Are Your Hip Flexors a Pain in the Butt?
By, Noah Citsay, MSPT, CSCS at Moore Darien
The hip flexor group is one of the most powerful muscle groups of the body. It is also one of the most common muscle groups that are high risk for developing tightness due to a lack of stretching as well as lifestyle of frequent long sitting – a typical day at work for most.
The hip flexors consist of muscles that cross vertebrate from the lower spine into the pelvis as well as muscles that cross the hip into the knee. The hip flexors consist of two muscles: the iliacus and the psoas major. These muscles originate from the lower vertebrate of the lower spine and insert into the pelvis. These muscles primarily function on flexing the trunk forward as in aiding in performing an abdominal crunch. Tightness within these muscles can pull the lower spine forward creating an increase curvature of the spine. This creates increase compression and strain to the joints of the vertebra as well as increase pressure of the discs of the spine.
What is the function of the Hip Flexors
The hip flexors not only help flex the trunk forward but also assist in direct hip motions especially with marching the hip up to the trunk. This is usually performed as in walking or running during the swing phase of the leg. Due to the way the muscles connect from the lower spine to the pelvis, these muscles also help swing our leg to the side (as in helping with lateral motion with tennis); as well as help rotate our hips as when an individual needs to take a diagonal step to change direction.
How does tightness of these muscles impact the lumbar spine, hip, and knee joints?
A tight hip flexor is most commonly found in people who spend hours seated at a desk all day at work. A chronically tight hip flexor muscle can develop trigger points which refer pain (or numerous other possible sensations like tingling, numbness, aching) either radiating out from the muscle or felt in other parts of the body like the abdomen and front of the hip
Tightness of the hip flexors can also cause pain and dysfunction to athletes of any level. These muscles can play an underlying role in limiting overall step length and functional hip joint mobility that is required in general running and walking; as well as any cutting or changing direction on the field. This is seen especially in the phase of walking or running when the affected leg is behind and is preparing to leave the ground. As this pattern of tightness develops, important lateral glute and buttock muscles begin to grow tighter, since they rely on adequate hip motion to stay active.
A chronically tight hip flexor can also lead to pain and dysfunction down the chain of the leg into the knee joint, especially the tracking mechanism of the patella (knee cap) over the knee. As the hip flexors can restrict adequate joint mobility of the hip, it can especially limit functional rotation of the femur bone which is required for normal tracking of the patella as it glides over the underlying femur and tibia bones. This can lead to increase stress of the undersurface of the patella as well as soft tissue inflammation around the patella. This is most commonly seen in running and cycling athletes.
How do you treat tightness of the Hip Flexors?
Half kneeling hip flexor stretch:
- assume a half kneeling position (kneel on the side of the painful hip)
- keep your stomach tight and tighten your back buttock
- slowly lean your pelvis forward keeping your torso upright (do not arch your lower back)
- you should feel a stretch on the front of your back hip. This is a very small movement.
Bridges to improve glute strength:
- Lie on your back with your knees bent at 90 degrees, keeping heels on the ground and toes up.
- Raise your hips off the floor so your knees, hips and shoulders are in a straight line
- You should not overarch your back and keep your stomach drawn in.
If you have a desk job, get up and move around during the day to minimize tightness. This condition can creep up on you so be proactive and stay flexible!
There are many other treatment techniques, manual therapy procedures and modalities that are performed in Physical Therapy*. Moore’s Fitness division and Physical Therapy treatments focus on what your strengths, deficits and asymmetries are and work to improve your strength and flexibility to decrease your pain and prevent further injuries.
Noah Citsay is a staff physical therapist at Moore for over 6 years of experience. He graduated from the University of Sacred Heart in Fairfield with a Master’s in Physical Therapy. He is also a Certified Strength and Conditioning Specialist.
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