I have been working with a client for a few visits.  His main complaint: L low back pain and L hip pain.  He has made some good progress and will feel good for about a week or so and then the discomfort will come back.  In our last session we found that he couldn't lift his left thigh off of the table when he was on his stomach, and it really hurt his back.  I could see that his back muscles on his left side were really working hard.  I released the back muscles and his discomfort went away, but he still couldn't lift his leg.  His left gluteus maximus was not responding what so ever!
This last weekend I attended a training called  "Finding Center"  by Gary Ward of Anatomy in Motion.  The first day of training we spent 4 hours exploring the 3D movement of 6 key muscles in the body. One of these muscles was the gluteus maximus.  Many of us know the glute max actions: hip extension, hip external rotation and hip abduction.  Typical ways to strengthen this muscle is through concentric contractions as in clam shells, fire hydrants, bridges, lunges and squats.  
According to Gary Ward, the first rule of movement is: "Muscles lengthen before they contract."  His theory is that you want to lengthen the muscle as far as it can go, and it has nothing to do but contract.  I applied this concept when I returned from my training. 
My client came in this week with his left back and hip a little aggravated.  I tested my client again on his stomach.  He could not lift his thigh off of the table, and he had incredible pain in his back.  I had him stand up onto his left leg and move through the single leg squat and 3D reach.  I had him allow his hip and knee to move into flexion, adduction and internal rotation (prior to this training, I would have controlled for knee adduction and internal rotation).  After completing about 10 repetitions he says, "I don't have the pain in my glute anymore."  We moved through a few more patterns, got him back on the table and retested his ability to lift his thigh off the table:  Full lift without any pain!  He was completely amazed, and quite honestly so was I!  He got off of the table, took a walk and didn't have any pain.  Next time you feel like you are stuck in your training, or you have a case of "dead butt", remember: muscles lengthen before they contract.
I have included one of the movement patterns I went over with my client in the video below.  Rather than tapping down with the foot, you can also try reaching your arm out to touch the floor in a clockwise fashion.

If you didn't know already, the squat is hot. Everybody is doing it..... The squat is one of the most effective ways to strengthen your glutes.  But.... not every body is ready to bust the move and go deep into the squat position without losing their balance or hurting their knees.  
This post demonstrates how to perform a double leg squat and a single leg squat with a vertical shin.  A vertical shin helps take the load from the knees and puts the weight back into the posterior chain: hamstrings and glute max.  The single leg squat also engages the gluteus medius, which is important for stabilizing the pelvis.

We have two psoas muscles on each side of our body: psoas major and psoas minor.  This blog is specific to our psoas major.  
This summer I took a very cool tele-class from Liz Koch, of Core Awareness.  In this 5 week series we explored the location and function of the psoas and its relationship to the nervous system and our "fight/flight/freeze" response,  to our emotional well-being and to our skeletal support.
The psoas is centrally located: emerging from the midline at thoracic level 12, attaching to every lumbar vertebra and inserting into the inner thigh at the lesser trochanter.  
The psoas allows the lower limb to move and swing a as a pendulum: multidirectional/orbital.  
As a physical therapist I see many people with SI dysfunction, hip and back pain.  In almost all cases, the psoas is the top priority to rehabilitate.   On muscle testing the psoas is usually weak, and the flexibility test is usually tight.  What I have come to understand through this tele-class, through my training as a Restorative Exercise Specialist™ and as an NKT™ practitioner, is that rather than manipulate the psoas through deep tissue work and stretching, the psoas needs to rehydrate and recover from over-exhaustion.
I have compiled my favorite top 10 ways to release, rehydrate and restore the psoas.  It is helpful to perform a release before going onto the movement sequences.  Some of these are from Liz Koch's book, "The Psoas Book" and some are from the Whole Body Alignment Program.

The inner thigh (adductor group) is made up of five muscles:

1. Pectineus
2. Adductor brevis
3. Adductor longus
4. Adductor magnus
5. Gracilis

When the foot is not planted on the ground, the adductors will bring the leg toward the midline, and flex the hip when the thigh is in an extended position as in the swing phase of the gait (walking) cycle.
The adductors play a significant role during walking and are active in all phases of the gait cycle. The adductors are a part of two important functional kinetic chains:

1. Lateral Sling: comprised of the adductors, same side gluteus medius/minimus, opposite side quadratus lumborum.  This chain is responsible for frontal plane stabilization of the lumbo/pelvic/hip complex during single leg stance (stance phase of gait), squatting and lunging.
2. Anterior Oblique Sling: comprised of the adductors, same side internal oblique, opposite side external oblique and hip external rotators.  This chain is responsible for transverse plane stabilization during trunk rotation in gait, throwing, swinging, twisting activities.

Dysfunction within the slings can result in overuse of the adductor group leading to over facilitation,  increased tension and bound up connective tissue, and potentially pain.  Here is a videoblog demonstrating how to release the adductors using a foam roller.

Tension in the piriformis muscle can trigger irritation of surrounding tissues.  The sciatic nerve exits the pelvis just below the piriformis.  When there is dysfunction in the lumbo/pelvic/hip complex, the piriformis often gets overworked, creating compression and friction on the sciatic nerve.  Sciatica is defined as aching/burning/stinging pain along the distribution of the sciatic nerve: buttock, back of the thigh, lower leg and foot.
Stretching the piriformis can be a very effective way of diminishing the compression, and therefore irritation of the nerve.  Pictured to the left is a very common stretch given as treatment to relieve sciatica.

A traditional piriformis stretch, is often done with a tucked pelvis (and/or flexed spine) and can irritate the nerve if the leg is pulled  too aggressively.  Instead, using the wall and props can be an effective way of maintaining a neutral spine and pelvis. By staying in alignment, and by being able to adjust the load by gradually bending the knee to 90 degrees, the tissues will begin to yield and let go, rather than work to hold the body in position.  
Picture on the left: The half cylinder and block supports my shoulders and head to allow me to rest with a neutral spine, with my ribs down and a level pelvis.  Due to my current tension patterns, I also have to support my lumbar area with a rolled yoga mat so I can comfortably attain neutral pelvis (pubis and ASIS level).  
Middle picture:  I place my left leg straight on the wall and cross my right leg over the left, making sure not to tilt the pelvis. Picture on the right:  I begin to slide my heel down the wall and stop when I feel that I am at my resistance barrier, or my pelvis begins to shift.  Hold at least one minute and repeat on the other side.  If you can tolerate the stretch stay longer, up to 5 minutes on each side.

Some people will try to get a deeper stretch by pressing the right knee down.  Make sure that you don't drag your whole pelvis when you do that (as shown in the pic on the left).  The purpose of this refinement is to maintain neutral, and that means a level pelvis (as shown on the right).   
Even if you don't have sciatica, this is a wonderful stretch to open the hips, and allow more freedom to your pelvis!  Enjoy!

Trigger points in a muscle can be the culprit in many pain disorders.  In this post, I provide a self care technique to assist with these potentially troublesome trigger points. The muscles that can refer pain into the hip area are the tensor fascia lata, iliacus, psoas and sartorious.  If you are interested in learning more about what causes trigger points and how to treat them, I have listed some websites dedicated to trigger points and myofascial pain syndromes at the end of the blog.   Click on the pictures below to enlarge the picture and to link you to triggerpoints.net, an amazing resource for trigger points and referred pain.

Release tension in the psoas,  and the surrounding hip musculature by performing a constructive rest position with a bolster.  Allow yourself to breathe and relax for 5 minutes.  For instructions on how to do this click here.

Perform a release technique utilizing myofascial release balls such as Yoga Tune Up Therapy Balls for Self Massage (that's what I have and I love them),  Melt Method Products, or good old tennis balls.  There are a lot of different ways to get into the muscles.  For this technique you will take two balls held together in a sock or bag.  My finger is pointing to my ASIS on the iliac crest.  Place the balls horizontally just below the ASIS.

You will be working near a tender area due to the superficial exposure of the femoral vein, artery and nerve at the femoral triangle.  If you start to feel tingling and nerve sensations, move to a different area.  Just underneath the vessels and nerve lies the iliopsoas.  The next muscle laterally (to the right in this pic) is the sartorious, and the muscle in red is the tensor fascia lata.  Sandwiched in between the two is one of the quadricep muscles, the rectus femoris.  This will get released as well.

The balls are placed as above on the left side here.  With the right leg you can adjust how much body weight you put down into the balls.  If it is more comfortable, you can prop up onto your elbows.  If you are not able to get down onto the floor, you can place the balls at your hip, and lean into the wall or a door jam. Try to allow your muscles to relax and mold over the balls.  If you find that the balls are too intense to start with, place a folded hand towel over them to disperse the pressure.  If you are holding your breath and tensing your muscles to deal with the pain, this defeats the purpose.  You should be able to feel the sensation and breathe into the area as the muscles release.   Once you feel that the muscle has let go, move the balls into a new area.  Spend 5 minutes on each side.  Enjoy how you feel when you get up to walk.  Feel the freedom in your hips!

Resources:
 http://www.triggerpoints.net/, http://saveyourself.ca/tutorials/trigger-points.php, http://www.myofascialtherapy.org/

Hip mobility is key to the health of the spine.  When we lack the motion at our hip joints, the spine will take up the slack by moving into flexion or extension. Here I am trying to lift my leg backward.  Compare the two pictures.  You can see the increase of the lumbar curve on the left, this is called extension.  This creates compression and degeneration of the tissues and tension in the back muscles. This picture on the right shows my true hip motion without compensating by getting more motion through my spine.

Now, here I am lying on my back with my knees bent.  On the pic on the top, the dots demonstrate having a level pelvis.  As I bring my knee toward my chest, I moved past my actual motion at my hip joint and my pelvis tilts posterior or toward the floor.  This action creates flexion at my spine and places more stress on the lumbar discs making me more susceptible to a disc herniation or degeneration.

Restore mobility to your hips, and save your spine from wear and tear from all that extra motion! Below are 10 of my favorite Restorative Exercises™ to free up the hips and the spine!  Unless stated otherwise, hold the stretch for one minute each side.