Living Pain-Free: Sonographer back pain, part 4

By Doug Wuebben, contributing writer, Mark Roozen, contributing writer

January 21, 2016 -- We hope you are having a great start to the new year and want to make sure we do everything we can to help you live pain-free in 2016. Continuing our seven-part series on correcting the movement problems that cause back issues, we will now address tight hips and a lack of mobility in the hip area.

If we can improve hip mobility, we can sit, squat, walk, and move better. Even if we have limited hip mobility, we still have to move, though, because of work and activity. What happens then is that we start to use, or try to get movement through, our lumbar spine. Because the lumbar spine is meant to be stable, movement in the lumbar region can cause back pain.

Instead of trying to stretch out the back, what you need to do is stretch the hips. I believe that if we can improve hip mobility, we can eliminate more than 50% of back pain. By training hip mobility, we aim to achieve more range of motion and also progress to getting great hip separation; as one leg goes forward, the other has the ability to go back.

The movements we've selected below require very little equipment -- nothing more than some space and a piece of PVC pipe or a wood dowel. All can be done in a small area, so some of you can even do them at work in your office. Coach Rozy loves their versatility; you can use the exercises as a warmup to get ready for more exercise and training, or as a stretching session to help eliminate back pain at work or at home. Depending on your fitness level, you could also include them along with a training session.

The following exercises can be performed as stretches. If you do multiple reps, they can be a workout, or, as we said, they can be part of your dynamic warmup. They're great because you can do them in one spot, or you can perform them while moving if you have room, such as in a hallway.

PVC overhead squat

Squat as low as possible while holding a piece of PVC pipe over your head. Keep your feet planted flat on the floor and think about pushing your knees out over your toes. This will open up your hips and increase the depth of the squat. Remember to keep your chest as upright as possible.

PVC overhead squat
All images courtesy of Doug Wuebben.

Toe-touch squat to overhead reach

Keep your feet planted flat on the floor, with your legs straight but with a slight bend (don't lock your knees). Then reach down and work to touch your toes, or put your palms on the ground if you can. Next, grab your ankles and sit into a deep squat. Holding the squat, raise your right hand over your head and then your left hand (work to keep your chest up during these movements). With your hands now overhead, stand up into the beginning position.

Toe-touch squat to overhead reach

Kneeling hip extension

Kneel on one knee and plant your opposite foot firmly on the ground. Gently lean forward to the desired range of motion, while keeping your chest as upright as possible. Raise your arms overhead to get an even deeper stretch. Perform the same movement on the other side to avoid muscle imbalances.

Kneeling hip extension

Spiderman stretch

Starting in a pushup position, move your right foot forward toward your right hand and plant your foot firmly. Next, lower your body toward the ground until you feel a mild stretch in the muscles of your inner thigh and hip flexor. Depending on the depth of your stretch, you may feel this in your glutes as well. Perform the same stretch on your left side.

Spiderman stretch

Glute bridge

Lie on your back with your feet planted flat on the floor. Keep your head on the floor and your arms extended. Move your hips toward the sky. You should feel a stretch in your hip flexors and quadriceps.

Glute bridge

Fire hydrants

Beginning on your hands and knees, raise one leg and bend your knee 90°. Abduct the hip (raise it up to the side) while maintaining the same knee angle. Next, reach your knee up as far as possible and then return to the starting position. Do not let your body sway or move, and keep your back flat. Perform on the opposite side.

Fire hydrants

Knee circles

Just as you did with the fire hydrant exercise, begin on your hands and knees, raise one leg, and bend your knee 90°. Now move your knee through a full circular range of motion, forward to back and vice versa. Imagine raising your knee over an object (like a cone). Keep your torso steady and your back flat. Perform on the opposite side.

Knee circles Knee circles

If you perform two or three of these exercises two to three times a week (you can do more if you have the time), you will see improvement in hip mobility and back pain. Do these at home or at work, or as part of your routine if you go to the gym. When in a closed-off area, work to hold the positions for 30 to 45 seconds. If you are in an open area and the exercise allows you to move a distance, like Spiderman, travel 15 to 20 yards.

Be on the lookout for part 5 of our back pain series, in which we'll discuss tight or weak quadratus lumborum (QL) muscles and how to fix them. Not sure what your QL muscle is? Find out in our next article!

Doug Wuebben is a registered echocardiographer and also a consultant, international presenter, and author of e-books in the areas of ergonomics, exercise and pain, and injury correction for sonographers. He has also been published on the topics of telemedicine and achieving lab accreditation.

Mark Roozen is a certified strength and conditioning specialist, a certified personal trainer, and a fellow of the National Strength and Conditioning Association (NSCA). He also consults, presents, writes, and works with groups, teams, and organizations around the world. He has been in the strength, conditioning, and performance field for over 30 years.

Wuebben and Roozen are co-founders of Live Pain Free -- The Right Moves. Email or go to for more information on programs, training, or speaking requests, or if you have any questions or comments.

The comments and observations expressed do not necessarily reflect the opinions of

Copyright © 2016
Member Sign In:
MemberID or Email Address:  
Do you have a password?
No, I want a free membership.
Yes, I have a password:  
Forgot your password?
Sign in using your social networking account:
Sign in using your social networking