From walking and running to sprinting and cutting, your hip needs movement, control, and a little room to do its job.
If you’ve ever dealt with low back pain, there’s a pretty good chance you’ve spent some time trying to figure out what the heck is going on with your back.
Maybe you’ve stretched.
Maybe you’ve strengthened your core.
Maybe you’ve done physical therapy.
Maybe you’ve had a massage.
Maybe you’ve been told your glutes are weak and you need to do more glute bridges.
So you did more glute bridges.
And then more.
And somehow your back still hurts.
Here’s a thought:
Maybe your glutes aren’t the problem.
Maybe your hip isn’t doing its share of the work.
And when your hip can’t do its job, your lower back may end up picking up the slack.
That doesn’t mean every case of low back pain comes from the hip. It doesn’t. But the relationship between your femur, pelvis, hip socket, and lower back is worth understanding—especially if you’ve been treating the same problem over and over without getting a lasting change.
Your Femur Isn’t Supposed to Be Glued Into Your Hip Socket
Let’s start with the basics.
The large bone in your upper leg is the femur. At the top of the femur is a rounded end that sits inside a portion of your pelvis called the acetabulum, or hip socket.
The two surfaces are designed to work together.
And while the femur needs to be stable inside the socket, it isn’t supposed to be completely frozen there.
It needs to make small, controlled adjustments as you move.
A little rotation.
A little shifting.
A little movement forward and backward.
Nothing dramatic.
Your femur isn’t supposed to start doing interpretive dance inside your hip socket.
But those small movements are important.
Think about parking a car in a one-car garage.
If you pull in straight and park in a good position, you can back out without much trouble.
Now imagine parking at a weird angle. Maybe you’re too far to one side, the front end is crooked, and you’ve somehow managed to make backing out of a one-car garage into a 14-point turn.
The car isn’t broken.
The position is the problem.
Your hip is obviously much more sophisticated than a car in a garage, but the principle is similar.
The position of the pelvis and the orientation of the femur influence each other.
When those two aren’t cooperating well, the femur may not be able to make the small movements it needs to make inside the acetabulum.
And when those movements aren’t happening smoothly, things can get a little…grindy.
And your joints are not particularly fond of grindy.
Your Hip Needs a Little Room to Move
This is where we need to rethink what “hip mobility” actually means.
Mobility isn’t about making your hip move as far as humanly possible.
It’s about having enough movement where you need it, when you need it, with enough control to use it.
Your femur doesn’t need to travel miles inside your acetabulum.
It needs to be able to make the small adjustments that allow the entire leg and pelvis to work together.
Consider something as simple as walking.
Your foot contacts the ground.
Foot rollin’, rollin’, rollin’…
Your lower leg responds.
Your femur responds.
Your pelvis adjusts.
Your opposite leg begins its own cycle.
And somehow, without giving any of it conscious thought, you end up across the room.
That little sequence requires a tremendous amount of coordination.
If the femur can’t make the movement it needs to make inside the hip socket, the body still has a job to accomplish:
Get you where you’re going.
So it finds another way.
And this is where compensation comes into the conversation.
The Movement Chain Starts at Your Feet
Your hip doesn’t exist in isolation.
The movement chain is much bigger:
Foot → tibia and fibula → femur → hip socket → pelvis → spine
What happens at one end can influence what happens farther up the chain.
For example, if the foot is consistently positioned outward, that can influence the rotation of the tibia and fibula. That can influence the orientation of the femur. And that can change the way the femur interacts with the acetabulum.
That doesn’t mean an externally rotated foot automatically causes hip or back pain.
It doesn’t.
It’s simply one example of how the chain can be disrupted.
Think about a row of people trying to get through a doorway.
If the person in front gets stuck, everyone behind them has to figure out another way through.
And usually the person at the back has absolutely no idea why everyone is suddenly moving sideways.
Your body can work the same way.
You may feel the problem at your hip or lower back, while the movement issue may involve something farther down the chain.
If you haven’t read the earlier articles about the feet, this would be a good time to go back to them.
[INSERT LINKS TO FOOT BLOGS HERE]
Your Glutes Aren’t Weak. They Might Just Be Busy.
Now let’s talk about those glutes.
Because this is where I think we sometimes oversimplify things.
You have low back pain.
Your hip isn’t moving well.
Someone tests your glutes and tells you they’re weak.
So naturally, the solution is:
More glute exercises.
Glute bridges.
Hip thrusts.
Clamshells.
More bridges.
Maybe a resistance band gets involved for good measure.
But here’s the thing:
A muscle can have plenty of strength and still be poorly positioned, poorly coordinated, or constantly recruited for stabilization.
That means the muscle can be working very hard without doing the job you actually need it to do.
Your glute may not be weak.
It may simply be busy doing something else.
Stabilizing Isn’t the Same as Moving
This is an important distinction.
Your muscles have to help stabilize the femur.
They also have to help move and guide the femur.
Those aren’t exactly the same job.
Imagine your glute has 100 percent of its available effort to give.
If it has to spend 80 percent of that effort simply trying to stabilize the femur because the hip isn’t moving well, there’s only 20 percent left for everything else.
The muscle isn’t necessarily incapable.
It’s just overloaded with responsibilities.
It’s like hiring someone to be your personal assistant and then making them spend 80 percent of their day holding a door shut.
Sure, technically they’re working.
But they’re not getting much of the actual assistant work done.
The gluteal muscles have several jobs involving the hip and pelvis. They help with movement, rotation, stabilization, and control.
They need to be able to guide the femur while also helping maintain control of the hip.
If they’re constantly occupied with one job, the rest of their responsibilities don’t magically disappear.
Something else has to pick them up.
And Your Body Will Find Someone Else to Do the Job
Your nervous system has one big priority:
Accomplish the movement.
It doesn’t care that you have a carefully organized list of which muscle is supposed to do what.
If the muscle you normally rely on isn’t handling its job efficiently, your body can recruit other muscles to help accomplish the task.
It’s basically the body’s version of:
“Well, that’s not working. Who else can do this?”
And sometimes the answer is a muscle that was never intended to handle that much of the workload.
That muscle may be perfectly capable of helping occasionally.
But when it has to help all day, every day, with every step you take, that’s a different story.
Eventually, it can become overworked.
This is one way a movement problem at the hip can contribute to muscle fatigue, discomfort, and low back pain.
Again, this isn’t the only reason someone develops back pain.
But it’s one possibility worth considering when your back keeps complaining and nobody seems to be asking why.
Remember the Psoas?
This is where the psoas we talked about in Part 2 comes back into the story.
The psoas connects the lumbar spine to the femur and passes through the hip region.
That makes it one of the structures connecting the three areas we’re talking about:
the lower back, the pelvis/hip, and the femur.
So now we can start to see why these areas can’t always be treated like separate rooms in the house.
If the femur isn’t moving well inside the acetabulum, that can change what the muscles around the hip have to do.
If the hip isn’t contributing enough movement, the muscles around the lower back may have to contribute more.
And if the psoas is part of the connection between the femur and lumbar spine, it becomes part of that conversation too.
This is why the next part of this series is going to focus on the lumbar spine.
Because we’re starting to see the bigger picture.
Your hip doesn’t stop at your hip.
What Happens When the Hip Doesn’t Move Smoothly?
When the femur and acetabulum aren’t moving well together, the way force is distributed through the joint can change.
Ideally, those surfaces should be able to move smoothly together.
When they don’t, certain areas may end up taking more pressure than they should.
Over time, depending on the individual and the underlying cause, that can contribute to problems involving the cartilage or labrum.
You’ve probably also heard the term hip impingement.
That’s worth knowing about, but we’re not going down that rabbit hole today.
The point isn’t to diagnose yourself with an internet search.
The point is much simpler:
Your hip is designed to move.
And good hip movement isn’t just about how far your leg can go.
It’s about whether the femur and pelvis can work together while you move.
This Matters Even More When You’re an Athlete
For an adult walking around the house, these small movement differences may not seem like a big deal.
But add speed.
Add force.
Add repetition.
Now we’re talking about something completely different.
Think about a youth athlete sprinting down a baseball field.
Or a soccer player changing direction.
Or a basketball player stopping, cutting, and accelerating again.
Or a softball player rotating, planting, and driving through the ground.
The demands on the hip are much higher.
The faster the movement, the more important movement control becomes.
An athlete doesn’t just need strong muscles.
They need the ability to coordinate those muscles while the bones and joints are moving underneath them.
That’s one of the reasons the concepts we’re talking about here are important for both adults and young athletes.
The weekend golfer and the 12-year-old baseball player have very different demands on their bodies.
But neither one benefits from a hip that can’t move and control itself well.
And that’s a big part of what we’re trying to build with NextGen Performance Lab: not simply stronger young athletes, but athletes who have the movement foundation and control to use that strength effectively.
Performance begins long before strength. It begins with movement.
So Maybe Your Back Isn’t the Whole Problem
Here’s the big takeaway.
If you’re experiencing low back pain, it’s natural to focus on your lower back.
That’s where you feel it.
But where you feel the problem isn’t necessarily where the movement problem begins.
Your foot can influence your lower leg.
Your lower leg can influence your femur.
Your femur interacts with your hip socket.
Your hip interacts with your pelvis.
Your pelvis interacts with your spine.
And the muscles connecting all of those areas have to coordinate the entire process.
If your femur can’t make the small movements it needs to make inside the acetabulum, your body still has to get the job done.
So it compensates.
Maybe your glute works overtime trying to stabilize.
Maybe another muscle picks up some of the movement.
Maybe the muscles around your lower back get asked to contribute more than they should.
And eventually you’re wondering:
“Why does my back hurt when the problem seems to be my hip?”
That’s the question I want you to start asking.
Because sometimes your hip isn’t necessarily the problem.
The way your femur and pelvis are interacting may be the problem.
If You’ve Tried Everything, Maybe It’s Time to Try Something Different
If you’ve been dealing with recurring low back pain and you’ve already tried physical therapy, chiropractic adjustments, massage, stretching, strengthening—or some combination of all of the above—it’s reasonable to ask whether you’re addressing the underlying movement problem.
If you keep getting adjusted, feel better for a little while, and then find yourself right back in the chiropractor’s office a couple of weeks later because your back is acting up again, maybe it’s worth changing the question.
Not:
“How do I get my back put back into place again?”
But:
“Why does my body keep needing to be put back into place?”
Sometimes doing the same thing repeatedly while expecting a different result isn’t particularly productive.
Maybe it’s time to work on how your muscles are guiding your bones instead.
Posture therapy exercises can give you something you can actually work on at home—rather than making another appointment every couple of weeks just to temporarily quiet the same complaint.
That’s part of what we work on at Professor Posture in Tampa Bay.
Not just getting you through today’s discomfort.
But helping you understand how your body is moving and giving you tools to work with that movement yourself.
Because your body already knows how to move.
Sometimes it just needs a little help remembering how.
Next Up: Your Lower Back
We’ve spent the last few parts looking at the hip from several different angles.
We’ve talked about the psoas and its connection between the lumbar spine and femur.
We’ve looked at how the femur and acetabulum are supposed to move together.
And we’ve talked about how the foot, lower leg, femur, pelvis, and hip can influence one another.
Now it’s time to look at the other end of that conversation.
The lumbar spine.
Because when your hip isn’t doing all of the work it should, your lower back may find itself volunteering for a job it never applied for.
And that is where our next chapter begins.
