# If You Have Hip and Back Pain, Start With THIS Source: https://www.youtube.com/watch?v=zhNU3FnFMTA Recap page: https://rapidrecap.app/video/zhNU3FnFMTA Generated: 2026-01-29T22:33:37.141+00:00 --- ## Quick Overview For combined hip and back pain, especially in a tall individual post-hip replacement, the primary recommendation is to immediately start strengthening the core (abs) first, followed by the glutes, as stronger core muscles help control the spine and support the hips, preventing the back issues from interfering with hip treatment progression. **Key Points:** - For combined hip and back pain, prioritize strengthening the core (abs) first, followed by the glutes, to stabilize the spine and support the hip. - The caller, Sharon, is 58 years old, menopausal, 9 months post-total hip replacement on her right hip, and also has L1 through L5 herniations/bulging discs causing back pain. - As a tall person (6'4"), the caller experiences issues where chairs and seating do not provide proper back support, leading to difficulty sitting straight up. - The caller inadvertently triggered sciatica pain by overusing a massage gun on her glutes, highlighting the need for careful technique. - Dr. David suggests a 70/30 split in exercise focus: 70% on lower abs and 30% on glutes initially, ensuring the back pain does not halt hip recovery. - The caller mentioned that her father was a first-round draft pick for the Knicks, indicating a tall family history, which influences body mechanics. ![Screenshot at 00:00: The title card asks the central question: "I have back and hip pain where do I start first?", setting the stage for Dr. David's consultation.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-00-00.jpg) **Context:** The video features Dr. David answering a live phone call from a viewer named Sharon who is experiencing simultaneous hip and back pain. Sharon is 58, menopausal, and 9 months post-total hip replacement on her right side, while also dealing with diagnosed L1-L5 spinal issues (herniation and bulging). She is seeking advice on where to begin her treatment protocol since she understands that the hip and back are connected, and she does not want to isolate the hip treatment while neglecting the back. ## Detailed Analysis Dr. David advises Sharon, who has complex hip (post-op osteoarthritis) and back issues (L1-L5 herniations), to start treatment by focusing on her core, specifically the lower abdominals, first. He recommends working on the abs (70% focus) before the glutes (30% focus) because strong abdominal muscles help control the spine, which is crucial for preventing the back issues from negatively affecting the hip recovery. This approach addresses the interconnected nature of her pain, as she noted that standard seating often fails to support her back adequately due to her height (6'4"). Sharon also shared an anecdote about inadvertently causing sciatica pain by overusing a massage gun on her glutes, having previously found great relief from those exercises before the flare-up. Dr. David emphasizes that both abs and glutes must be worked, but the core stability (abs) should lead to ensure stability is built before aggressively training the glutes, which in turn support the hip. ### Patient Profile & Complaint - 58-year-old, menopausal, 9 months post-right total hip replacement, L1-L5 herniations/bulging, experiencing simultaneous back and hip pain - Primary question: Where to start treatment when everything is connected? ### Initial Treatment Priority - Start with working on the abs first (core stabilization) to control the spine, which sets up the glutes for better performance later - Recommended Ratio: Focus 70% on lower abs and 30% on glutes initially. ### Patient History/Context - Caller is 6'4" and struggles with proper seating support; previously overused a massage gun, which triggered sciatica pain, leading to hesitation. ### Concluding Advice & Feedback - Continue working both muscle groups simultaneously, but maintain the core focus to prevent back problems from halting hip progress; caller expresses gratitude for Dr. David's accessible help via YouTube. ![Screenshot at 00:17: Dr. David summarizing the patient's conditions: 58 years old, menopausal, diagnosed with osteoarthritis in the hip, 9 months post-op total hip replacement on the right hip, and L1-L5 herniations/bulging.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-00-17.jpg) ![Screenshot at 01:34: Dr. David gestures to his midsection while advising the caller to start by working on the abs first, as they help control the spine.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-01-34.jpg) ![Screenshot at 01:55: Dr. David explains that because the caller is tall \(6'4"\), they tend to have longer torsos relative to their legs, making core strength critical.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-01-55.jpg) ![Screenshot at 03:37: Dr. David suggests a 70/30 split for exercises: 70% on abs and 30% on glutes initially to stabilize the spine while treating the hip.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-03-37.jpg) ![Screenshot at 04:35: The caller laughs while recounting how she overused a massage gun on her glutes, which subsequently triggered sciatica pain the next day.](https://ss.rapidrecap.app/screens/zhNU3FnFMTA/00-04-35.jpg)