Are your Hip Flexors Really “Tight”?

This is a common question or sometimes a statement made my clients and athletes.

The anterior hip musculature, for this post, the hip flexors, can be a common area that lacks mobility and can be “tight”.  They can play a huge role in the function of the lower body, upper body, and can impact many orthopedic diagnoses throughout the chain.

Increased tightness in the hip flexors can limit hip extension and can in turn affect the ability of the gluteus maximus to control the lower leg.  It can create limited mobility into hip extension that can force the lumbar spine to have to compensate and move more. Lack of hip extension mobility or tightness in the hip flexors can cause compensations and adaptations at the upper body for certain athletic endeavors.

Overall, limited hip extension mobility or “tight” hip flexors can play a major role on the entire kinetic chain.

But, here’s the more important question, “Are they really ‘TIGHT’?”

One quick way to determine if there is true “tightness” or lack of mobility is by using a test called the Thomas Test.  See Below:

 

In this test, sit on the edge of a table.  Lie back and bring both knees to your chest.  Then, let one leg drop down towards the ground.  

Normal Hip Flexor Mobility: thigh is parallel to the ground, knee in line with the hip joint, and knee flexed to 90 degrees.


Not “Normal”: knee not flexing to 90 degrees, thigh above parallel, or knee outside of the hip (not in line with the hip).

As shown in the video, the left leg, or 2nd leg to be tested has a positive Thomas Test, or has increased hip flexor tightness.

What if your Thomas Test was “normal”?

What if you dropped your legs down and they looked fine?  Everything was where it is supposed to be, but you still feel “tightness” in your hip flexors.

Did you ever think the hip flexors may be “weak”?

If you want to see if your hip flexors are “weak”, try the Standing Hip Flexion Test.

 

Stand and pull one knee up to your chest as far as you can go while maintaining a tall posture.  Once you have your knee up as far as it can go, take control of that position using your leg muscles and let go of your leg with your hands.

Ideally, the leg should stay where it is.  Basically, wherever you brought it up to with your hands, the leg should remain once you let go and take control of with your leg muscles.

If it doesn’t, this can mean there is some weakness in those hip flexor muscles, specifically the Iliacus and Psoas Major/Minor.

 

psoas.jpg

Commonly, tightness is seen in the Rectus Femoris (Quads), Tensor Fascia Latae (TFL), etc.  But, hip flexor weakness at Iliacus, Psoas Major/Minor can play a major role in anterior hip tightness.

Iliacus and Psoas Major/Minor are active for hip flexion above 90 degrees of hip flexion.  Below 90 degrees of hip flexion, Rectus Femoris is  largely responsible.

If a muscle feels “tight”, it potentially could be not short at all, but is working very hard to maintain strength or stabilize something.  Eventually, it can feel “tight” when in fact in may not be tight at all.

Now that we have gotten hip flexor tightness or weakness out of the way, what do we do about it?

Here are a few simple exercises to start with:

Supine Psoas March No Resistance

 

Key Points:

-Lie on your back.

-Bring your knees up above hip height.

-Maintain a flat back to the ground.

-Slowly extend one leg down to the ground without letting the other knee drop below hip height.

-Alternate side to side for 5 reps per side for 3 sets.

Supine Psoas March Light Resistance

 

Key Points:

-Lie on your back.

-Bring your knees up above hip height.

-Maintain a flat back to the ground.

-Slowly extend one leg down to the ground without letting the other knee drop below hip height.

-Alternate side to side for 5 reps per side for 3 sets.

-Use a resistance that you can perform with proper form.

Supine Psoas March Moderate Resistance

 

Key Points:

-Lie on your back.

-Bring your knees up above hip height.

-Maintain a flat back to the ground.

-Slowly extend one leg down to the ground without letting the other knee drop below hip height.

-Alternate side to side for 5 reps per side for 3 sets.

-Perform with a resistance where you can maintain proper technique.

The goal should not be to try and go with harder and harder resistance.  Here are a few options to try and help alleviate anterior hip tightness.  Give these a try and see if they can help.

Andrew Millett