Hips and Shoulders: How They Connect Through the Trunk
The hips and shoulders feel far apart, but they are linked through the trunk. Abdominal muscles, back muscles and a broad sheet of connective tissue called the thoracolumbar fascia connect the pelvis and spine to the arms and legs. The anatomy is well described. What it means for training, injury prevention and treatment is less settled, so this article separates what is established from what is still a good idea waiting for proof.
The trunk as the link
The thoracolumbar fascia is a multi-layered sheet of connective tissue in the lower back. It wraps the muscles beside the spine and blends with the tendons of several larger muscles. The latissimus dorsi, a big back muscle that moves the arm, forms part of its surface layer, and the fascia of the gluteus maximus, the main hip extensor, connects with it too. Anatomists describe this as a path for transferring load between the trunk and the legs.
The deeper abdominal muscles, the transversus abdominis and internal obliques, also attach into this fascia through a shared tendon. In a laboratory study on donated tissue, tensioning that tendon while the muscles beside the spine were pressurised increased tension mainly in the posterior layer of the fascia. The researchers suggested this could help the spine brace itself. It is an experimental model of one mechanism, not a measurement of what happens in a moving athlete.
Hip to shoulder: what is solid and what is not
Dissection studies show fairly consistent connections along the back functional line, which runs from the latissimus dorsi through the thoracolumbar fascia to the opposite gluteus maximus. A systematic review rated the anatomical evidence for this line as strong, but also stated that testing its functional relevance is the most urgent task for future research. A separate review found moderate evidence that force can pass along these chains, while noting that the functional significance is still unclear. One small experiment in healthy volunteers suggests that tensing the latissimus dorsi can change the passive properties of the hip and lower back, which is interesting but preliminary.
There is also healthy scepticism in the literature. One critical review concluded that the idea that deep abdominal tension through the fascia generates a meaningful extension force on the spine, or that one abdominal muscle always switches on first, is not well supported by experiments. So “the hips and shoulders are connected by fascia” is true as anatomy. “Training or releasing that connection will fix your shoulder or back” is not yet shown.
In football
Running is a cross-body movement: the right arm swings with the left leg while the trunk rotates between them. A recent systematic review of sprint mechanics found prospective evidence linking greater gluteus maximus and trunk muscle activation during sprinting with fewer hamstring injuries. That is an association worth knowing about, though it does not prove that a specific exercise changes injury rates.
Kicking, jumping and challenging for the ball also start in the legs and pass force through the pelvis and trunk. The strongest research on the “kinetic chain” idea comes from overhead athletes such as throwers and tennis players rather than footballers. In those groups, reduced hip strength or range of motion has been linked with shoulder problems, and a meta-analysis found that shoulder pain was associated with low back pain and with hip pain, although the certainty of that evidence was very low to low. For footballers, the clearest relevance is probably for goalkeepers and throw-ins, but this is an extrapolation rather than something football-specific studies have confirmed.
Everyday movement
Carrying shopping, lifting a child, reaching onto a shelf or pushing open a heavy door all need the legs, trunk and arm to cooperate. If the hip cannot rotate or extend easily, or the trunk cannot stay steady, the shoulder or lower back may be asked to do more. This is a plausible explanation for some people’s aches and a useful starting point for movement assessment, but it is a hypothesis for the individual, not a proven rule.
Practical exercises to try
These are general movement ideas for healthy adults. Move slowly, breathe normally and stop if pain is sharp or worsens. Two to three sets of 6–10 controlled repetitions per side is a sensible starting range.
Dead bug. Lie on your back with arms and knees up. Slowly lower the opposite arm and leg while keeping the lower back still.
Pallof press. Stand sideways to a resistance band and press it straight out, resisting the pull to rotate. This trains the trunk and hips to control rotation while the shoulders stay stable.
Staggered-stance band row. Stand with one foot forward, anchor a band ahead of you and row with the arm opposite the front leg. Keep the hips steady and feel the back leg’s glute working.
Side plank with top-leg lift. Support yourself on one forearm and lift the top leg a few centimetres. This challenges the side trunk, hip and shoulder together. Use a bent-knee version first if needed.
Suitcase carry. Walk slowly holding a weight in one hand, keeping the trunk upright and the ribs stacked over the pelvis.
A sensible conclusion is to train the hips, trunk and shoulders as a connected system, use strength and control exercises that suit your sport, and avoid any claim that one muscle, fascial layer or technique is the single key.
Safety Notes: When to Seek Help
Shoulder, neck or upper back pain that comes with chest pain, breathlessness, sweating, or pain spreading to the jaw or left arm needs urgent medical help. Do not treat it with exercise or manual therapy.
Seek medical assessment before continuing if you have:
sudden shoulder weakness, a visible deformity, or pain after a fall or collision
a history of shoulder dislocation or a joint that feels like it may slip out
numbness, tingling or weakness in an arm or leg
back pain with fever, unexplained weight loss, pain that is worse at night, or any change in bladder or bowel control
Avoid holding your breath or bracing hard during exercises if you have high blood pressure or a heart condition, and check with your doctor first. If you are pregnant or postpartum, recently had abdominal surgery, or have a hernia or separation of the abdominal muscles, get individual guidance before doing core exercises. Fascia and “release” techniques should not be used over injured, bruised, numb or swollen areas. The exercises above are general examples, not a substitute for individual assessment.
When to take action
At Webster Body Therapy in Hovås, Gothenburg, we look at how the hips, trunk and shoulders work together and combine hands-on treatment with practical movement guidance. If you have shoulder or back niggles, play football or other sports, or feel that one side of your body always compensates, contact Webster Body Therapy to book an individual movement assessment and discuss what makes sense for your body and goals.
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