Have to lift your leg into the car

‘I have to lift my leg into the car”.  This is pretty common and we see it most weeks.

Ben Tolson, one of our acupuncturists and a Sports and Deep Tissue Massage therapists was tackling one of these recently.  We’ve had a good discussion about it over coffee in the clinic.  Hence this blog.

We came to the conclusion that the classic and often misdiagnosed problem here is low-grade mechanical back pain as a result of a twisted pelvis.

Why should this hurt and so stop you lifting your leg?  Well, the answer here is in your anatomy.  The main muscle that you use to lift your leg is the iliopsoas muscle.  This muscle originates along the edges of all the vertebrae in your lumbar spine and inserts on the top of your femur.  You use it to bend at the hip and so lift your leg into the car.  The muscle has to contract in order to pull the femur bone closer to the body but hinged at the hip.  An unfortunate side effect of this is that it also causes all the vertebral bodies in the lumbar spine to be compressed.  This compression will hurt your low-back.iliopoas-hip-flexor

The world guru on this is a bloke called Professor Stuart McGill.  He writes in his book that the compression caused by carrying out the traditional sit-up “..imposes approximately 3300 N (730 lbs) of compression on the spine”.  He adds that a bent leg raise – so, the action you do to get into your car, imposes 1767 N of compression.  If your low-back is irritated, then this compression will cause your low-back joints to howl.  Your brain will then prevent you from even carrying out the move.  You will not want to lift your leg in and out of the car.  What you are doing to prevent this compression is not using this muscle but lifting your leg in and out by hand.  You will have to lift your leg into the car.

Prof McGill adds that the National Institute of Occupational Safety and Health set the limit for low-back compression in workers at 3300 N.  So, it certainly makes sense to never do a sit-up again.  And now you know why your low-back hurts.  You also know why you have to lift it in and out of the car (and I bet it is pain free when you do this as your iliopsoas muscle is not being used at all).

Watch out

However, there are a few other nasty reasons you can’t lift your leg.  However, these are very rare and pretty easy to diagnose once you know what you are thinking about.  They are:

  • You can injure the iliopsoas muscle and cause it to calcify right at the muscle to tendon junction and as it passes over the pelvic rim this will sting.
  • A tear in the cartilaginous edge of the hip – a labral tear but this should be pretty obvious if checked correctly.
  • You can have a Sartorius muscle injury or a groin strain, and, again, this should be pretty easy to diagnose if you think about it first.
  • Arthritic changes can also cause the same problem but you should know about these.


39 thoughts on “Have to lift your leg into the car

  1. Peter, you’ll have to give me more information than that – that’s a bit thin on detail!

  2. This summer I had severe nerve pain that ran down the outside of my thigh, around the front of my leg and under my knee cap. From my knee to my ankle the front side of my leg was numb. After PT, traction and a ton of meds I am functioning again. The only thing I notice is the pain in my left leg getting in and out of the car. I push through getting my leg in or actually lift it in. I’m not sure if any of this is related. What can I do to alleviate this pain?

  3. ok so let me give a quick run down. i havent had sex in 5yrs and i got back at is 5 days ago (only once sunday) but thursday morning the right side of my hip started when i woke up and got worse through out the day and over night and now today it was very hard to get dress and out on shoes. and i had to lift my leg to get in the car. i have been limping for about 24hrs

  4. My upper right thigh is very painful when rotating in inward and outward, trying to lift it from a sitting or laying situation. Lifting it to get into car, my lower back hurts. This started shortley after I pulled weeds 4 hrs a day for 2 days sitting on a garden stool. Had mri, found fluid in the hip, had it drained and then a cortisone shot in hip. Also had xray on hip. Uncomfortably feeling in my abdomen also. Was very active prior to this but feeling weak painful and depressed.

  5. Veronica, when you say the right side of your hip do you mean under where you put your hand when they go in your hip pockets on a pair of jeans? I’m not sure the one event you mentioned is linked to the other but it is more likely to have happened at the about the same time.

  6. Amy, I am assuming the original problem was in the right leg and it is the left that is painful when getting in and out of the car. Have a look online at a way to stretch your Iliopsoas muscle – as well as everything else they are asking you to do. It is the main muscle for lifting your leg and is easily overlooked. It can be very painful and will lead to hip pain and weakness, or better described as reluctance to use the muscle.

  7. I can’t lay on my side and lift my leg no mater how hard I try. I also can not lift my leg to get in my car. I can not put weight on that leg as I climb stairs either. This hip pops horribly if Iie on my back and raise my knee up towards my chest. The popping happens as I put my leg back down.

  8. I think I may have hip flexor pain because it hurts when I lean my weight on my right leg. And when I get in my car I have to face outward and put my leg in (heal first, sort of like kicking back) then turn around to sit right. It also hurts when I walk for a long period of time. And sometimes I even feel a burning like feeling in my hip area. What can I do to get rid of this pain? I never had an injury so I don’t even know how it happened… will it ever go away???

  9. Hi i damaged my back about 6 years ago just by turning on the sofa and heard a crack , i was in terrible pain as couldnt move and doctor just told me to keep moving about and gave me some pain killers , it took 4 months for me to be able to sit down properly. then 10 months later it went again same thing, same amount of time to recover. i had just lost my job at the time so couldnt afford a scan as my doctor wouldnt give me one. Now five years later i am struggling to even lift my thighs up to walk upstairs, my whole waist area and thighs feei like they are made of concrete and its the same every day nochange but getting worse,, people have been asking why i walk funny and when i go to bed all i can do is lay on my front as get pain when on side and back . When i get in the car i have to sit side on and then swivel round lif ing my legs into the car which hurts.My back goes into spasm a few times wacj month where everything shifts to one side My doctor gave me an xray but wouldnt give me a scan in september but just said i will need a new right hip eventually and just told me to stretch . which i just cant and Im totally disillusioned with my doctor as this now as its disabling me as i have always been v sporty and i cant do anything. Would a scan show up my discs more than an xray as im sure its disc problem as my hamstrings i have full movement . any information on what i could would be so appreciated, thank you so much hope you dont mind me asking

    Best wishes
    Mr S harris

  10. I slipped and jolted my back 2 weeks ago,I was in a lot of pain lower back,struggled to walk,sit,move etc,but carried on over Xmas. It got a lot better,then I feel over!! The pain now is more my hip(top of thigh near groin). I cannot lift leg propley. I need to drag it out of bath,and lift it in car.Putting underwear on is hard!!

  11. I’m 48 and 4 months post op total right hip replacement.
    I can do all movements, just a bit weak, but experience severe pain when I raise my knee?
    So cannot climb stairs singularly, experience pain getting in and out of the car as you described….lift my leg in, then no pain. Can’t raise my leg to put underwear or trousers on.
    Have raised it with my physio. She said she hasn’t come across it.
    I don’t know whether I need to have massage treatment on it, to continue with gym and swimming as physio advised, because it’s realy not improving?

  12. I am having the same pain. I get in and out of cars all day and now I have stabbing pain in my lower back and hip. I can’t lift my left leg and when I knee I have to use my right knee to get up. I had an mri done two weeks ago. It said L1 and L2 are bulging. Acute lower back pain. Back muscle spams and bulging lumber disc. I didn’t have this issue two weeks ago with my leg not lifting or my hip pain. I can’t twist my foot/leg/hip with out stabbing pain. I’m just lost on what to do. I am only 30.

  13. Kay, you say you can’t lift your leg – is that because it’s painful or just unable to move? The clicking/popping is nearly always the Glut Med or Glut Min muscles getting stuck and then being released from round some bone edge, so like happens in people’s knees. Have you had a chiro or perhaps even more useful right now a sports injury therapist have a look at it?

  14. Olivia, that sounds pretty grim. The powerful muscle (iliopsoas – google it!) that lifts your leg attaches to your lumbar spine and so trying to lift a leg can cause a load of compression in your low back. So, for you it will squeeze your discs and you already have a problem in this area, and cause more problems. Startlingly, disc problems are a younger persons problem as you need to have well filled discs for them to bulge. As you grow older (45+) your discs start to dry out and flatten to a certain extent and it is harder, but not impossible. to bulge a disc. The good news about your current problem is that you WILL get better. yes, it will seem like a long time and a struggle but you will be fine in due course particularly if you learn form this episode and become a black-belt in core stability. Don’t panic, go and see a chiropractor and you’ll get there.

  15. Jackie, I’d get to a sports massage therapist as well and have them have a look at your hip heights and your hip flexors to make sure they are as happy as they can possibly be as it sounds that these are really struggling and possibly not having to love they deserve!

  16. The pain in the top of your thigh is exactly the sort of pain a hip flexor problem would deliver. If you injure the joints of your low-back you will almost inevitably irritate the long psoas muscle that is one of these and your main leg lifter. You’ll not be able to use it well until after the low-back has fully recovered as doing so will really hurt those joints. Clearly, if things continue then go and see your doctor.

  17. Hmmm, nasty one. I would suggest that this is a job for a great chiropractor who lives near you – so google them, as this sounds really complex and really nasty. I think MRIs are valuable but only if they change the way you would be treated and I suspect that’s how your doctor might be thinking: “how would this MRI change the way I’m treating this patient?” If the answer is not at all, which I suspect is what the answer will be, then they are really unlikely to push for it. What you need is a fresh pair of eyes to look this problem and see if there is a better answer – and I bet there is.

  18. I was exercising and did spread legs and drop to floor slowly. I couldn’t walk for 3 months. Finally and slowly it return to normal. I could walk with walker. So Iam feeling normal and go to a amusement park and miss the seat because it was dark. Now I can’t lift both of my legs. I don’t know what muscle I hurt Frist time I sure don’t know what I hurt this time. I need help to get to bathroom and sleep sitting up. My ankles are swollen. I do know I can’t lift legs. I missed bench and fell on cement floor right side of buttocks. I instantly couldn’t stand are walk. Please help.

  19. Pam, that sounds terrible. Firstly, go to your GP and if given the all-clear then to your nearest chiropractor or osteopath and get them to have a look. What you MAY have done is twisted your pelvis out of alignment as doing the spread legs thing is a terrible thing to do to a pelvis (have a read here: http://c1healthcentre.co.uk/leg-length-inequality-or-leg-length-discrepancy-causes/). Try to find a chiropractor who has an x-ray machine and get a pelvic series done – this’ll tell you if you have dragged your pelvis out of alignment. How old are you?

  20. 65 years young I also have a sprain ankle. After the fact right leg has swelling to the point it’s black and blue in weird places not where injury I feel more like it’s a muscle that moves both legs. Insurance is also a issue.

  21. I know I have a nerve on bone at S1, for over a year. I was getting into car a month ago and had really bad pain behind knee, as I bent to get leg in car. Pain has come and gone a few times, but now I’m in a lot of pain. Pain is behind knee. In calf and outside of knee. Is this the same thing?

  22. I have the same problem as Liz. It is like my leg just stopped working. I have to lift my right leg backwards to get in the car. The pain is excruciating!

  23. Hi, I was a male dancer in the NYC Ballet company, I am in my 50 now . I have been having hip pain on and off for a very long time . I am now at a point where I can’t even lift my leg to get my pants on. I have had a back MRI and a nerve induction test both which show nothing really wrong. I have a lot of pain in the front area of my hip just below the bone. The spot where your pockets would be on your jeans. Pain radiates down the inside and sometimes the outside. I believe I also may have troubles with the pisiformis muscle as I turned out for so many years. I am feeling like no one will be able to help me. I also get a shooting pain sometimes when I stand on my leg. I have seen a chiropractor and a physical therapist and I do get some relief but it is only temporary and it comes back as soon as a walk more than 1/2 mile aka around the supermarket or mall. I would love if you could tell me what I can do to fix this. Have no quality of life at this point. Always in pain.

  24. David, this sounds grim. MRIs are great for showing up the condition of the bones, joints and the cartilage and if nothing too terrible is happening then that is really good. One thing that you should really be sure about is that your pelvis is level. Have a look at this and other articles on this we have: http://c1healthcentre.co.uk/leg-length-inequality-or-leg-length-discrepancy-causes/. Pain under where you put your hands into your pockets in nearly always to do with your Gluteal medius and minimus muscles – and nearly invariably so. These are always in trouble if you have a leg length inequality or discrepancy. If you treat the muscles with deep tissue massage the pain will go but unless the underlying cause is treated it will always return. You need to get a wise chiropractor to check which is really easy if they know what they are looking for. Finally, as a dancer the sort of injury that leads to pelvic twisting and associated leg length inequality is really common.

  25. Una, the S1 nerve innervates the areas you are describing so it may be a referred pain form the nerve compression. A good way to separate out referred pain from real structural pain is to prod the area. If it is a problem with the structures what should happen is you should feel the pain – like prodding a bruise should feel painful, however, if it is a referred pain caused by a structure located away from the pain then nothing (much) should happen. Give it a go and let me know.

  26. Pam, this one sounds like you need to visit a doctor I’m afraid. I’m sorry but I don’t know much about insurance issues as that is not a problem in the UK, as it’s free at the point on need.

  27. Last week one I stood up after having had dinner I had a pain in my right groin. I didn’t think more of it. As it appeared over an hour sitting on a chair, I assumed it would go away quickly too.
    One week on I can not lift my right leg up in a 90 degree angle due the pain. Even when I try to force myself to lift my leg and ignore the pain, it’s like my leg just can move any more.
    I now have to lift my leg with my hand when I need to move it towards any position near a 90 degree angle!
    Does anyone have an idea what I should do? Ignore it and keep pushing regardless of the pain or rest?
    I’m really a bit puzzled as it happened within an hour or maximum two just sitting down at a restaurant having dinner. I have not over exercised it or pulled it.
    Please let me know your thoughts on this.

  28. Bertha, I don’t want to sound too prying but how old are you? Also, does the shape of your hip look altered in any way? Does it hurt when it is you lifting your leg by hand – if not then it is probably going to be a muscular problem (if you lift your leg by hand your hip joint has to do that same range of motion, your ligaments control the movement in the same way but you’ve taken out of the equation your muscles).

  29. for over a year I have not been able to lift leg up into car without extreme pain in and around groin . had sort of tripped over cat and did not fall but went to doctor with groin pain . he said was nasty groin strain . went to physio but she just pulled hard on leg and felt worse after . went to oesteopath for few months but now hurts to much in hips and knees and ankles to drive car . was going to hydro therapy pool at least twice a week . feels good in pool and good range of movement . but pain back as soon as get out . have to half drag myself up my back steps . can’t get up out chair . only can lie on back in bed . I use a cane for support to walk . am 52 but hate life of chronic pain . take paracetamol . codeine and naproxen .

  30. Sharon, this is madness – no one should be living like this. Has someone had a look at your hip heights? If not or you can’t remember then I’d phone round your local chiropractor or osteopaths and ask them what they know about leg-length inequality and pelvic twisting. They won’t like it as they don’t like being told what’s up but, as you case shows, these are really badly diagnosed and treated. If they say they do understand this sort of thing then ask them if they are able to manipulate your pelvis. If they say yes then go and see them 6 times and each time they should ‘clunk’your pelvis around. At the end of the 6th session see how you feel. If it feels better, even marginally, then you are on the right track and keep following their guidance.

    Has anyone done an MRI as yet?

  31. I have had thigh pain for about 8 weeks hoping it was muscular and would gradually improve.Have not seen my GP yet.It is problematic getting into drivers seat as it is my left leg.I have to lift my leg to use the clutch which is unsafe.Any advice would be appreciated.Thank you

  32. Hmm, Jan, is your thigh weak and unable to lift itself or is it painful and you are not wanting to lift it? Either way, I’d get this one to the GP. It’s being going on too long.

  33. Thank you.My thigh is painful ,and I have to lift it because it is very difficult otherwise.Am seeing GP tomorrow.

  34. Jan, let me know what they say – and remember “it’s the squeaky wheel that gets the oil” when you are talking to your GP!

  35. Hello! So my leg hurts when I get into the car and start running but once I warm up it doesn’t hurt anymore… it hurts to walk more than to run… why?

  36. Ana, sorry, before we can be helpful here can you give us some more information needed for this one! Which leg and is it only one? Where does it hurt? Does it hurt immediately you have got into the car?

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