Do your hip flexors always feel “tight”?
Have you been performing the same hip flexor stretches every day without any improvement?
Although the stretches may feel like they are working and are releasing some of the tension, in many cases of hip flexor tightness, the issue is often due to the hip flexors being overworked as a spinal stabilizer. Therefore, it is perceived they are tight because you are in an anterior pelvic tilt position (Figure 1), your core isn’t able to stabilize the spine, thus, the main hip flexor (Psoas) overworks to take up the slack. With that said, in order to ensure that there is not a fundamental shortness in the tissue or some other neurological driver causing the “tightness”, it is recommended to first visit one of our Ace Certified Practitioners (Physiotherapist, Osteopath, Chiropractor) to assess the hip joint and the surrounding tissues and obtain an accurate diagnosis and plan.
Our Psoas muscle (main hip flexor) attaches to the femur with several other parts up the chain, eventually connecting to the lumbar spine and diaphragm. As seen in Figure 1, the psoas flexes our femur, tips our pelvis forward (Anterior Pelvic Tilt) and can externally rotate our femur (turn the femur out), which are all important functions during walking.
Figure 1. Anterior Pelvic Tilt caused by hip flexors tipping pelvis forward and erector spinae (back muscles) pulling up
When you tip your pelvis forward (Refer to Figure 1), the psoas becomes short, and in order to maintain some semblance of stability, it pulls the lumbar spine forward into extension. This in effect causes our abdominals and deep spinal stabilizers to be weak and elongated, and the Psoas now has to pick up the extra work to stabilize the spine so that we can stay upright.
So, why does this matter?
Well, by performing all of those hip flexor stretches, you are attempting to lengthen a muscle that seems to be the only thing stabilizing your spine! This can lead to back pain, anterior hip pain, knee pain, and other possible pathologies like facet joint sprains.
However, if the muscle is not tight, then why do you feel like you need to stretch the hip flexor all of the time? You may feel tightness in the front of the hip, especially when extending your leg because you’re lengthening a muscle that is stabilizing the spine and this action causes the psoas to contract as a protective strategy in order to prevent you from stretching the muscle further, and possibly to the breaking point. Think of the muscle as an elastic band; what is happening is like pulling an elastic band as much as possible, and then trying to pull it even more. Eventually the band will reach a point where it can’t be pulled any further without breaking.
The question now becomes, if I am not supposed to stretch, then what should I do?
Firstly, we need to restore the optimal position of the pelvis in more of a posterior tilt (belt buckle to the ceiling), which flattens out our lower back, and exhale through the mouth to drop the rib cage towards the pelvis. This posterior tilt and rib cage position will now give the abs and deep core muscles leverage so that they can stabilize the spine and restore the psoas to its optimal position.
After restoring the position of the pelvis and restoring the optimal length of the psoas, we also need to strengthen it as it has been overworked and we want the body to remember this position so it does not default to the anterior pelvic tilt which can jam up our back joints.
With all of this in mind, give these three exercises a try instead of making stretching your go-to:
1. 90/90 Hip lift (2-3 sets of 4-5 full breaths):
• Lay on your back and place feet on bench/wall/chair with hips and knees bent at 90 degrees
• Place Foam roller/rolled up towel between your knees and squeeze
• Inhale through your nose
• Exhale through mouth, press lower back into ground, drive heels into bench and tilt pelvis while maintaining the lower back on the ground
• Hold this position for 4-5 breaths trying to go further and further without compromising position
2. Deadbug with reach (2-3 sets of 6-8 reps on each side):
• Lay on back, arms reaching up with knees and hips bent at 90 degrees
• Reach long through the arms towards the ceiling
• Before you move any limbs, exhale to bring the ribs down and press your lower back into the floor maintaining this position the whole time
• Inhale through the nose without losing back position
• Extend your leg then exhale through the mouth, letting all the air out of your lungs
• Front plank (2-3 sets of 8-10 full breaths):
• Start on elbows and knees, extend legs back, knees straight (can perform this on your knees)
• Make sure palms are on the ground, and reach through your forearms, slightly rounding the upper back
• Tuck the pelvis (belt buckle to ceiling) as much as you can while keeping abs tight
• While maintaining the previous position, as you exhale try to reach longer through your forearms (push ground away and fill upper back) each time
To learn more about your body and understand the right exercises for you, call us today at Ace Sports Clinic where we offer proven solutions for pain, injury and performance.
We can tailor a program for you to lengthen and strengthen your hip flexors which can help banish back pain and develop your core.
www.theptdc.com/2014/06/5-steps-dealing-anterior-pelvic-tilt/. Figure 1 Diagram of Pelvic Tilt