Hip Pt. 1 - Hip (flexors) don't lie
By Dr. Joshua Kiely, DC
Every week, I see patients at my chiropractic office in Ottawa who are complaining about tension across the front of one or both hips. Tight hips are usually our body telling us that we’re sitting a ton without balancing our day with enough movement.
Most often, anterior hip tension isn’t painful, but it can be bothersome when we go to run, bike, or lift. This blog will cover a few of the muscles involved in generating this tension feeling and some strategies we can use to reduce it, as well as the considerations for specific sport applications.
A Quick Hip Anatomy Lesson
The hip joint is a robust powerful joint. It is essential that it remains strong and mobile in order for us to walk, lift, carry, and play sports at every age.
The joint consists of two bones - the femur (leg bone) and the ilium (pelvis bone). The pelvis is formed by two ilii configured in a ring attaching to the sacrum and coccyx (the tailbone) at the rear. Up from the sacrum are your lumbar vertebrae.
In healthy people, the hip bones tend to have very high bone-density because they carry the load of our upper body throughout our normal activities. These bones also allow us to transfer huge amounts of power through our legs when walking, running, and jumping.
Why do we get tight hip flexors?
The hip joint is surrounded by several large ligaments that create stability while still allowing mobility. Superficial to these ligaments are many muscles that power our hip through a wide range of motion. This article will focus on the muscles at the front of the hip.
The action we are most concerned with at the front of the hip is flexion - the movement of bringing your knee toward your chest. The main muscles that generate flexion are the psoas, the iliacus, and the rectus femoris.
The psoas travels from the low back to the front of the femur and pulls the leg toward the chest while also stabilizing the low back.
The iliacus travels from the inside of the pelvis and attaches with the psoas on the femur to help with hip flexion.
The rectus femoris is a quadriceps muscle but is unique because it crosses the hip and the knee. Because it crosses both joints, it acts to flex the hips and straighten the knee.
When we sit all day our hips remain in a relatively flexed position, and our body adapts to this. Since we become expert hip flexors, we often struggle to perform hip extension, which is the opposite movement and involves bringing your leg behind your body. Usually, we find that we can improve hip extension by targeting the muscles at the front of the hip.
What do we do about tight hips?
To improve how our hip feels we can do three things:
stretch the front of the hip
move the hip through a wide range of motion often
strengthen the muscles surrounding the hip
There are many tools and movements we can use to accomplish these goals. I’ve demonstrated three exercises that I really like in these short videos on Instagram. These can be performed at home with minimal equipment and are great for prepping for sport or reducing discomfort after a workday.
First, the basic lunge stretch is fantastic for temporarily improving the range of motion in the hip and reducing the feeling of anterior tension. Next, I use the goblet squat with a curl to pry open the hips and practice traveling through a wide variety of hip movements. Lastly, I use the glute bridge to strengthen the hip extensors (glutes, hamstrings, adductors) while dynamically stretching the hip flexors to reinforce this important range of motion.
Sport-specific Considerations and Chiropractic Care
A few key things to consider for athletes are the needs of the sport and the capability to fulfill these needs. For example, a gymnast and a cyclist will have very different requirements to perform their best. Common issues I treat in my Ottawa practices include:
runners complaining about low back pain and tight hips after 2-3km
cyclists who have a very hard time extending their hips after a long ride
weightlifters who get a pinching sensation in the bottom of their squats and deadlifts
When these problems become persistent, it’s usually beneficial to have an assessment to determine any functional or structural issues. If any issues are identified, it’s possible to customize a program of hip-specific exercises in warmups and workouts to improve hip motion to better suit the athlete’s needs.
Often, individuals who find their performance or comfort are suffering due to hip tension also find substantial improvement with 4-6 treatments of chiropractic care. Depending on the patient, treatment can include hip manipulation, soft-tissue therapy, acupuncture, and customized exercise programming.
If you think you may benefit from an assessment and a customized treatment plan, please get in touch and I’d be happy to provide a free consultation to explore your needs and answer any questions you might have. Together we’ll determine if chiropractic care may be a suitable approach to help you play, work and relax more comfortably.
