Hip rotation and lower back pain

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Don’t give too much stress on thinking of heading , there is No brain surgery here . Previously we talked about stability and mobility importance. We had mentioned earlier which segment is responsible for mobility as well as stability..

BACKGROUND:

Hip rotation range-of-motion (ROM) impairment has been proposed as a contributing mechanical factor in the development of low back pain (LBP) symptoms. There is a hypothesis which suggests that a limited range of hip rotation results in compensatory lumbar spine rotation. Hence, LBP may develop as the result. This article reviews studies assessing hip rotation ROM impairment in the LBP population.

Conclusion : The precise assessment of hip rotation ROM, especially hip internal rotation ROM, must be included in the examination of patients with LBP symptoms.

Clinical guidline during gait cycle……….

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When one foot is on the ground, the opposite leg is in swing phase. The swing phase requires the hemipelvis on ipsilateral side to move forward as well. This means that the pelvis of the stance limb rotates on the static femoral head and this rotation is internal hip rotation.

If one does not have sufficient internal hip rotation then the heel lifts prematurely. The foot may undergo an adductory twist (the heel moves medially into adduction which can look like the foot spinning “relatively” outward into external rotation) to name just a few (of many possible) pattern consequences.

The loads can also move upto the lumbar spine, because, if the rotation is not there in the hip, the lumbar spine acts as mobility. Actually the lumbar spine is responsible for stability. Therefore, lumbar spine gets loaded and eventually end up with back pain. There are many strategies and patterns of loading responses available to the framework, it is your job to find them, source out the problem, and remedy. One must look for and understand the importance of sufficient internal hip rotation in your patient.

This study brings this principle to mind.

https://www.ncbi.nlm.nih.gov/pubmed/26751745

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