How to fix hip flexor tightness

How do you fix those twinges or outright spasms of the hip flexor? Remember when I blogged about functional versus positional hip flexor tightness?  Well, in a nutshell, the twinges my client Carley was having while she was running in her hip flexors was functional tightness. Those muscles are working in her preferred movement pattern, and now they are getting too tight and causing pain. I also have a really good story about a client of mine who looked like Santa and was once in a bilateral (both sides) hip flexor spasm, but I’ll get to that in a minute.

Hip Flexor Tightness

Wondering where legitimate hip flexor tightness might be on a body? Look at the photo below.

The green arrow is where you would feel the hip flexor tightness, kind of in the front of the crease of the hip where the pleats on your pants would be. (Am I dating myself? Do people wear pleats on pants? 🙂

The blue arrow is actually where A LOT of clients tell me they have hip flexor tightness, but that is actually quad ( a secondary hip flexor or the body’s second choice muscle to pick the leg off the ground) tightness.

Not the same.

The best stretch 

What then do we do? I suggested an exercise called Supine Groin. It takes a bit of time as we are primarily relying on gravity to work its magic with the floor as a frame of reference. Let’s get into the position, and talk about what’s going on.

Here is one way to do it with one chair as your primary “equipment”:

You’re going to lie on the floor with one leg in a neutral 90 degree angle in the seat of the chair, and the other leg straight on the floor, in this case wedged inside the chair legs. This allows you to relax the outside ankle up against the legs of the chair, so your foot can be straight up and down, but relaxed. This is key, as most feet want to roll out and stay there when relaxed. Make sure that foot is straight, and the leg in line with the hip.

Great! The hard part is done.

Now we need to check in with how tight that hip flexor is, exactly. I’m often asked: “How much time do I spend in this position?” There are two ways of figuring that out. You obviously can’t contract it lying down in the position you are in, so how do you know? First, contract the quad (front of the leg) without help from other muscles and hold. Where is the concentration of the contraction of the quad? Is it down by the knee, about halfway up the leg, all the way up the leg and near the hip, or there isn’t one spot you can nail down.

Take note.

Additionally, the other thing to correlate the quad contraction with is space in the low back. Is there any? Can you slide your hand under your back easily? Again, take note. The goal is to have no space in the low back, and not one spot in particular you can feel in your leg. This position takes advantage of gravity working its magic not only on the hip flexor, but the whole low back/pelvic/hip region as well as the knee! Stay there. It might take 30 minutes, or an hour. If you can’t stay that long, chip away at it. Your quad will tell you when to trade sides.

Here’s another way to do it, with an ottoman style bench. In this case, a handy kettlebell (or books, or small speaker, or heavy basket) props up the outside of the foot so it can be relaxed and yet perfectly upright.

Take a look at how much space he has between the floor and his knee. OOOsh. He’s had several surgeries on each knee, and we are trying to passively and  gently reposition the knee taking into consideration the back and the hip.

My Santa story

Want to hear the Santa story now that you are all snuggled in? This is a great time to turn on a movie, or in Bill’s case, he watches basketball while doing what he calls his “knee stretch”. Remember my reference to Santa above? This is my favorite Supine Groin story to tell while my clients are waiting for gravity to work it’s magic.

Once upon a time, I had a client who wanted to climb Mt. Everest. He trained, and trained, and trained (not with me) and flew off to Nepal, where he happily eventually arrived at his dream destination: Base Camp at 20,000 feet. Suddenly, fate struck a cruel blow, and he without warning all of a sudden went into a bilateral hip flexor spasm. Hard. Fast.

Boom!

Do you know what you look like when you are standing, and then go into a hip flexor spasm? You are bent forward- close to a 45 degree angle- from the hips. STUCK THERE HE WAS! Did I mention he looked like Santa? Long flowy white beard, and snowy white wavy hair. That wasn’t the only problem that hit that day. Recall that the hip flexor attaches to the T12-L4 vertebrae (12th Thoracic just below the ribs, and almost all the way to the tailbone). Let’s add bilateral sciatic pain down the backs of his legs to his feet to this misery, shall we? Screaming, burning, lightening bolts of nerve pain down the backs of both legs.

Horrible!

Image of Mt Everest courtesy Huffington Post

Unfortunately, the camp doctor didn’t know what to do with him, so he sent him on a pack animal ( I think a Yak?) down the mountain to the nearest village. Imagine how much fun that ride must have been. 🙁 Super unfortunately, the village doctor didn’t know what to do with him either, other than put him on a direct opiate derivative. He said at that point it didn’t cut the pain, but he didn’t care. Super duper unfortunately, just when you think this can’t get any worse, our Santa starts to hallucinate because this drug is so powerful.

Oooooh no.

Imagine this: a tall American who looks like Santa bent forward at a crazy angle hallucinating in a village in Nepal. What’s the most logical thing to do at this point? Oh, I know. Let’s send him to a psychiatric ward in India!

What????

At this point in the story, his wife finally tracks him down, flies to India, rescues him, and takes him back to Los Angeles where she has to immediately admit him to a rehab facility thanks to the direct opiate derivative. Lest we forget, no one has done anything about those hip flexors! Finally, he makes his way to the Egoscue clinic where I worked, and he and I spend the next six months on the floor doing Supine Groin.

How does this story end?

A year later, he came back for a follow up visit. He was doing great, and mentioned that he jokingly told his wife that now that he was feeling good, he was thinking about returning to Everest. “Do that, and I’ll divorce you!” was her reply. 🙂

The moral of the story: let your hip flexors relax. Do your Supine Groin. Your marriage is worth it!

🙂
Let us know in the comments below if you’ve had troubles with hip flexors and what you’ve done about it!