Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)
I get it, you don’t have to be a physical therapist or a fitness professional to know that tight hip flexors can create some havoc in how you feel. I’m sure a large amount of you have been told at one point or another to stretch your hip flexors do decrease something like low back pain. That isn’t bad advice, but it is incomplete.
You see, people are told maybe to JUST stretch their hip flexors and that results in people feel like they are running on a hamster wheel. The hip flexors are stretched, you go about your day, later on, they feel tight again. People often feel the stretching hasn’t worked and they should be doing something else.
That has led to this odd new narrative to focus on isolated hip flexor strengthening. Let’s review what is not really right about this idea and how we can help hip flexor issues far more effectively.
Our Hip Flexors Are Tight Because We Sit Too Much
It is true that we do sit too much and there is an impact to the hip flexors because we do so. Most assume because when we sit and our hip flexors are shortened when we sit this causes our hip flexors to become tight when we move around. This is somewhat true, but again, incomplete.
What has confused many is that our hip flexors can be tight, but they can also be weak. Now, before I address this, please realize you have to actually test hip flexor strength to know IF they are weak. While there are few ways to look at hip flexor strength, I prefer to have someone lie on their back and use a little manual resistance as you see below. The reason I like this form of testing strength is that by lying down we don’t start with the hip flexors already shortened. When you shorten a muscle and test its strength it may give you an incorrect result because shortened muscles can’t create their optimal strength (this is know as length-tension relationships).
In general, if I can give a fair amount of resistance and the individual can keep the leg from moving, the hip flexors are reasonably strong. The point being, if you don’t even measure hip flexor strength (or use a very novel exercise as a form of measuring strength), you can’t say the issue is weakness.
With all that said, research actually tells us that sitting too long fatigues our core stabilizers. When our core stabilizers are tired, then flexors tend to dominate (especially muscles like the hip flexors) and this is reinforced by additional research. Comparing people with and without low back pain, those with low back pain tend to use their flexors MORE when sitting than those who do not have low back pain (they tend to use their trunk extensors more). With this information we can reasonably conclude that lack of core stability is probably MORE at the root of the issues with hip flexors than strength.
I realize that when most people see an issue at a muscle they think it must be either strengthened or stretched, but the reality is that our body is more complicated, but this all hopefully makes sense. It also doesn’t mean stretching is all a bad idea either. There is quite a bit of evidence to show that stretching hip flexors actually can help low back pain. Including a 2021 study that found, “The results demonstrated a significant difference in passive range of motion, pain, and disability after 8 weeks of stretching exercises in participants with non-specific low back pain (NSLBP) and limited hip extension. Therefore, it would be reasonable to infer that NSLBP might be partly related to hip flexors tightness.”
Not just stretching, but more integrated stretching can be incredibly effective. A study in The Journal Of Strength & Conditioning Research, using more integrated stretching can greatly improve that hip mobility.
“A more thorough stretch would be obtained if stretching included not only hip joint motion but also the entire side of the body which was under stretch at the hip, thus incorporating some of the principles of myofascial force transmission.”
Not just integrated myofascial stretching, but also breath work may help our hip flexors. How? A 2012 study found diaphragmatic breathing exercises can lower spinal loads and can increase the stability that the deep core stabilizers create. A 2021 study found that when deep breathing exercises were combined with stretching the hips it was far superior than just stretching the hips without the breath work.
So, we have more integrated myofascial stretching and breath work combined as one strategy, another is to address core stability itself. Research in The Journal Of Strength & Conditioning Research found that those who use core stabilization exercises significantly improved their hip mobility. Exercises like what? Check out some ideas below but keep scrolling for more!
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Really hip mobility and hip flexors comes down to three keys…
-Myofascial stretching with deep breathing
-Good core stability training
-Training the posterior muscles as improved hip strength has been shown to improve hip mobility as well.
What does this all look like? Check out some ideas below…
This week you can save 30% on all our DVRT online programs and Ultimate Sandbags with code “heart30” HERE. That includes courses like our Science Of Breathing Course (which covers myofascial stretches to go along with the breath work) HERE, mobility programs you can find HERE, and my DVRT Rx courses.
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