Tight hip flexors are the second most common complaint I hear – right after tight hamstrings. Chronically tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are tight, it can be painful or uncomfortable to walk, run, play golf, exercise, and even stand up straight.
Typically, the recommended treatments for this problem include lots of stretching, foam rolling, massage, and myofascial release. But what if none of that works? What if no matter how often you stretch, the tightness just keeps coming back?
If this is happening to you, muscle tightness is likely not your problem. The tightness you feel could be due to overworking of your hip flexors because something else is weak. And the common culprit is often weakness in your core.
Your hip flexors are made up of a group of muscles located in the front of your hip. They are responsible for flexing or bending your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back. Two of the major hip flexors are your rectus femoris (part of your quadriceps muscle group) and your psoas (part of your deep abdominal muscle group.) Your rectus femoris is primarily responsible for lifting/flexing your thigh. When you are walking or running, or doing any activity that involves repetitive flexing of your hip, this is the muscle that’s primarily working. Your psoas, on the other hand, has more of a stability role. When functioning properly, it will assist in exercises like “the crunch” (also known as sit-ups), and it helps to stabilize your pelvis during any of these movements as well as when you are standing upright. Your psoas, abdominals, and glute muscles all have to work together in harmony for you to have good posture and to be able to stand for prolonged periods.
Let’s talk about the psoas for a moment, because this is where many folks I speak with are misinformed.
The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis and your back pain will disappear. Sadly, this is rarely the case. Most of the time, your psoas feels tight because it’s either too weak and not able to keep up with what it’s being tasked to do, or it’s overworking to compensate for your deep abdominals and core not working properly. Either way, the result will be an angry psoas that retaliates against you by feeling tight and achy all the time.
Here’s a case study that illustrates this exact problem…
“Mary” had a huge curve in her spine when she stood and her pelvis tilted forward. This posture was giving her back pain plus a very tight hip. When she stretched her hip it felt really good, but the relief was only temporary. Over time, the tightness in her hip started to become painful when she exercised. Again, stretching would help her get through her workouts, but it wasn’t enough to keep the pain gone. The problem was exactly what we’ve been talking about… Mary’s abdominals weren’t “turning on” enough when she exercised. Because of that, her psoas was taking over and doing all the work of her abdominals. What Mary needed to do was strengthen her glutes and hamstrings, as well as some very specific core exercises designed to get her deep abdominals to engage to balance out her pelvis. Once this was accomplished, her psoas could finally have a break and start to relax. Mary’s pelvis was sinking forward not because her hip flexors were too tight, but because the rest of her abdominals weren’t engaged enough to pull her pelvis up and stabilize it. Once she started to strengthen her core properly, Mary’s psoas tightness started to go away! Stretching wasn’t what was needed.
If you’ve got tight hip flexors and your current stretching regimen isn’t working, it’s possible your real problem is a weak, underfunctioning core. Specialized and targeted core strengthening could help – but keep in mind this is not a quick or overnight process. You may not see results for 6-8 weeks. But give it a try and be consistent. If it helps, then you’ll know you found the root source of your problem!
Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for www.seacoastonline. To get in touch, or grab a seat in her upcoming Pilates 101: Get [Your] Back to Health program, email her at [email protected] or call (603) 380-7902