Simple Stretches to Improve Hip and Low Back Pain

Stretching for Relief: The Couch Stretch and Piriformis Stretch

If you’ve been dealing with persistent lower back or hip pain, incorporating targeted stretches into your routine can help alleviate discomfort and improve mobility. Two stretches in particular, the couch stretch and the piriformis stretch, are excellent for addressing tightness in the hip flexors and glutes, two common culprits behind back and hip pain. And they can be performed right on the couch while watching TV! 

Main Culprits of Lower Back and Hip Pain

Maybe you are experiencing hip pain when sitting or pain that radiates from the lower back to your lower leg. The main culprits of these types of symptoms when dealing with lower back and hip pain are tight hip flexors (psoas muscle) and piriformis syndrome (tight glutes). 

Luckily, addressing these two issues can be simple and all you need is a little bit of time on the couch! By utilizing the couch stretch and the piriformis stretch, we can loosen up some of the muscles that contribute to lower back and hip pain and provide lasting relief to your pain! 

The Couch Stretch for Hip Flexor Length

The hip flexors are a group of muscles that allow you to lift your knee to your chest and bend your hip. They are prone to becoming short and tight because we perform a lot of activities in hip flexion like sitting for long periods of time. Even activities like running involves a lot of hip flexion and can cause the hip flexors to get short and tight usually leading to other problems in the hips and lower back. 

The couch stretch targets these muscles, helping to open up the hips and reduce tension. 

How to Perform the Couch Stretch:

1. Place a pad or pillow on the floor in front of your couch. Stand with your back to the couch in front of the pillow. 
2. With one leg, kneel on the pillow with your shin placed up against the couch and your other foot flat on the floor with the knee bent. It is a good idea to have something to hold onto for balance. You should look like your are in a kneeling position with your back shin against the couch and your foot resting on the seat. 
3. Hold onto something and try to keep your torso upright. Now try to flex the glute muscle of the leg that has the knee on the pillow or pad. You should feel an intense stretch in the front of your upper leg (the one with the knee on the pillow)
4. Try to hold this position for 1-2 minutes before switching legs and repeating. Take notice as to which hip muscles felt tighter. 
5. To regress this movement, just perform the stretch without your shin against the couch, this will make the stretch less intense if necessary. 

This stretch helps to release tight hip flexors and encourages better upright posture, which cna relieve strain on the lower back. 

3 sets of 1-2 minutes per leg

The Piriformis Stretch for the Glutes

Piriformis syndrome is a condition that occurs when the piriformis muscle, located in the gluteal region, becomes tight or spasms. When the piriformis becomes irritated, it can compress the sciatic nerve, causing pain in the lower back, buttocks and even down the leg to the foot. The pain almost feels like it radiates down the leg. If you feel this, you may be dealing with piriformis issues. 

You may also be dealing with tight glute muscles from prolonged periods of sitting. The piriformis stretch may be just what you need to loosen up those muscles and give you some relief! 

How to Perform the Piriformis Stretch

1. Stand in front of your couch or a bench or any other flat surface. Place your hands on the couch or bench, put one foot up on the bench (if it is your left leg, place it closer to your right hand). 
2. Externally rotate your leg and place the outside of your shin on the bench. If it is your left leg, your knee should be right next to your left hand and your foot should be right next to your right hand. 
3. Use your upper body to help relieve some of the tension and slowly lower yourself until your back leg is kneeling on the floor. Depending on how tight your muscles are, or how high your bench/couch is, you may or may not be able to touch your knee down to the floor. Regardless, you should feel a stretch in the glute of the leg that is up on the bench/couch. 
4. Hold this stretch for 1-2 to minutes or to your comfortability. If you experience knee pain, place your foot off the edge of the bench or couch. You can also place a pillow or pad underneath your knee of the leg that is on the bench to make the stretch less difficult.
5. Repeat the stretch on the other leg. Again, take notice which side the glutes are tighter. 
6. This move can also be performed on the floor. This is called a pigeon pose. 

Regularly stretching the piriformis and glutes can reduce gluteal tightness and relieve pressure on the lower back and hips, possibly decreasing pain in those areas.

3 sets of 1-2 minutes per leg

Conclusion/Training Protocol 

Both the couch stretch and the piriformis stretch target muscles that contribute to lower back and hip discomfort. When the hip flexors or glutes are tight, they can pull the pelvis out of alignment, leading to increased strain on the lower back. 

Perform these stretches for one minute on each leg, for 2 to 3 times each which should take around 10–15 minutes. Do this 1 to 2 times per week and you should start to feel relief in the lower back and hips. 

It’s always a good idea to consult a healthcare professional or physical therapist for personalized advice. But incorporating these stretches can be a simple and effective step toward relieving your lower back and hip pain and improving your overall range of motion. 

Key Takeaways

References: 

1. Halpin RJ, Ganju A. Piriformis syndrome: a real pain in the buttock? Neurosurgery. 2009 Oct;65(4 Suppl):A197-202.
2. Nishimura T, Miyachi R. Relationship between low back pain and lumbar and hip joint movement in desk workers. J Phys Ther Sci. 2020 Oct;32(10):680-685.
3. Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthop Clin North Am. 2004 Jan;35(1):65-71.
4. Porter JL, Wilkinson A. Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men. Spine (Phila Pa 1976). 1997 Jul 1;22(13):1508-13; discussion 1513-4.