Hips Don't Lie
I hardly know anyone, runner or otherwise, who doesn’t say that their hip flexors are tight. This is a common problem for most of us, especially with the amount of time we sit at work or in the car. Runners and Triathletes are even more susceptible to sensing tightness in the front of their hips because of the repetitive hip flexion required for running and cycling. Tight hip flexors can cause a myriad of problems, including low back pain, hip pain, and knee pain. Restriction of the front of the hip can also make it difficult to utilize and strengthen the glutes properly. This can be further accentuated by poor running or cycling posture and muscle activation. So what is an athlete to do?
First, let’s go over the anatomy of the hip flexors. This is actually a muscle group, and includes the iliopsoas, Rectus femoris, and Pectineus. The Iliopsoas originates from several vertebrae along the lumbar spine as well as the ilium, or hip bone. The Rectus Femoris is one of the quadriceps muscles, and is unique in that it crosses both the hip and knee joints. The Pectineus (not shown) is much smaller and less discussed in this cohort, but aids in flexing the hip as well as adduction, or moving the leg toward midline.
While knowing how to stretch these muscles is important to relieve tension, it is also important to understand the root cause to stave off this problem. Tightness and fatigue of any muscle is often an indication that it is weak, or unable to handle the task that you’re asking it to do. Therefore, part of the fix is to strengthen the hip flexors and get them used to working in the correct posture.
“Lower Crossed Syndrome” is a term to describe this common phenomenon of tight hip flexors and low back extensors coinciding with weakness of the abdominals and glute muscles. The reason that these occur together is that the posture of accentuated lumbar lordosis and anterior pelvic tilt places the abdominals and glutes in a poor position to work properly.
First, let’s review hip flexor stretches. There are a few different ways we can do this, and one stretch may feel better than another, which is totally fine! Just make sure that you hold the stretch for a total of 90 seconds, as that is the amount of time under stretch that the research states is required to cause change in muscular length.
Next, we need to strengthen the pelvic girdle. These exercises should be completed intentionally, with the focus on maintaining posture throughout. When I say “posture” throughout this article, I’m referring to the relationship between the pelvis and ribcage. Ideally, the pelvis and ribcage remain “stacked” during dynamic activities, such as running. To simplify this idea, think of the ribcage and pelvis as two cylinders. If the cylinders are stacked, an object dropped through them will fall straight to the ground. If one of the cylinders is at an angle, an object dropped through will land either in front or behind the desired target of straight through.
Translating this to the human body, this means that the pelvis is neither tilted forward nor backward, and there is no extension or “flaring” of the ribcage. Below are some examples of hip flexor and abdominal strengthening exercises that help teach your body to maintain this posture.
For all of these exercises, it is important to keep your back flat on the surface that you are lying on. Monitor the position of your hips and take a break if you find that you can no longer maintain your posture. The moral of the story is that Shakira was really on to something when she sang "Hip's Don't Lie", because if your hips are weak and tight, there's no way you could do those dance moves. All joking aside, make sure that your strengthening your hips, not just stretching them!
Keep going, you got this!
Kacy Seynders, PT, DPT