Tuesday, 21 February 2017

Your Tight Hip Flexors and You

I get plenty of people complaining about how tight and sore their hip flexors are. The mainstream likes to blame sedentary lifestyles and the flexed-hip position of sitting in chairs on this condition. However, if sitting were to blame, why have my new clients had no luck lengthening them, even if they stretch excessively?

Furthermore, I see clients of both the active and sedentary demographics.While those sedentary individuals certainly have plenty of physical ailments befalling them, the group that complains about their hip flexors the most are the active ones. Interestingly, in my experience, the most vigourously active of them are the ones with the most complaints.

Curious. While spending ample amounts of time sitting may contribute to shortened hip flexors, they don't seem to be the most significant factor at work. So where is the blame to be pointed?

Anatomy

The most major of the hip flexors is the psoas major, originating from the lowest of the spinal vertebrae and inserting onto the femur. The psoas minor and iliacus are present as part of the "iliopsoas" complex as well, but those two tend to be less clinically-significant.


The last hip flexor muscle is the rectus femoris, which duals as a quadricep muscle for extending the knee.


Mechanics

I'm always talking about the importance of core strength. Essentially, every muscle surrounding the spine is going to contribute to its protection.

However, let's remember that that big, strong psoas major muscle attaches to the spine! What comes of this?

Well, normally, your major core muscles such as the abdominals and obliques are the main stabilizers of the spine. The dysfunction occurs, though, when those muscles stop meeting the demand of the load being placed upon the spine. Without those main muscles being able to bear the load, any other muscle in the surrounding area, such as that psoas, are going to increase in tone and stiffness to try and compensate for that instability.

In a sedentary person who does not typically exercise, this affliction may go more unnoticed. The difference with an active individual is that, since they are experiencing more regular physical activity, the psoas has a greater amount of inherent strength and tone, causing an increased sense of tension.

The Fix

It should be obvious that restrengthening the primary core stabilizers is key in allowing the hip flexors to release their protective stiffness.


This doesn't always prove to be enough, however. A number of times, those dysfunctional mechanics have been so ingrained for so many years that the psoas has a difficult time learning to make the switch back from core stabilizer to hip flexor, even when the core muscles themselves are retrained. Getting the psoas to contract into hip flexion independently of the rectus femoris, for instance, is one method I've employed, but that's another topic for later.

All in all, core stability work is the best start, whether it's for rehab or "prehab". If you don't have a problem, make sure it stays that way by keeping your spine sound and supported. (And for crying out loud, minimize your weightlifting belt use.)

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