Hip + Low Back Pain: The Fix Is Usually in the “Invisible” Stuff

Most ‘low back pain’ is a hip stability + hinge problem.
If your hips don’t control rotation and load… your back will.
Here are 4 drills I use constantly: single-leg stability, single-leg hinge, internal rotation hinge, hip airplane.

(Hip stability + a real hinge pattern)

If you’ve had low back pain that “keeps coming back,” you’re not alone.

Here’s what I see all the time in active adults, parents, runners, lifters, golfers, and CrossFitters:

  • The back becomes the hero because the hips won’t do their job.

  • Relief happens… then symptoms return the moment life (or training) ramps up again.

  • Everyone focuses on stretching, but the real missing piece is usually control.

And control comes down to two things most people never actually train:

  1. Hip stability

  2. A proper hinge

When those two improve, a lot of “low back pain” starts to feel… less like a back problem.

Why your back is complaining (even if your MRI is “fine”)

The low back is built for stability and force transfer, not endless motion.

But when the hips are stiff, unstable, or weak—especially in rotation—your body still has to get the job done:

  • Picking up kids

  • Deadlifting

  • Running

  • Sitting all day then trying to train

  • Golfing / rotating

  • Lunges, step-ups, RDLs, squats

So it borrows motion and effort from the next available place:

👉 the lumbar spine

The result is a predictable cycle:

  • Tightness

  • Pinch

  • Spasm

  • “It feels out”

  • Temporary relief

  • Back to square one

The back isn’t broken. It’s overworked.

The hinge: your back’s insurance policy

A “hinge” is the ability to load the hips while keeping the spine stacked and controlled.

It’s the foundation for:

  • Deadlifts

  • RDLs

  • Kettlebell swings

  • Picking up laundry

  • Lifting kids out of a car seat

  • Shoveling snow

  • Moving furniture

  • Being an adult

A proper hinge means:
✅ hips move back
✅ hamstrings + glutes load
✅ ribs stay down / core engaged
✅ spine stays stable (not doing the work)

A broken hinge usually looks like:
❌ low back rounding or over-arching
❌ weight shifts to one side
❌ “hinge” turns into a squat or a back bend
❌ hamstrings never load
❌ pain shows up right where you least want it

When you don’t own a hinge, your back becomes the hinge.

Hip stability: the missing link people don’t feel… until it’s gone

Hip stability is your ability to control the pelvis and femur under load—especially on one leg and in rotation.

That matters because real life is rarely symmetrical.

Walking is single-leg. Running is single-leg. Stairs are single-leg. Getting out of a car is rotation + single-leg. Golf and throwing? Rotation under load.

When the hip can’t stabilize, you’ll often see:

  • a hip shift in squats or hinging

  • knees collapsing in

  • one-sided low back tightness

  • a “pinchy” hip on one side

  • hamstring strains that keep recurring

  • SI joint irritation

  • that deep glute ache that never fully leaves

Here’s the important part:

Stability isn’t just strength. It’s control.
And control is trainable.

Why rotational control matters (and why “stretching” often fails)

A huge driver of chronic hip/back issues is poor control of hip rotation:

  • Internal rotation (IR) — the femur rotates inward in the socket

  • External rotation (ER) — rotates outward

If you lack hip rotation or can’t control it under load, your body will find rotation somewhere else.

Guess where?

👉 the low back
👉 the SI region
👉 the hamstrings
👉 the knees

So people stretch the back… stretch the hamstrings… stretch the hip flexors… and still feel tight.

Because the tightness is often protective tension—your nervous system bracing because it doesn’t trust the hip.

The fix is rarely “more stretch.”
The fix is give the body a new option: controlled hip motion with stable spine.

The 3 drills I use constantly (and why they work)

I’m including videos below of three of my go-to movements because they train the exact missing pieces:

1) Single-Leg Hip Hinge

Why it helps:

  • builds hip stability under load

  • teaches pelvis control

  • forces the glute/hamstring to own the pattern without borrowing from the back

What you should feel:

  • hamstring + glute working

  • foot tripod (heel, big toe, pinky toe)

  • steady pelvis (no twisting)

What you shouldn’t feel:

  • low back pinch

  • hamstring cramp (often a sign the glute isn’t doing its job yet)

2) Internal Rotation Hinge

Why it helps:

  • trains the hip to accept load in IR (a common “missing” position)

  • reduces the tendency to twist through the lumbar spine

  • improves control for squats, running, cutting, and rotational sports

This is huge for people who:

  • feel “stuck” in the hip

  • shift to one side when hinging/squatting

  • get back pain after leg days

  • feel pinchy in the front of the hip

3) Hip Airplane

Why it helps:

  • teaches the hip to stabilize while the pelvis rotates

  • lights up deep hip stabilizers (glute med/min, external rotators)

  • improves balance, control, and alignment

Translation: less compensation, less back guarding, better movement quality.

The real goal: build a body that doesn’t need “constant fixes”

If you’re tired of chasing symptoms, here’s the mindset shift:

Don’t just calm the pain. Upgrade the pattern.

When you improve hip stability and hinge mechanics, you’re not just “rehabbing” — you’re building:

  • a stronger foundation for lifting

  • better performance and longevity

  • more confidence in daily movement

  • less flare-ups from normal life

This is what we do every day in the clinic:
Find the weak link, restore control, and build capacity so your body stops relying on the low back as the backup plan.

Want help figuring out what YOUR body is doing?

If your low back pain keeps returning—or your hip feels tight/pinchy—there’s a good chance your hinge and hip control are part of the story.

And if you’ve been struggling to find relief, we would love to help you!

Team IC

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The Kansas City Guide to Feeling Better (and Staying Better): Chiropractic Care That Actually Lasts