Fix Tight Hip Flexors (Without Stretching!)

Fix Tight Hip Flexors (Without Stretching!)

How To Fix Tight Hip Flexors (Without Stretching!)

Are you tired of stretching or rolling out tight hip flexors with no improvements? If you are a runner, weight lifter, or team sport athlete, chances are you have heard a teammate or friend complain about having “tight hip flexors”. Either that or you yourself have had to deal with the problem. The problem with these tight hip flexors is that people will stretch, stretch, and ……..stretch some more (until the cows come home) and get NO RELIEF. This keeps people in a perpetual cycle of ALWAYS stretching their tight hip flexor with no real permanent relief.  The cycle looks something like this:

  1. Roll/Mash a ball or foam roller into your hip flexor muscle until it “releases”
  2. Perform a hip flexor stretch that you found on YouTube or one that someone had shown you
  3. Repeated Step 1 and 2 with NO real results!

This leaves you frustrated and yes……….with consistently tight hip flexors.  A crucial step is often missed with trying to stretch away tightness or pain. Before anymore blame is placed on the hip flexor muscle, it needs to be properly assessed. Then after an assessment is performed you can determine what the right hip flexor exercise for you to do is.

Hip flexor anatomy

Let’s brush up on some hip flexor anatomy so that you can understand what exactly a hip flexor is and what it’s function is in the body. The Hip Flexors are actually a group of the following muscles: Hip tightness

  1. Iliopsoas (combination of psoas muscle and iliacus muscles)
  2. Rectus Femoris (part of your quadricep muscles)
  3. Tensor Fasciae Latae (sounds like a fancy drink)
  4. Note – There are other muscles that aid in hip flexion but for this article let’s focus on the main ones.

These muscles are all involved in the action of flexing the hip which is required during squatting, running, and playing sports. Something important to take note of here is that the psoas muscle (part of the iliopsoas) actually starts at the spine and runs down to the hip. It is considered to play a role in spinal stabilization. Common complaints include a pinch/sharp/tight sensation when getting down into a squat, pain in the front of the hip/thigh during running, or sensation of tightness when sitting for long periods of time.

How to test hip flexor flexibility

A simple and common test that can be used to determine whether or not you need to stretch your hip flexor is the Thomas Test. Follow the steps below:

  1. Lay at the edge of a table, mat or equivalent surface with your tailbone resting at the edge.
  2. Pull one knee to your chest and let the opposite leg hang down.
  3. See pictures below.

hip flexor

2. Leg parallel. No lack of flexibility. 

hip flexors

1. Leg in the air. There is lack of flexibility!

  Take note to see if the thigh rests down parallel to the ground (Picture 2) or if it stays up in the air (Picture 1) (You will need someone to be nearby to see what your leg does). Perform on both sides and compare. If the thigh does not stay raised up in the air then there is no true hip flexor tightness and stretching does not need to be performed. If one of the thigh/legs stays up noticeably higher than the other, then stretching will need to be performed. If your leg is able to hang down comfortably parallel to the ground or lower then you passed the test!

So what can cause hip flexor tightness if there’s no lack of flexibility?

As stated before, one of the primary hip flexor muscles is the psoas major. This muscle plays a role in core stabilization (something that is needed during running, squatting, and sitting) due to its attachment site at the spine. If there is a lack of core stability or poor movement patterns during these tasks then the hip flexor can become overworked/tired/fatigued (think what happens when your co workers or teammates don’t do their job, you have to pick up the slack and work harder, bringing you more stress and fatigue). It is when the hip flexor becomes fatigued that the sensation of tightness sets in. This is because the hip flexor has to “work harder” to compensate for other muscles not doing their job.

What can be done to alleviate this hip flexor tightness?

The first step that needs to be taken is to determine if the tightness is due to a true lack of flexibility (perform the Thomas test above) or if it is because of weakness in the muscle itself. Once that is determined you need to focus on reducing the tension felt in the hip flexor and improving core control/stability so that the issue does not return. As with any condition, the root cause must be found (the root cause is not often at the site of pain) in order to get long lasting relief. This is why so many people unfortunately have to deal with this issue for several months or even years…..because the root cause was never found and they were just given generic information to “open up the hips” or “just stretch more”. Below are some common exercises I like to give to patient’s to start out with to help alleviate this condition. (Please keep in mind that every individual patient has different needs but these exercises tend to work in MOST cases.) The first hip flexor exercise involves actually strengthening the hip flexor while focusing on a neutral spine for core stability.

  1. Wrap a band around your feet and lay on your back.
  2. Bring both knees in the air so hips are at 90 degrees.
  3. Maintain a neutral spine by keeping your back flat against the mat. DO NOT let your back arch up in the air.
  4. Now slowly straighten out your leg, return, and repeat to other side.
  5. Perform to fatigue of 20-30 reps for 2-3 sets 3x a week. (You can also perform for 1-2 minutes 2-3 sets if you don’t like counting.)
  6.  You will likely feel fatigue in your lower abdominals and the front of your hips.

Working on gluteal muscle strength (buttock muscles) can be beneficial to reduce hip flexor tightness. Working the glute muscles pulls the hip into extension (the opposite of flexion which is what the hip flexor does) and improves muscle balance at the hip. Increasing the strength of your gluteal muscles can help calm the hip flexor down and reduce the feeling of “tightness”.

  1. Lay on your back.
  2. Press affected leg heel into the ground and slowly lift hips into the air.
  3. As you lift your hips into the air, kick the opposite leg out and hold.
  4. Hold each lift 5-10 seconds for 10 reps on each side to start at 2 sets each. Perform 3-4x a week.

If you’ve been dealing with tightness in the hip flexors or hip flexor pain for quite some time now and haven’t found the solution, then give these exercises a try. You may be pleasantly surprised with the results! Want more information on Hip Pain? Download our Free Report on Hip Pain “5 Secrets About Hip Pain That Will Surprise You….And Help Get Your Back To Exercising/Running Pain Free” Click Here to Download This Free Hip Pain Report

Hip Bursitis

Hip Bursitis

Lateral Hip Pain Signs and Symptoms (Hip Bursitis)

Lateral Hip Pain is common among the active population. A painful hip can keep a runner from running farther, a weightlifter from increasing weight, and can prevent a good nights sleep!  Lateral Hip pain can be classified under many diagnosis including hip bursitis, gluteal tendinitis, gluteal tendinopathy, greater trochanteric syndrome, glute pain and IT band syndrome. However for the simplicity of this post we will refer to the general term “lateral hip pain” because often times these conditions and syndromes are misdiagnosed which leads to failed treatment. The key to treating lateral hip pain is first understanding whether or not that the root cause of the pain is due to the hip or another region in the body. Then you must decipher which structure in the body is causing the pain that is keeping you on the sideline. Watch this video below to learn more.


Hey everybody! My name is Dr. Nick Scotto with River City Physical Therapy located right here in the heart of Jacksonville. We are one of the best in Jacksonville Physical Therapy.

Today I want to talk to you about the Top 3 Most Common Signs and Symptoms of lateral hip pain. Now there are many diagnoses that include:

  • Hip bursitis gluteal tendinopathy
  • Glute pain
  • Greater Trochanteric Syndrome.

There are a lot of medical terms that are thrown out the diagnosis top type of pain, but for the simplicity of this video, we’re just going to call it lateral hip pain. Hip Bursitis is the most common diagnosis that is given. The hallmark sign of lateral hip pain is that you have pain when you lay on the side of the hip that hurts. If you have pain on your right hip when you go to sleep at night, and it’s hard to fall asleep, you may have lateral hip pain. Sometimes you can’t even really lay on the side of the pain. That’s actually the number one complaint and symptom that people have when they come to see me for this condition.

Another common sign or symptom that people have with lateral hip pain is that if you are extremely active, you have this pain when you are training. This commonly happens with runners, dancers, weightlifters and Cross Fitters. It’s tricky because they will not typically have pain when they are sitting down or doing day to day activities, but it will flair when working out. Sometimes it will not even get bad until towards the middle or end of the workout, causing some to think it’s just overworking during a workout. Don’t let that fool you. If the pain persists hours or days after the workout, you may be experiencing lateral hip pain.

Again, with this lateral hip pain you’re going to have pain mainly when you’re moving around. The third common symptom that people have is they can point to where their pain is, usually with one or two fingers. When they press on the side of the hip where that bony aspect is on the side of hip, the pain is reproduced. Either an extremely sharp sensation occurs, or a hard ache/hard dull ache happens in that area where their pain is. The ability to really pinpoint where the pain is can give some more clues into whether this is true lateral hip pain or not for instance, being able to reproduce the pain by pressing the side of the hip. To recap, if you have true lateral hip pain it’s not a pain coming from the back or the SI joint sacroiliac joint. Most likely, you’ll have pain when you lay on that side. So, if the pains on the right side hurt when you lay on the right side you’re most likely to have pain during activity. Whether the activity is CrossFit, running, weightlifting, dancing, or you’re participating in your specific sport you usually have pain during the activity. Usually afterwards, it starts to ache as well alongside pain with specific pressure to the outside of the hip. If you have any of these signs or symptoms and want to learn about how to get this pain, give us a call at (904) 566-7070 and we’ll be happy to talk with you to see exactly what’s causing your pain. Call us so we can help you perform at a high level with your dancing, your sport, your exercise, your CrossFit, your lifting or any physical activity you enjoy doing. We look forward to hearing from you soon. Check us out on Facebook!

Top 3 Causes of Hip Pain (Video)

Top 3 Causes of Hip Pain (Video)

Top 3 Causes of Hip Pain

Hip pain can be a common complaint with runners, cross fitters, weight lifters, and people who like to get out and play. The key to treating and ending it is to discover the “Root Cause”. In order to get lasting  relief the root cause must be identified so that appropriate treatment can be given. Some of the major causes of pain can include hip arthritis, hip impingement, IT band syndrome, Hip Bursitis, Gluteal Tendinopathy, and greater trochanteric syndrome. Learn the top 3 common causes of Hip Pain and why it is important to learn what the “root cause” of your pain is before you receive any treatment. This is important to understand because many treatments fail because the root cause of the pain was never determined. You can learn more about how to effectively treat and end hip pain here Click here to learn more!

Video Transcript for the hearing impaired.

Hey everybody Dr. Nick Scotto here with
River City physical therapy located
right here in the heart of Jacksonville
today I wanted to talk to you about the
top three most common causes of hip pain
now hip pain usually occurs when you’re
active and move around quite a bit so
you might be a crossfitter
a weightlifter you might be a runner or
a dancer or maybe you’re someone in that
middle age category or older who likes
to stay active and fit playing tennis or
golf and it can affect people of all
ages and people who participate in all
different kinds of sport so but one of
the first most common causes affects
that kind of middle-aged and older
active older population that is hip
arthritis or hip osteoarthritis this is
usually kind of like a painful and stiff
hip usually the pain is felt in the
front and on the side of the hip now
another common cause of hip pain is what
some might call hip bursitis it’s also
be called greater trochanteric syndrome
greater trochanteric bursitis you know
say that three times fast
it’s also been called gluteal
tendinopathy or trochanteric
tendinopathy or glute pain so there’s a
lot of different diagnoses for this but
I like to call it just lateral hip pain
to simplify things so lateral hip pain
kind of encompasses all of those types
of pains and again all of those hip
bursitis greater trochanteric syndrome
gluteal tendinopathy all of that pain is
felt to literally just on the side of
your hip on the outside of your
you usually don’t feel pain elsewhere
and usually that pain occurs when
participating your favorite sport
exercise routine or activity and it most
often affects women middle-aged women
actually now the third one I’m going to
I’m kind of incorporate two different
two different diagnoses are very similar
hip impingement and labral tears in the
hip so hip impingement and labral tears
and hip this is when you get kind of a
pinching sharp sensation when you’re
squatting down and coming back up or
when you’re cutting you feel kind of a
catch or a click in your hip those are
some of the signs of symptoms of a hip
impingement or labor tears
usually affects your athletes including
your dancers or your CrossFitters or
specific sports soccer players
footballers tennis players really
anybody who’s who requires a lot of hip
mobility to move around in their sport
so this this can be a painful condition
and definitely affect your more active
population and keep them from performing
at a high level now all of these three
conditions have one thing in common and
that is they keep people from performing
at their highest level whether they’re a
walker or Runner a crossfitter a
weightlifter a tennis player a soccer
player all of these conditions can be
painful and keep you from performing at
the level you want or maybe you’re just
someone that wants to be able to play
with their kids and grandkids getting up
and off the ground running around with
them but you can’t because you have this
pain that keeps you from doing it and
then particularly with lateral hip pain
it may keep you from sleeping
comfortably so all of these conditions
can be quite painful and debilitating in
our lives so if you have some hip pain
and aren’t sure what’s going on or what
to do about it I would invite you to
give us a call at 904-370-3257 and we’ll
talk to you to see what type of hip pain
you may have and what it might look like
for you to get back to the onto the road
of pain free movement and pain free
living look forward to hearing from you soon.