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Hip Flexor Tightness: Self-Assessment

Posted on 07.15.13

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Tight hip flexor muscles can hamper the ability to extend the hip. This may affect the mechanics of simple activities such as walking or more complex activities such as kicking a ball.1,2

                 The Hip Flexors

The muscles we are primarily concerned with are the:

Gray430

Iliopsoas – This muscle(s) originates on the vertebrae of the lower spine/pelvis and inserts in the upper portion of the thigh bone. The term iliopsoas is a common reference to two muscles: the iliacus and the psoas major.

Rectus Femoris – This is one of four quadriceps muscles. It is unique in that it crosses both the hip and knee. It originates in the pelvis and inserts at the kneecap.

Exercise professionals typically refer to these muscles when the hip flexors are tight. In such a scenario, extending the hip and keeping the spine in a neutral position may be difficult.

 

Testing for Tightness3,4

In order to test for hip flexor tightness, sit at the edge of a table or bench and proceed to:

  • Roll backward bringing your knees to your chest
  • Release one leg while keeping the lower back against the table
  • Ensure that your lower back is against the table and release the leg to be tested.
  • The leg needs to be relaxed
"Normal" Test

“Normal” Test

This picture represents a “normal test.” Notice that the thigh is parallel to the table and the knee is bent to nearly 90 degrees.

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Rectus Tightness

This picture suggests tightness of  the rectus femoris which crosses the hip and knee. Notice that the knee is lacking in the knee bend compared with the normal depiction.

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Psoas/General Tightness

This picture depicts tightness of at least the iliopsoas and possibly the rectus femoris.  The ligaments and joint capsule of the hip may also be contributing to decreased hip extension.

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What to do with this information

If you are healthy and have tight hip flexors, you may want to perform static hip flexor stretches to help improve how you move. Improvements in mechanics during walking or kicking a ball are examples of potential benefits.

Stretches targeting the hip flexors can improve mobility and function and potentially decrease mechanical stress on the hip and lumbar spine.

In some cases, attaining “normal” hip flexibility may not be optimal.  For example, the rhythmic gymnast or cheerleader may require greater hip flexibility.

Stretching

I have covered two effective stretches in an article on static hip flexor stretching. Below is a picture of one of my favorite hip flexor stretches.

Psoas/Rectus Stretch

Psoas/Rectus Stretch

  • Place the leg to be stretched on a table or bed
  • The other leg will remain on the floor
  • Use a strap or dog leash to pull the leg toward the buttocks
  • A gentle pull should be felt in front of the thigh or hip

To specifically address the iliopsoas, bring the leg on the floor further forward and allow the leg to remain flat on the table.

Hold for 3 sets of 30 seconds.

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Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
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Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.
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References

1. Young, Warren, et al. “Relationship Between a Modified Thomas Test and Leg Range of Motion in Australian-Rules Football Kicking.” Journal of Sport Rehabilitation 12.4 (2003): 343-350.
2. Kerrigan, D. Casey, et al. “Effect of a hip flexor stretching program on gait in the elderly.” Archives of physical medicine and rehabilitation 84.1 (2003): 1-6.
3. Winters, Michael V., et al. “Passive versus active stretching of hip flexor muscles in subjects with limited hip extension: a randomized clinical trial.”Physical therapy 84.9 (2004): 800-807.2.
4. “Assessment of the flexibility of elite athletes using the modified Thomas test.” British Journal of Sports Medicine 32.1 (1998): 68-70.

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