The Importance of the Hip Hinge in Preventing Back Injuries

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.

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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. 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. doi.org/10.1186/s40798-018-0150-3