These muscles are really catching my attention more recently, maybe because I've been sitting for longer stints at a time driving to Indiana to see clients, or maybe because I have more recently recognized their role in core strength, diastasis recti, and lower back pain. The hip flexors are major contributors to our lumbar spine stability (Konrad et al., 2021), so when they are weak or tight, our core stability will be compromised. Sitting makes this even worse.
Addressing this muscle group was never really an intentional part of my workout routine, that is, until I became a #yoga instructor and now this maybe one of the biggest physical impacts I recognize in my own body when I skip time on the mat. Stretching the hip flexors is great for reducing the muscle tightness and with some, the real concern is neglecting these enough that they actually shorten, but beyond stretching these muscles, strengthening them is vital as well.
Stretching is commonly used as a warm-up in any physical activity with the goal of increasing our range of motion and to sort of prepare our body to perform in effort to reduce injury. There isn't a lot of data with regards to whether this actually improves strength or speed, but we know that a single stretch exercise can reduce muscle tightness and stiffness (Konrad et al, 2021). It is really impressive just how little tightness is actually needed in our hip flexor muscles before we feel significant pain in their lower back and before we start to compromise our core strength.
Not only does this impact athletic performance, but it impacts our ability to #balance, can create a belly pooch, and can even flatten our bums worse than menopause (Konrad et al., 2021). Our bodies will adapt when these muscles are neglected, so when our hip flexors are too tight from long bouts of sitting, other muscles compensate but our movement patterns, even our neuromuscular strategies, are negatively impacted which has consequences far greater than you may realize.
Research has indicated that as many as two-thirds of the population have limited hip extension flexibility, and hence, tight hip flexors (Konrad et al., 2021). Those with tight hips have weak abdominal muscles (Kim & Lee, 2016). If you're sitting eight hours a day, young or old, this is an important aspect of your physical fitness to be mindful. We do need to assure we have full range of motion by stretching, but we also need strengthen in these muscles and of course, address the core as they are harmonious with the limbs and maintain our overall stability.
What Exactly are My Hip Flexors?
The hip flexor muscles are a group of muscles that attach our pelvis to our long thigh bones, the femur. These muscles help us lift and lower our legs as well as every tiny little movement in between. They comprise the psoas major (PM), which is the largest of them all wrapping all the way around the back of your spine from the femur, and the iliacus (IL), which connects the top front of your pelvis straight down to the same tendons on the femur as the psoas. Your rectus femoris (RF), sartorius (SAR), adductor longus (AL), and the tensor fasciae latae (TFL) are also part of your hip flexor muscles (Yamane et al., 2019).
Do you ever sit for a bit and then when you want to stand, it takes you a minute to get your body upright or to even get moving? This would be the result of tight hips. Do you find your push your hips forward or even your belly when you sit in a desk chair, or even while walking? This too can be from weak hips and a weaker core. Pregnancy can cause muscle memory for that posture we create so we can create counterbalance for the weight of our protruding belly, but then after we birth, when that belly isn't so prominent, we don't always recalibrate ourselves. Our muscles want to fall back into our pregnancy posture, which will impact our physical function and appearance more long term.
These muscles tighten primarily with long sitting. We need to use our muscles, or we lose them, right? So with our hips, if we sit on our bums which not only minimizes the blood flow they receive, but this reduces engagement so they essentially hibernate or go completely off-line. In time, they can become pretty unresponsive. We can even throw them off when we rush through our #squats in the gym and aren't isolating the muscle properly, so if you are a workout enthusiast and your hips still hurt, check your engagement.
The hips flexors attach to the front of the spine and cross over the front of the hip, so if your core is inactive, then you will slouch or hyperextend into your lower back which creates more tension in the hip flexors and again, less activity in your glutes. The butt muscles turn off, go to sleep, and your hips spill either forward or backwards, making your belly protrude more and sometimes your hamstrings even beef up to accommodate and compensate.
Spin and cycling classes are high on the list of offenders for causing tight hip flexors too, but really, it's about sitting. You may be a horseback rider, airplane pilot, truck driver, kayaker, or sit at your desk a lot during the day and either way, those hips may contract, get tight, even shorten, which puts your butt to sleep so it atrophies and flattens, and your core weakens so you can really start to pop out here as well. Don't forget that lower back pain too, all very associated. The fix though, is more exercises to stretch, lengthen, and strengthen your hips.
How Might We Best Challenge Our Hip Flexors?
Similar to the other muscles of our lower leg, such as plantar flexors, doing simple stretches with our hip flexors decreases tightness after we have set for a bit of time and this likely will be sufficient to counteract periods of sitting if we do these more regularly. These stretches can also really reduce lower back pain, reduce injuries, and likely lead to an increase in athletic performance. Stretching for just 120 seconds has a positive effect on balance (Konrad et al., 2021).
Yoga is great at stretching, but depending on your class, it may not be that strengthening is an integral component, particularly for the hip flexors. If you have neglected this area of your body for a smidge, or been a bit sedentary, it might be that stretching these muscles just aren't offering you enough relief because the issue is now more about weakened glutes and weaker belly tone. You'll need more than just a stretch. It's time to build strength. If you can't do an active straight leg lift to at least 60 degrees, then your psoas and iliacus muscles are weak (Yamane et al. 2019).
Yoga offers a great deal of opportunity for moving through these movements. The low crescent lunge is a perfect hip flexor stretch. Moving through transitions in yoga, especially in a vinyasa flow, so that we are moving through what might otherwise be called a balancing squat. If we are standing in our tadasana pose and transition back into a Warrior I or even drop this down to the mat into a low crescent lung, we have done a balancing squat. This adds a challenge to the standard squat and even the crescent lunge, as in itself, the crescent lunge is a nice stretch but doesn't necessarily build strength. If repeated and exaggerated, it can cause also worsen inflammation on the anterior side of the hip, so adding the squat will fire your hips, glutes, and abdominals while building strength.
The standing slow side kick is yet another exercise that activates the core while working out the hip muscles. Focus on using strength here to lift and lower and not momentum. If you stand feet hip-width apart, hands on hips, simply raise either leg directly out to the side as far up as your hip, if you can, but do this slowly so that it takes a good three counts to raise the leg. If you can get your inner thigh parallel to the floor, this is awesome. Hold for a count, and then lower to the count of three. Switch sides. Repeat as you desire.
The side-stepping curtsy will get your attention. This is a sort of traveling lunge so that you cross your leg in a curtsy in front of the other. You can start with your hands up by your ears, and as you cross one leg crosses behind the other into a curtsy lunge, you can reach your opposite hand to the floor and then quickly stand up, returning your hand to the side of your head. Repeat each side.
Alternating side jumps will get your heart pumping alone with challenging your entire lower body. Start in a standing position, feet hip-width apart, and hands on hips. Hop three feet one way, landing on your foot with your knees slightly bent, and then lift opposite foot off the floor when landing. Jump to the opposite foot, repeating sides, jumping from foot to foot.
The hinging deadlift is a popular exercise for strengthening your lower back and hips, even your legs and your bum. Grab a pair of dumbbells and stand with feet slightly wider than hip-width apart, knees slightly bent, and hold the weights in front of your thighs, palms facing inward. Maintain a neutral spine, hinge forward from the hips and reach the dumbbells to the ground until your torso is almost parallel with the floor. Focus on those glutes to raise the body halfway back up, then repeat... like twenty times.
Hip raise, or yoga bridge, is great. You can do this too, balancing on just one foot and then lengthening the other. You might even try this exercise on a bosu balance trainer for additional challenge. I like to do these just prior to the cool down after a great vinyasa flow. The shifting side lunge I often teach as well, and it's where I find many of my students have more tightness. You can add weights to this as well, but think about the wide leg stance in yoga or the sumo squat and then move from side to side into the lunge. This is one fluid motion with lots of hip workout.
While you are on the floor, try a forearm plank but while doing so, assure your bum isn't popping up too high. Your back should be flat with your mat, and then engage your core and your bum. Hold for 15 to 30 counts, and then breathe deeply.
My own nemesis though, the traveling squat-kick, is excellent for the hips. You will cuss, but channel your inner martial artist for this one. Your hips, quads, and butt will just love it. Stand with your hands on your hips and kick off either leg in an arc across the front of your body before bringing your foot back to the floor into a squat. Step your feet closer together again and repeat with the other leg. It's also great fun to bring one leg up directly in front of you, extended at the knee and just hold.. hold... hold. Then repeat.
External hip raises, like we all did in the 1990s, on the floor, on our sides, with resistance bands are great. Loop a mini-band around your ankles, support your upper body with your arm, and brace those arms and lift that upper leg slightly higher than your hip with heel rotated towards the ceiling. Do about twenty leg lifts, and repeat on the other side. You can stay here and work the inner thigh as well, by moving your weight back just a little and bringing that bottom leg forward. Use your upper arm to brace yourself in front of you, with the floor, but then lift that bottom leg slightly in front of you keeping your hips stacked. Pulse your leg, maintaining tension. Enjoy, and then repeat on the other side.
Come up into your hands and knees position, and you can lift either leg directly out to the side for a single leg raise, then maybe drive your foot back behind you, still keeping that leg up. You'll feel this in the tush and outer thighs, as well as your hips. Alternate even between driving your knee forward to the side and then back. Switch sides.
Another great exercise for strengthening the hip muscles is to put your foot in the hole or handle of your kettleball, and while standing with hands on your hips, lifting the kettleball with your foot and straightleg and then raising it in an arc in front of you. Repeat this a few times, maybe trying to lift over a stack of books, and then repeat with the other leg.
The core again, is also vital to addressing our hip mobility, spine strength, and core health. Historically, fitness experts have recommended the sit-up for strengthening the upper rectus abdominis while the straight leg-raises in the supine position were used to target the lower rectus abdominis. We have to be cautious here though as many do suffer separation of these muscles following pregnancy or even from obesity, so if especially weak, these exercises can worsen an already existing problem. We discuss this more in our abdominal healing and strengthening program, but assure you are an appropriate candidate for doing sit-ups before engaging.
If we want to really maintain stability though, the abdominal muscles need to be activated simultaneously, rather than by targeting a single muscle (Kim & Lee, 2016). Being mindful of the external oblique for example, and engaging our rectus femoris and iliopsoas between our core exercises can be helpful, as mentioned above. It's important we are engaging muscles, not just moving through exercises. Many activities can wake up our core, such as dance, yoga, swimming, and pilates.
References
Kim, K., & Lee. T. (2016). Comparison of muscular activities in the abdomen and lower limbs while performing sit-up and leg-raise. J Phys Ther Science, 28(2), 491-494.
Konrad, A., Mocnik, R., Titze, S., Nakamura, M., & Tilp. M. (2021, February). The influence of stretching the hip flexor muscles on performance parameters: a systematic review with meta-analysis. Int J Environ Res Pubic Health, 18(4).
Yamane, M., Aoki, M., Sasaki, Y., & Kawaji, H. (2019, February). Understanding the muscle activity pattern of the hip flexors during straight leg raising in healthy subjects. Prog Rehabil Med, 4.
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