If your lower back is causing you grief, it could be from your lower back muscles.
You might be saying, “Umm, obviously.”
But here’s the confusing part: Your lower back pain could also be from OTHER muscles–muscles that get hurt and then SEND their pain to your lower back.
Muscles like hip flexors, for example.
So, the question: “Can hip flexors cause back pain?” can be answered with a resounding HECK YES. Here’s why.
Your Psoas and Iliacus muscles are hip flexor muscles. But when these guys get injured, they like to “share the love” with your lower back.
So, don’t JUST blame your lower back for your back pain. Maybe your attention should be on your hip flexor muscles–the Psoas and Iliacus!
Today, I’ll explain:
- HOW the Psoas and Iliacus Defer Pain to Your Lower Back
- How to Massage Your Hip Flexor Muscles
- How to Stretch & Strengthen Your Hip Flexor Muscles
- Other Muscles That Cause Lower Back Pain
- Can Hip Flexors Cause Back Pain FAQs
Can Hip Flexors Cause Back Pain?: Blame Your Psoas!
First up on the chopping block: Your Psoas.
Where is the Psoas?
With your hand, make a diagonal line from your belly button to your bony hip bone. Your Psoas is right in between these two landmarks on either side of your body.
The Psoas muscle is like a bridge between your lower back bones (lumbar vertebrae) and the upper part of your thigh bone (femur)--basically attaching your upper body to your lower body.
What Does the Psoas Do?
Any time you lift your knee to your chest, your Psoas gets involved. This hip flexor muscle helps with pelvis stabilization as well.
How Do I Know If I Have Psoas Pain?
Sometimes, life requires us to sit for long periods of time. Unfortunately, the Psoas muscle doesn’t really like when that happens.
If you stand up after a long day of work at your computer, and you feel chronic, stabbing lower back pain, your Psoas could be at play. You might also feel it in your outer hip.
Can Hip Flexors Cause Back Pain?: Blame Your Iliacus!
The Iliacus is also part of the same muscle group–your hip flexors, and it has a very similar function. The Iliacus can be an equally responsible party for your lower back pain!
Where is the Iliacus?
Use your thumb just above the beltline to find the soft muscle on the inside face of your hip bone. This is your Iliacus.
What Does the Iliacus Do?
The Iliacus works with its counterpart, the Psoas, to bring your knee to the chest. Together, they work as a unit.
Sitting too long has its consequences with both your Psoas and Iliacus. The sitting position tends to shorten the muscles and pull on your lower back, which is what causes lower back pain.
How Do I Know If I Have Iliacus Pain?
Your lower back and upper thigh take the brunt of the hit when your Iliacus is involved–as shown in the picture below.
[1]
Hip Flexor Release: How to Fix Lower Back Pain Caused by Hip Flexors
So, how do you get rid of lower back pain caused by hip flexors?
The first step is to understand your muscles, which we just covered.
The next step, my friend, is deep tissue massage.
Once you understand how your muscles work and what they’re doing to wreak havoc on your lower back, you can use deep tissue massage and trigger point therapy to target these muscles and break up the tightness that exists.
Massage your hip flexor muscles, and you’ll feel relief in your lower back.
Best Massage Tool for Hip Flexors
While professional massage is always a great option, it can become costly. Plus, you don’t have constant access to it.
That’s why I recommend getting an at-home massage device. It saves the repetitive cost of a massage if you're pinching pennies, and it basically gives you 24/7 access to a hip flexor massage without being dependent on someone else.
When it comes to at-home massage devices, I’m totally biased toward the QL Claw.
Here’s why I like it:
- The QL Claw hits all 5 muscles responsible for lower back pain.
(not just 1 or 2)
- There are tons of online resources for how to use it: like our Blog and YouTube Channel.
- It’s made by our founder, Ben–a guy who designed it to solve his own back pain!
(So, you know it’s good!)
- It’s purposefully designed to hit trigger points in your lower back, hip flexors, and glutes!
How to Fix Your Hip Flexor Pain TODAY With the QL Claw
So, now that I’ve sold you on the QL Claw–or just “The Claw” for short, let’s dive in to how you can fix your lower back pain from hip flexors starting TODAY using the QL Claw.
You’ll need to know some Claw terminology first:
- The smaller end of the Claw is called the trigger point.
- The larger end of the Claw is called the ramp.
Psoas Massage for Hip Flexor Release
1) First, find your Psoas. Place your thumb on your belly button, and then stretch your pinky down toward your hip bone. Your Psoas is right in the middle–on both the right and left sides of your body.
2) Lie down on your stomach.
3) As you do this, place the ramp side of the Claw on your Psoas (between your belly button and hip bone).
4) Lean your body into the ramp, so the pressure is on the Psoas muscle.
5) Use your toes on the working side to raise up your knee just off the ground. Then, slowly rotate your leg from one side to the other.
6) Breathe deeply and slowly through the massage.
7) Repeat on the other side.
Level-Up Your Psoas Massage
Once you get the basic motion down for how to massage your Psoas, take it to new heights, and give yourself an even deeper massage!
Pressure #1: Engage your glute muscle. When you do this, you’ll add extra pressure to your Psoas, providing a deeper massage.
Pressure #2: Think tree pose in yoga for this one. With your opposite leg, bring the knee out to the side of the body while keeping both your knee and foot flat on the ground. When you do this, even more pressure gets added to your working Psoas.
More of a visual learner? Check out this video for step-by-step instructions for a Psoas hip flexor massage.
Iliacus Massage for Hip Flexor Release
1) Place your thumb on the inside of your hips and about 0-2 inches above the beltline. You’ll feel a tender muscle there, which is your Iliacus!
2) Lie down on your stomach.
3) As you do, place the trigger point of the QL Claw on your Iliacus muscle–with the ramp side of The Claw facing out. Make sure The Claw is on muscle and not bone.
4) Using the foot on the working side, raise up your knee just slightly off the ground. Then, slowly rotate the leg from one side to the other.
5) Breathe deeply and slowly through the massage.
6) Repeat on the other side.
Level-Up Your Iliacus Massage
Pressure #1 - Glute Activation: Just like your Psoas massage level-up, your Iliacus will get a deeper massage if you activate your glutes!
Pressure #2 - The Windshield Wiper: Lift up your foot on the working side, bending your knee into a 90-degree angle. Move your elevated foot slowly to the right side and then to the left side.
Pressure #3 - The Stinger: Lift the working leg up in the air, using your glute for support!
Check out this video for step-by-step instructions for an Iliacus hip flexor massage.
Stretch & Strengthen for Back Pain Caused by Hip Flexors
So, what do I recommend apart from massage?
- Stretching: When you stretch your hip flexors, you help extend them back to their original length.
- Strengthening: When you strengthen them, you help prevent future injury.
Here is 1 of my favorite stretches and 1 of my favorite strengthening exercises for hip flexors!
Hip Flexor Stretch: Couch Stretch With Floss
How to Do This Hip Flexor Stretch:
1) On all 4’s, back your left knee up against a wall.
2) To do this, you’ll notice your leg automatically bends up, which is exactly what it should do! Your whole leg should be flush against the wall–forming a straight line from your knee to your foot.
3) Place both hands flat on the floor, shoulder-width apart.
4) Place your right foot flat on the floor, so it’s in line with your hands, bending this knee.
5) Then, begin to floss–meaning slowly thrust your hips forward and then back, using your glute to propel the motion.
6) Floss for a full minute. Then switch sides.
Pro tip: For extra progression, raise your torso and lift your hands off the floor. Then, use a chair to place a hand on for support. Continue flossing in this upright motion!
For a video tutorial on this hip flexor stretch +1 more, check out the video below!
Hip Flexor Strengthening Exercise: Standing Cable Hip Flexion
How to Do This Hip Flexor Strengthening Exercise:
1) At a cable machine, set the pulley to its lowest setting.
PRO TIP: I like to find a cable machine that has two pulley systems close to one another so that I can grab onto the other machine for support!
2) Place an ankle cuff around your ankle. I recommend starting with the weaker leg, so for me, this would be my LEFT ankle.
3) Set the machine to a desired weight. Start light if you’re just trying this move out for the first time!
4) If you can, place your hands on a stable object nearby for support.
5) Raise your left knee up to your waist while supporting yourself on your right leg.
6) Slowly lower your foot back down without letting it touch the ground.
7) Repeat. Then switch legs.
Check out our video on hip flexor strengthening exercises below!
Other Muscles We Can Blame for Lower Back Pain
While we’re pointing fingers, let’s take a look at a few other muscles you might want to inspect to see if they’re the cause of your lower back pain.
Quadratus Lumborum (QL)
Your Quadratus Lumborum or QL could be to blame for your muscle tightness. This is a deep back muscle that tends to cause pain in your lower back, tailbone, and other gluteal muscles.
Check out how to release your QL here.
Gluteus Medius/Minimus
Speaking of, your gluteal muscles also love to send their pain to your lower back. It could be your gluteal muscles: Medius and Minimus.
Their brother, the Gluteus Maximus, might like to steal the show elsewhere, but when it comes to back pain, these two muscles take center stage. They tend to pull your pelvis to the back of your body, causing a world of pain in your lower back, upper glutes, and tailbone.
Check out how to release your Glutes here.
Looking for a massage tool that can hit your hip flexors, QL, and glutes all in one go?
Shop the QL Claw below!
Can Hip Flexors Cause Back Pain FAQs:
How do you fix hip flexor back pain?
For this, I recommend trigger point therapy and deep tissue massage. This approach gets down to the core issue: sore muscles. Specifically, it helps bring the Psoas and Iliacis muscles back to their regular length–since they tend to get shortened by extended periods of sitting.
What are the symptoms of tight hip flexors?
If your hip flexors are tight, you might feel chronic, stabbing lower back pain, outer hip pain, or pain in your upper thigh. All of these are symptoms of pain in your Psoas and Iliacus.
How do you know if your back pain is from your hip?
One way to tell if your lower back pain is from your hip is if you have a job that has you sitting for hours on end. This tends to shorten your hip flexor muscles, which in turn pulls on your lower back.
Often, outer hip and upper thigh pain is also accompanied by lower back pain when hip flexors are involved.
Can hip flexor pain radiate to the back?
Totally! These two muscle groups are super connected, so when your hip flexors get tweaked, the lower back suffers.
Should I stretch my hip flexor if it hurts?
Stretching is a great way to help your hip flexors! In this article I recommend massage, stretching, and strengthening exercises. With these 3 approaches, your hip flexors are bound to feel better!
Is walking good for tight hip flexors?
Walking and running can be a great way to help tight hip flexors.
Now that you've read about hip flexors, read more about your Sartorius Muscle!
Sources:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.
[3] Konrad A, Močnik R, Titze S, Nakamura M, Tilp M. The Influence of Stretching the Hip Flexor Muscles on Performance Parameters. A Systematic Review with Meta-Analysis. Int J Environ Res Public Health. 2021 Feb 17;18(4):1936. doi: 10.3390/ijerph18041936. PMID: 33671271; PMCID: PMC7922112.
[4] Sajko S, Stuber K. Psoas Major: a case report and review of its anatomy, biomechanics, and clinical implications. J Can Chiropr Assoc. 2009 Dec;53(4):311-8. PMID: 20037696; PMCID: PMC2796950.