better for relieving sensitive pressure points. A Journal of Chiropractic Medicine study suggests that latex foam may outperform traditional memory foam as it reduces body pressure and evenly distributes weight along pressure points. (Low F. Z. et al., 2017)

Motion Transfer

Motion transfer refers to a mattress’s ability to isolate body movement.  It’s helpful to consider how much you and your partner are affected by each other’s movement throughout the night. This may not be necessary for individuals who don’t sleep with a partner. So, if you or a partner disrupt sleep throughout the night, a mattress with better motion absorption is recommended.

Sleep Position Can Affect Arthritis and Joint Pain

Mattress manufacturers often design mattresses to accommodate back, side, or stomach sleepers, as different sleeping positions usually require different types of support. One study suggests that sleeping-related pain can be reduced in those with lower back pain when they choose the right sleeping surface for their preferred sleep position. (Jacobson B. H. et al., 2010) Therefore, purchasing a mattress for the preferred position is important.

Durability

A mattress’s expected lifespan depends on the materials it’s made from. A mattress that immediately loses some of its features and benefits won’t last very long. This is why it is recommended to know how long the trial period is for the mattress and keep track of its performance. Count on at least six to seven years, but latex and hybrid mattresses can last longer.

Trial Period

Considering the trial period on the mattress is important when buying online. Determining if it’s right for your body can take a little while as it takes a while to break in a new mattress, so look for a longer trial period to see and feel if it is the right choice. (Mattress Firm, 2023) Most online mattress retailers offer at least a 100-day trial period, while some offer 365 days to send it back. However long the trial period, looking into the terms and conditions of any return policy is recommended. A company can say you can return it if it doesn’t meet expectations; however, restrictions or exclusions may apply to your purchase.

Injury Medical Chiropractic and 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, prevent injury, and 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.


Fighting Inflammation Naturally


References

Sleep Foundation. Noyed D. (2024). How to Choose a Mattress. https://www.sleepfoundation.org/mattress-information/how-to-choose-a-mattress

Low, F. Z., Chua, M. C., Lim, P. Y., & Yeow, C. H. (2017). Effects of Mattress Material on Body Pressure Profiles in Different Sleeping Postures. Journal of Chiropractic Medicine, 16(1), 1–9. https://doi.org/10.1016/j.jcm.2016.09.002

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. https://doi.org/10.1016/j.apergo.2010.05.004

Mattress Firm. (2023). Breaking In a New Mattress: Tips for a Comfortable Night’s Sleep. Mattress Firm Blog. https://www.mattressfirm.com/blog/sleep-tips/break-in-a-new-mattress