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“Tight hip flexors” is a popular term in gyms and fitness studios around the country. People in yoga studios are stretching hip flexors, runners are blaming a short stride and injuries on these muscles, and your clients are probably asking you about their own tight hips.
It’s important to understand exactly what it means to have tight hip flexors so you can help your clients. They may genuinely have tight muscles in the hips that need stretching, but they may also need to strengthen the hip flexors or related muscles, like the glutes or core.
Tackle the issue with information so you can determine if your clients really do have tight hips or if there is another problem. With a few new stretches and exercises, you can help those with tight hip flexors loosen them up, get better mobility with less pain, and avoid injuries.
Want to help your clients achieve better results and reduce their chance of injury? Get the knowledge you need with ISSA’s Glute Specialist Certification.
First, help your clients understand what the hip flexors are, what they do, and how you know when they’re tight. The term hip flexors refers to a group of muscles in and around the hips that help move the legs and the trunk together, as when you lift your leg up, bending at the hip.
The hip flexor includes the following:
Iliopsoas muscle. The iliopsoas is actually two different muscles that help stabilize the lower back: the psoas muscle and the iliacus muscle. The psoas muscle runs from the lumbar spine (lower back), through the pelvis, and attaches to the femur (thigh bone). The iliacus muscle attaches the pelvis to the femur and is used to rotate the thigh.
Rectus femoris muscle. The rectus femoris attaches the pelvis to the knee. It is also the quad muscle that is used when performing squats or lunges.
Sartorius muscle. Also running from the pelvis to the knee, the sartorius muscle is used to flex the knee and leg.
Pectineus muscle. More commonly known as the groin muscle, the pectineus is used in hip flexion. It is also used for thigh rotation and adduction.
Together these muscles produce flexion, the movement and tightening of muscles that allows for flexing of the hip joint. They also help to stabilize the spine.
Strengthening the core is important to supporting the hip flexors, but are sit-ups the best way to work your abs? Read this ISSA blog article: 5 Best Exercises to Include in Your Core Workout
The obvious sign, of course, is that these muscles just feel tight. You try to stretch them and they don’t move much. But there are other signs too. Tight hip flexor muscles can impact several other areas of your body, so you might have:
Tightness or an ache in your lower back, especially when standing.
Poor posture and difficulty standing up straight.
Neck tightness and pain.
Pain in the glutes.
You can also do a test to evaluate tightness. Lying on your back on a table or bench, pull one knee up toward your chest and hold it there. Let the other leg relax downward over the edge of the table. It helps here to have someone hold that leg for you so you can do it slowly.
If your hip flexors are fine you should be able to fully extend the thigh so its parallel to the floor and bend the knee to 90 degrees without the thigh rising up. Any difficulty with these movements indicates tight hip flexor muscles.
The biggest cause of tightness is what we do all day long: sitting for too long is a major culprit in tightening the hip flexors. When you sit all day at a desk, the iliopsoas shortens, making the flexors tight.
Some athletes are also more prone to tight hip flexors. Runners use the hip flexors, especially the iliopsoas, to lift the leg up with each stride. This repeated shortening of the muscle isn’t compensated for by a lengthening movement. Runners often end up with tight hip flexors for this reason.
Having a weak core can also be an issue that contributes to tight hip flexors. Because these muscles are connected to and stabilize the spine, they often take over when the core is not strong. This can lead to tightening and pain.
Having tight hip flexors can cause injuries, pain, and restricted mobility. So it’s worth taking a few minutes per day for a hip flexor stretch session if you have tightness. Here are some stretches to try, for you or your clients:
A foam roller can be useful in stretching and loosening hip muscles. Get into a forearm plank position on the ground with the roller under the front of one hip. Let the other leg stay out to the side, off the roller. Roll up and down for about 30 seconds, focusing on points that feel especially tight.
Indeed, compared to traditional foam rolling, improvements in joint range of motion and decreases in pain and muscle stiffness were significantly better with use of the Hyperice Vyper 2.0 (Choi and Lee, 2021; Lee et al, 2018). Moreover, for a more targeted approach, the Hyperice Hypersphere can also be incorporated into routine/treatment. For example, the illacius tends to be a major contributor to hip flexor issues.
Like foam rolling, using your body weight while in the prone position, placing the Hypersphere slightly medial and inferior to the anterior superior iliac spine while using the low-frequency setting can release not only the illacius but also other muscles in the hip flexor complex (i.e., muscles in close proximity).
Finally, similar outcomes can be achieved using Hyperice’s Hypervolt percussion massage device while targeting the hip flexor complex, without the need to control body weight for pressure and/or intensity of treatment (Conrad et al, 2020; Cheatham et al, 2021). (Written by Hyperice Expert: Dr. Jeff Martin)
(Dr. Kamraan Husain)
Borrow this move from yoga to stretch out the flexors. On your hands and knees, pull the right knee forward. Bend it under your chest and stretch out the left leg behind you. Lay down on top of your bent knee as much as you can. With tight muscles, it may take some time before you can do this fully, so take it slowly.
Sit on the floor with the bottoms of your feet pressed together. Let the knees fall outward to stretch the hips. For an extra stretch, gently push down on your knees.
Perform a deep lunge with the right leg forward. Gently let the left knee rest on the ground and straighten that leg as much as possible. Put your palms flat on each side of the right foot, then raise the left arm up above your head and lean to the right. Hold a few seconds and repeat on the other side.
Yoga provides many advantages for clients who struggle with hip pain or stiffness from tight muscles. Consider these yoga poses for tight hip flexors to help open the hips and help strengthen weak hip flexors.
Moves that strengthen the hip muscles, glutes, and core will all be useful in preventing tightness in the hip flexors as well as injuries. These moves can improve strength and provide a good stretch at the same time:
This move will work your hips, core, and glutes. Lying on your back with knees bent, lift the hips up as high as possible and squeeze the glutes. To make it more difficult, cross one leg over the opposite knee and lift one side at a time.
To really focus on one area at a time, try a single leg skating squat. Lower into a typical squat and lift one leg up and back as you rise back up to standing position. Stretch the opposite leg out straight to lengthen hip flexors while also working the glutes, hamstrings, and quadriceps.
In plank position on your hands, alternate bringing each knee forward, toward your chest. You can use sliders for this and do it either fast or slow to work both hips and abs.
Start by lying down with arms to the side. Raise both legs toward the ceiling until hips are fully flexed, then lower back down.
Learn more about the versatile, powerful squat and what good form looks like in this ISSA blog post: The Squat: Muscles Worked, Form, Variations, and More
Hip flexor tightness can be a real pain, but there are other reasons your hips might feel sore. A hip flexor strain or tear can cause uncomfortable hip flexor pain.
A hip flexor strain is often the result of overuse. This is especially common in athletes who run, jump, or kick, such as dancers, cyclists, and soccer players. The muscles and tendons become sore and inflamed.
Signs you may have a strained hip flexor:
Pain when stretching your hip muscles
Pain when you lift your thigh to your chest
Sudden pain in your hips
Tenderness, swelling, or bruising at the front of your hips
A strained hip flexor could also indicate you have a tear in your muscle. According to the Boston Sports and Shoulder Center, the severity of a hip flexor strain falls into one of three grades:
Grade 1 tear: A few muscle fibers are damaged
Grade 2 tear: Damage to significant muscle fibers with moderate loss of muscle function
Grade 3 tear: The muscles are torn or ruptured, and you usually can’t walk without a limp
If you think your client may have a hip flexor strain or torn hip flexor, be sure they consult with their doctor.
Help your clients be more aware of their hips and diagnose any issues so you can correct them before they suffer injuries.
Learn about more common issues with these ISSA blogs:
If you’re truly interested in the fine details of movement and form and helping people avoid or recover from injuries, check out ISSA’s Personal Trainer certification course. You can get started right away online, or give us a call if you have additional questions.
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Dr. Jeff Martin, Ph.D., Associate Dean of Preclinical Academic Affairs and Research, and Associate Professor of Physiology at LMU-DeBusk College of Osteopathic Medicine
Jung-Hyun Choi, Chang-Hee Lee. (2021). Immediate Effects of Vibrating Foam Rollers on Neck Pain, Muscle Stiffness, and Cervical Proprioception in Patients with Forward Head Posture. Annals of the Romanian Society for Cell Biology, 889–894. Retrieved from https://annalsofrscb.ro/index.php/journal/article/view/189
Lee, C., Chu, I., Lyu, B., Chang, W., & Chang, N. (2018). Comparison of vibration rolling, nonvibration rolling, and static stretching as a warm-up exercise on flexibility, joint proprioception, muscle strength, and balance in young adults. Journal Of Sports Sciences, 36(22), 2575-2582. https://doi.org/10.1080/02640414.2018.1469848
Andreas Konrad, Christoph Glashüttner, Marina Maren Reiner, Daniel Bernsteiner, Markus Tilp. (2020) The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance. Journal of Sports Science and Medicine (19), 690 - 694.
Cheatham, S., Baker, R., Behm, D., Stull, K., & Kolber, M. (2021). Mechanical Percussion Devices: A Survey of Practice Patterns Among Healthcare Professionals. International Journal Of Sports Physical Therapy. https://doi.org/10.26603/001c.23530
Hip Flexor Strain Treatment Boston MA | Flexor Muscle Injury Waltham, Dedham Hip Pain. Bostonssc.com. Retrieved 28 July 2022, from https://www.bostonssc.com/hip-flexor-strain-sports-shoulder-center-boston-waltham-dedham-ma.html.
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