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:
- Roll/Mash a ball or foam roller into your hip flexor muscle until it “releases”
- Perform a hip flexor stretch that you found on YouTube or one that someone had shown you
- 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:
- Iliopsoas (combination of psoas muscle and iliacus muscles)
- Rectus Femoris (part of your quadricep muscles)
- Tensor Fasciae Latae (sounds like a fancy drink)
- 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:
- Lay at the edge of a table, mat or equivalent surface with your tailbone resting at the edge.
- Pull one knee to your chest and let the opposite leg hang down.
- See pictures below.
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.
- Wrap a band around your feet and lay on your back.
- Bring both knees in the air so hips are at 90 degrees.
- Maintain a neutral spine by keeping your back flat against the mat. DO NOT let your back arch up in the air.
- Now slowly straighten out your leg, return, and repeat to other side.
- 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.)
- 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”.
- Lay on your back.
- Press affected leg heel into the ground and slowly lift hips into the air.
- As you lift your hips into the air, kick the opposite leg out and hold.
- 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”
Dr. Nick Scotto is a leading and trusted physical therapist in Jacksonville, Fl. He founded River City Physical Therapy to better serve the active adults in Jacksonville who want to remain fit, healthy, and happy. Many fitness enthusiasts, runners, and active adults have consulted with Nick looking for a permanent solution to their pain. Through education and specific treatment plans he helps them to heal their body naturally and achieve their goals of returning to the activities they love.