Some of the biggest occupational hazards we see these days are postural faults from too much sitting. One of the main problems is tight hip flexors. Sitting most of the day shortens the muscles that cross the front of your hip. In turn, this can cause hip, knee or lower back pain. When these muscles are tight, they can pull you into a stooped forward posture when you are attempting to stand upright. Physical therapists have a variety of ways to stretch this muscle group, there’s a hip flexor stretch for everyone.
Hip flexor anatomy
Deep hip flexor anatomy
There are several muscles that act to flex the hip. The deep hip flexors are the psoas major, psoas minor and iliacus muscles. The psoas major has origins from each vertebrae of the lumbar spine so positioning is key if you want to isolate the deep hip flexors while stretching.
Superficial hip flexor anatomy
There are also superficial muscles that flex the hip. Some of these only cross the hip joint and some also cross the knee joint. Interestingly, even some of the muscles that move the hip inward and out to the side also help flex the hip. As you can see below, there are many layers of muscles in this area.
Hopefully after seeing the hip flexor anatomy, it makes more sense why tight hip flexors can cause back, hip and knee pain!
Active hip flexor stretches
With all hip flexor stretches, you get a more targeted stretch if you avoid arching your lower back. Slightly tuck your pelvis under to make your spine flat or even slightly rounded to increase the stretch. Hold stretches for at least 30 seconds in order to make changes in the length of the muscle.
This is the stretch you might think of when someone tells you to stretch your hip flexors. You’ve probably done this one in gym class. This stretch is great when you’re exercising outside or somewhere you don’t want to get down on the ground.
If you feel comfortable getting down on the ground, the kneeling hip flexor stretch is a great one because you can optimally set-up to maximize the stretch. Once you are in position, tuck your tailbone under as far as possible, then shift your weight forward to feel a stretch to the front of the hip of the kneeling leg.
Passive hip flexor stretches
One downside of the kneeling and standing stretches above is that you have to be pretty active to keep your form and even to maintain the position. And if you inadvertently fire the muscles you are trying to stretch, you’re fighting against yourself.
Foam roller hip flexor stretch
For this stretch (my personal favorite), you’ll need a foam roller, bolster, block or firm pillows. Even a stack of rolled up towels can work. Lay your pelvis over the raised surface and hug one knee deeply into your chest. Sag your spine toward the floor by pulling your navel toward your spine to make a “C” curve in your spine. Then drop the extended leg off of the raised surface.
There shouldn’t be any back, pelvis or hip pain. If you have any pain, choose one of the stretches that follow.
Stretch off the edge of a bed or table
If you have pain, lack props or the stretch above feels too complicated, choose between one of these stretches. These are great to do first thing in the morning before you get out of bed. The set-up is the same as before, try to have your back to the table.
What if you have a hip flexor contracture?
Sometimes you can’t even dream of achieving some of the postures depicted above. That’s OK, start where you are and slowly work your way towards more flexible hip flexors. Sometimes we can develop a hip flexor contracture which is where the tightness isn’t as elastic and has been there long-term. In order to make changes to a hip flexor contracture, spend longer periods of time stretching – anywhere from 90 seconds to 5 minutes.
Lay weight on top of leg
This passive stretch is recommended if you have a hip flexor contracture. The longer you can be in this position, the more gains you can make over time. Lie flat on your back, support your spine so that it isn’t over-arched, and lay a weight, bag of bird seed, or other heavy object over the top of your thigh.
Kneeling stretch modifications
If you have a hip flexor contracture, you may have to keep your hip in neutral or slightly in front of you in order to do an active hip flexor stretch. Also, you may not be able to position your torso upright. In time, you should be able to get your torso more upright and begin to move your thigh further behind you.
Happy hip flexor stretching to you!
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