Some Reasons Why You Should Stop Stretching Your Hip Flexors

 

If you were to overhear the odd conversation between people who were involved in any type of physical activity, you would probably hear some commonalities:

“I’m doing intermittent fasting.” “Really? I’m going paleo.”

 

“My trainer has me on this really hard workout he got from JillianMichaels.com. It’s gotta work since it’s so hard.”

 

“My shoulders been hurting for the past few years, but I think I could probably train through it and it will go away on its’ own.”

“I wanna run faster, so I’m going to double my mileage this week.”

Along with these little snippets of people who just don’t get it is the odd dozen few people who complain of chronically tight hip flexors that no matter how often they stretch them just don’t seem to loosen up.

Now maybe the thought process of doing the same thing over and over again and somehow getting a different response may seem like a good idea to some, whereas others may think they just need to “spend more time” stretching that tight and unforgiving muscle to make some headway, the simple fact of the matter is that if it’s not working, it’s probably not the right solution.

Let’s look at the hip flexor itself. The main components come down to the illiopsoas (the illiacus and psoas muscles), the sartorius, and the rectus femoris. The illiacus attaches on the upper portion of the femur and begins on the inside crest of the illium (inside of the pelvis), where the psoas attaches all the way through the transverse processes of the lumbar spine, even binding into the discs directly. The rectus femoris begins at the base of the anterior superior illiac spine, and attaches all the way down to the knee cap, whereas the sartorius starts in the same place as the rectus femoris, but attaches on the medial aspect of the knee, blending with the MCL and portions of the hamstrings.

When these muscles contract together without the use of the floor, we see hip flexion as in the case of a hanging leg raise. When we see the muscles contract while the feet are contacting the ground, we see a variation of hip flexion known as an anterior pelvic tilt, or buddy rockin a serious hard ghetto booty.

One of the more forgotten affects of the illiopsoas is as a component of spinal stabilization. Seeing as how the psoas attaches all the way along the lumbar spine, providing compression and stabilization against uncontrolled spinal flexion, lateral flexion, and shear. It’s kind of a big deal like that.

Interestingly enough, the psoas also has tremendously important fascial networks, such as the medial acrurate ligament essentially being a continuation directly to the diaphragm. It’s lower fibers directly attach to the pelvic floor. Here’s another reason why breathing patterns can affect everything.

Panjabi showed in Therapeutic Exercise for Spinal Segmental Stabilization that when the transverse abdominis isn’t working well after a low back injury, the psoas kicks up hard to cover the difference. This simple feat shows how much of a role the psoas plays in spinal stability.

So for people who have chronically tight hip flexors, is it a simple act of stretching the muscles that’s going to solve the problem, or is it the fact that they’re pulling double duty for an unstable spine and under developed core that’s causing them to be tight in the first place? Another way to look at it, if you stretched a short and tight muscle and it regained length, it shouldn’t get tight again, should it? Whereas if the muscle wasn’t technically “tight” but rather holding excessive tone in order to keep your spine from looking more like a losing game of Jenga, stretching it will just give more opportunity for low back pain, and quickly lead to the muscle tensing up again to defend the spine.

So is the hip flexor tight because it’s short or because it’s responding to a weak core? Simply put, it’s typically a core dysfunction, but then the fun begins. The core is weak, but it’s not simply an inability to do crunches and stuff like that. It’s the ability of the spine to maintain a stable and powerful foundation in a neutral pelvic position, and with fantastically awesome glute activationto drive the body forward.

One way to effectively “stretch” the hip flexors is to get the pelvis back to neutral, potentially even into a posterior tilt, while firing the living hell out of your glutes. I’m not simply talking about maximal voluntary contraction. I’m talking cracking walnuts with your cheeks. Making a tonne of coal turn into three carats worth of diamonds, that kind of pressure.

We can do this in a half kneeling position with a postural isometric hold….

…or to help someone hate their entire existence it could be through a rear foot elevated split squat focusing on vertical spine and pelvic tilt.

These tend to make people unable to walk for a few minutes after completing them, especially when they get into the right position where those hip flexor muscles (specifically the rectus femoris) become super tensioned and stretched to their limits under load.

If stretching these suckers out doesn’t produce the desired “stretching” of the hip flexors, we can work on getting the core stiff and stable to resist the need of the iliopsoas to contract to give more spinal stabilization.

We can plank the hell out of that sucker as long as we keep a neutral pelvis and spinal position.

THis is a long shot different from the typical plank you see in most facilities where you see a combination a Christina Milian music video and a cry for help.

In addition to planks, performing “anti” core exercises, which work on resisting external forces that are trying to push you through extension, flexion or rotation. I wrote about it in a T-Nation article HERE, so check it out for more info.

Following the core strengthening, working on glute activation through various hip extension movements is the big finale. For one, the glutes main function of hip extension is an agonist to the hip flexors, and are also directly involved in low back stability, which means they help to pick up the slack for the core during movements, and helps reduce the impulse on the psoas, therefore reducing the “tightness.”

Glute activation to combat hip flexor stiffness is best with full range hip extension exercises like deadlifts and hip bridges. Preferably with copiously mind-numbing amounts of weight that make loud noises when set to the floor so everyone can see as well as hear how awesome you are.

To learn more about core function and how to train hips, spine and shoulders to work together and recover from injuries faster and more dieseled out than anyone ever, check out Post Rehab Essentials. This 12 hour video series talks about everything you need to help build a bulletproof body following any kind of overuse injury. Get your copy today.

Till next time, stay classy.

  • http://www.corerunning.com/ Curb Ivanic

    Great info Dean. I also find another useful exercise is performing SL standing hip flexion while maintaining neutral spine. ROM may be limited initially but eventually the client’s body will figure it out. You can eventually add resistance via cables or bands.

  • http://www.facebook.com/mariliacoutinho Marilia Coutinho

    Your texts are the most entertaining informative material I’ve read. Or the most informative entertaining material I’ve read. Serious, Dean: it’s such good read. Now to the subject. While the argument is sound and solid, there might be other reasons for stretching hip extensors. I tried to collect whatever I found on both joint and muscle response to stretching at pubmed – there’s some, not many, not that hot. None that address one issue that particularly bothers me (and a few other athletes): after too many years of athletic activity (with little pre-hab), one tends to accumulate injuries. I have – too many. Today I’m a powerlifter, but I’ve been a fencer, many years ago. I’m right handed. So my left hip flexors are a bitch. If I neglect stretching the area, sooner or later I end up at the hospital with a psoas tear, usually after a deadlift lockout. We haven’t done an MRI there yet and I’m not sure I will. If I do my homework and stretch regularly, I’m ok. I mean, it doesn’t tear. 

  • Michael Ward

    Dude, have you been reading my training journal? I’m a marathon running, paleo intermittent faster doing Jillians kettlebells workouts!! Not sure why my shoulder hurts though…

    But seriously, I have fallen into the trap (??) of stretching my hip flexors alot. I have been using Kelly Starretts technique of adding a band around my glute while in a half kneeling RF stretch. The thing is, I have noticed that my right Rec Fem goes numb just above the knee if I hold that stretch for longer than about a minute. In fact, it may be going numb just from a lower body workout. Any ideas why?

    Thanks
    Mike

  • Jason Sweas

     You could be overstretching your femoral nerve.  Check it out in an anatomy book.  If anything goes numb, back off that stretch right away!

  • http://jasonsweas.wordpress.com/ Jason Sweas, PT, DPT

    Dean -  nice post. 
    I’ve been to a couple of Physical Therapy continuing education classes taught by Mark Comerford, who provides evidence for psoas and iliacus having pretty different functions.  Psoas can provide compression of the femur into the acetabulum, but very minimal hip flexion.  It’s primary role is posterior pelvic tilt (via fascial connection with the inguinal ligament and anterior pelvic rim) and spinal stabilization.  The reason it is active in end range hip flexion is to assist the pelvis in posterior tilting to allow clearance of the superior acetabulum (think upward rotation and posterior tilt of a scapula for an analogy).  Checking out MRI evidence of anyone with back pain will typically show an atrophied psoas on the anterior side of the lumbar vertebra.  It’s pretty interesting if you get access to the films with a transverse view. 

    Secondly, iliacus is typically overstretched in most people.  During a thomas test, if the hip extends past neutral with the knee extended and hip abducted, then the iliacus is too long, not tight at all.  Rectus Femoris and TFL are the tight muscles (problems like to pop up in the 2 joint muscles before the one joint muscles).  I consistently see this in patients with hip pain and for those hypermobile lumbar spine patients as well. 

    Just thought I’d share some additional info that fits well with your post.  If every trainer worked like you, I would have a lot more confidence sending patients out to trainers.  Thanks for providing such great info.

  • deansomerset

    Awesome, great clinical insights!! Thanks for sharing!!!

  • deansomerset

    I would agree with Jason. If you have numbness going on something is giving the nerves reason to cry out. Get to a physio or chiro who can help you to reduce the compression properly

  • Kristine Becker

    Jason – I’ve always kept the hip parallel to the midline with the Thomas test; what nugget of wisdom do you have regarding hip abduction during that test? I see limited hip extension all the time (or, rather, psuedo-permanent hip flexion from my ‘desk athlete’ population).  I usually tackle it with a half kneeling stretch similar to the one above, and lots and lots of posterior chain work. Do you have any other suggestions?  

    Thanks for sharing your wisdom! Kristine

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  • Char Martin

    OMG!!  Thank god, I thought I was losing my mind!!! :-) Char

  • Jason Sweas, PT, DPT

    If the hip abducts, then TFL is limited.  Another sign that TFL / ITB might be limited is tibial external rotation, make sure the foot stays straight and doesn’t turn out.  If you’re unsure about TFL / ITB, then you can always externally rotate the hip a little bit to make sure that TFL is really being stretched.

    If you extend the knee and abduct the hip, you’ll find that the hip generally will fall below parallel.  This would indicate the local hip flexors (iliacus, pectineus, psoas, anterior joint capsule) are not tight.  A lot of people fall into this pattern.  You can even palpate the femoral head at the anterior hip joint to see if it pops forward at all while doing this knee extension, hip abduction test.  If it does, then the joint capsule is too loose and you probably need to do some local hip flexor strengthening.

    Remember, when you are doing a thomas test, since the spine is in posterior pelvic tilt / lumbar flexion, then if the hip extends to neutral, it is actually in 15 degrees or so of hip extension and you won’t use any more than that in most functional activities.  

    The paradox that the thomas test can reveal is that the hip has limited extension due to rectus femoris and TFL / ITB and at the same time, have full length, or excessively long local hip flexors or anterior joint capsule. 

    (local hip flexors = iliacus, pectineus, psoas; global hip flexors = rectus femoris and TFL / ITB)

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  • Anabolicx

    Hi Dean!

    Some quick questions about this topic!

    I have some sort of problem with popping/cracking hip when doing hip flexion work  – bend- or staight leg raise + really big snapiing when doing a adbuction – knee extension as below – relly big snap on the left!

    Weak glutes are big issue – weak as hell – and this is my second question = I do glute bridge and I cant fully extend the hip – my hamstrings are working too much !!!

    What sort of exercises are good for this glute weakness + anterior pelvic tilit when standing + lumbar flexion when sitting / bending over  + snapping hips!

    Thank you Dean!

  • deansomerset

    Tune in for tomorrow’s post. I touch on this very issue in it.

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  • Gub

    Hiya Dean,
    Sorry if this is a dumb question but with reference to your T-nation article, I don’t have access to the machine you use for the Palloff presses. Could I use a band instead? Or are the dynamics changed to much? Thanks

  • deansomerset

    Bands would work

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  • Tomek

    Dean, wouldn’t stretching and inhibiting hip flexors before strengthning stabilizing muscles (especially glutes) lead to better results? Personally, without it I have hard time achieving enough hip extension so exercises become compromised…

  • deansomerset

    Everyone’s different, but I would say that the muscle is holding tension for a reason, not merely related to what position the hip is commonly being held. If you can’t get into hip extension without some form of static stretching, you may want to get some aggressive soft tissue work to get the area moving better. It’s magic when you get some ART or dry needling in the area and it moves free and easy.

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  • Suzanne

    For the first time ever, this post explains everything. I have chronic lumbar problems, including cervical instablity, which doesnt improve no matter how much exercise or chiro treatments I have. I will check out the videos and see if I can sort it out somewhat.

  • deansomerset

    Without seeing how you move specifically, I can’t make a specific recommendation, but I would say to step it back a bit and work on glute activation in either a half kneeling or side lying position so your hamstrings don’t have a chance to kick up.

  • deansomerset

    Thanks Marilla, and the overuse of the right side is a case for when stretching is beneficial. However, most people aren’t involved in a unilaterally dominant activity that would require the stretching regimen you have to undertake to keep from hating life, which is due to you working the muscle to function at a high level. Most people are full of compensations that result in weakness, not just stiffness.

  • deansomerset

    Not from what I’ve seen. The psoas is responsible for a large degree of spinal stability, so trying to inhibit it will leave the spine exposed, so to speak, to other forces until the glutes and low back muscles can come on line to help stabilize it. I’d rather have them become reactive than inhibited.

  • Daz

    Hi Dean,

    I was doing a half kneeling stretch (right leg trailing) while (gently) warming up for a run. After about 10 secs at the bottom position I felt something ‘pop’ in my right hip. Now it is tender and hurts if my leg moves backward extending the right hip. I can walk slowly and weight bearing alone or climbing stairs doesn’t cause pain. I hasten to add that i’ve included this kind of stretch in my pre & post stretching routine for about 10 years now, never hurt before. Also, I’ve never had any popping noises in my hips in any stretch position or movement previously. Any insight/advice much appreciated.

    Kind regards

    Daz

  • deansomerset

    I would say go get it checked out by a physio or chiro. They can see more than I can over the internet.

  • http://www.facebook.com/mikekiss67 Mike Kiss

    Wow, I have the identical problem Michael. I did some testing and definitely weak core muscles and imbalances which are causing the nerve compression … I haven’t found a fix yet but am obviously spending much more time on core strengthening exercises. If you have any luck with treatment I’d love to hear about it. Thank you. I completely agree with Jason and Dean.

  • albeit

    When a muscle is tight, its because many of its sarcomeres are in contracture. Sarcomeres can’t be pulled out of this state. The only way to get them working again is to push blood into them so they can relax. Stretching can’t make that happen.

    Stretching helps prevent a stiffening of muscle sheaths, which helps prevent circulatory issues that can cause problems for the sarcomeres. But stretching cannot undo the problem once its already established.

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  • Physical Therapist
  • Al

    At the risk of sounding ill-informed, I’m curious as to how pectineus fits into this story. I realize that it’s a tiny little muscle, but I’m wondering if chronic strains or tightness of pectineus would be related to glutes, or deficits in core? I’ve begun having some pretty persistent problems with pectineus – in both legs at different times. I used to dance ballet, but school has prohibitted it for the past year. I’d be interested to hear your thoughts. Thanks!!!

  • deansomerset

    There is always a chance it’s involved, but a better question would be why is that small little muscle cranked up when there’s bigger ones that are supposed to do more of the work, and there’s a lot of different tissues in the way above the pectineus to confound the detection of a problem there. I would see if there’s someone near you who could go through some movement screening on you to determine whether it’s a positional fault of the femur in the hip joint, or whether it’s damage from years of ballet or if it’s another movement issues with specific motions that could be contributing to the issue.

  • http://www.facebook.com/sandy.klimove Sandy Klimove

    That was great! Love this stuff!

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  • http://www.facebook.com/PTontheGO PT Onthe Go

    So very quickly if you feel you have anterior pelvic tilt and know that your posture isn’t the best and feel like you have belly protrusion even if you don’t have a belly of fat are you recommending don’t stretch hip flexors??

    Cheers