Hip Flexor Hell and How to Get Out of It

Have you ever been in Hip Flexor Hell? It’s a rough, painful place. If you’ve been there, you know what I am talking about. And for those of you who aren’t sure if you’ve been there, let me highlight some of the fun possibilities:

You can barely get out of the car.

You stay bent over for quite awhile after sitting and have to concentrate on standing up.

You can’t lunge.

You can’t get your hips through in your golf game.

Your back hurts.

Your thighs hurt.

Your back is arched and your abs stick out.

Your belt buckle is 3 inches lower than the back of the belt.

You have knee pain.

 

Yup, chronically tight hip flexors can be a real hell on earth. Boy, do I know. After just having a total hip replacement in early winter, I am finally crawling out of 2 or more years of tight hip flexors. So what are the hip flexors? And why the heck are they so important to understand and address?

Your hip flexors are actually a group of muscles that work together to bend the front of the hip, ie lift your knees towards your chest. The hip flexors attach the thigh to the pelvis. If you’ve ever been in a marching band, you’ve over used your hip flexors.  Picture the marching. Knees lifted, over and over and over.

Hip flexors can become very tight and aggravated from excessive sitting, as the hip space is closed, and knees are almost at 90 degrees to the hip. For the average person, this is the primary reason for hip flexor tightness- static, sitting postures. Over time, without attention, the shortened hip flexors can really wreak havoc with your low back. Shortened hip flexors can pull the front of the hips forward, causing an anterior tilt in the pelvis This pulls the low back into an arch, and the back muscles become shortened and tight. Hip flexors also impact the knees. Tight hip flexors create a longitudinal pull on the rectus femoris, the large muscle that inserts into the top of the knee and becomes the patella tendon. Tightness at the superior portion of this muscle can cause the knee to complain, especially during lunges.

There are many other reasons that the hip flexors can get strained, rather than just tight, and we often see strength and speed athletes who have chronic hip flexor issues due to over training or the actions of their sport.  Overuse of the hip flexors are more of a culprit in this population, rather than a chronically shortened muscle due to sitting. Overuse or weakness is a different animal than chronically shortened muscles, so a thorough physical examination would be necessary, should you suspect this issue, rather than just poor flexibility.

I have learned a lot about what it takes to undo chronic tightness of the hip flexors, even though I am still a work in progress. It takes a looooong time. It takes daily diligence. Muscles do not lengthen and relax easily, especially the longer they have been tight and shortened. It could take up to a year before you feel considerable relief. But it’s so worth it.

Here’s some of my big tips and techniques for reducing hip flexor tightness, achieving a more neutral lumbar spine, and ridding yourself of knee and back pain. **

(**- These suggestions are not a substitute for medical attention. Hip Flexor tightness can mimic many other things, so always get any injury or chronic pain checked out by your doctor).

Get out of sitting postures as much as possible. Drive less.  Don’t sit with your feet out in front of you and legs straight for too long.

Perform self-massage with tools such as rollers, sticks or balls, or your knuckles, to help speed along the process of loosening these stiff muscles. A professional Massage Therapist is even better.

Use heat on the front of your hips prior to rolling and stretching to improve pliability and flexibility potential.

Stretch your hip flexors gently, but hold the stretch for extended periods of time, up to 2 minutes, if you can. It takes a long time for the muscles to let go.

Stretch your hip flexors throughout the day. There are many stretches that can be done standing or sitting, if at work.

Stretch every day if possible. Here’s a video I made for Mass Golf women’s Newsletter “The Up and Down”: https://www.youtube.com/watch?v=ww4oMGCpkho

Here are a couple other hip flexor stretches that you might try:

My friend Andrew demos this challenging hip flexor stretch, not for the faint hearted. Sometimes it’s called a “Couch Stretch.”
Make sure you press straight leg down to floor as you pull other leg in to access the HF. Of course, do both legs.
This is a nice easy standing HF stretch for at work.

Stretching alone will NOT solve this issue. You also must then do strengthening exercises to counter the effects sitting has on the hip flexors. Exercises that work the glutes like bridges, hip thrusters and other variations, are very helpful to reverse the shortened hip space, and get you into hip extension and a neutral hip. Be careful when working the posterior chain (glutes and more) that you are NOT arching your back. This will keep the hip flexors shortened. To prevent over arching of the low back during glute exercises, keep abdominals engaged so low back and pelvis is in neutral.

As far as strengthening your core, tight hip flexors can be caused by, or lead to, a weak anterior core, ie. your abdominals. Perform pelvic tilts, heel slides, planks and even a modified crunch to get the abs to hold your pelvis in neutral, rather than allowing hips to tilt forward by the pull of shortened hip flexors. Even cat stretch can be an entry level abdominal exercise to get a tuck under made by the abdominals.

Finally, if these interventions are not enough, or if you are not comfortable dealing with this on your own, the BEST thing to do is to visit a Physical Therapist. A physical therapist can use manual techniques  as well as traditional exercise techniques, to assist the process of lengthening the hip flexors. Don’t wait too long…. the longer you wait…the harder it is to change.  Don’t underestimate the power of the devilish hip flexor!