In part two of our hip flexor series, we will discuss some stretching techniques to help lengthen tight hip flexors. A quick review of hip flexor anatomy will help understand how to make stretching more effective. The three main muscles responsible for hip flexion are the iliacus, psoas major, and rectus femoris (which is also part of the quadriceps group). The iliacus and psoas major are often referred collectively as the iliopsoas since they work together as one unit. In short, hip flexion can be thought of bringing the knee up towards the chest, which is the result of a concentric contraction (shortening) of the hip flexor muscles. To passively stretch the hip flexors, the opposite action must be done to lengthen the muscles without contracting them (no tension in the muscle). Therefore, stretching the hip flexors requires a passive hip extension, or bringing the knee back behind the hips and torso. Since the rectus femoris also acts to extend the knee (kicking motion), flexing the knee by bringing the heel towards the glutes will help lengthen the rectus femoris.
Here are a few of our favorite hip flexor stretches:
Knee to chest on top of a foam roller – the key is to keep the bottom leg down towards the ground. This is essentially the same position as the Thomas test discussed in part one of this series. However, adding a foam roller under the lumbar spine helps to place the bottom leg in a greater hip extension while blocking the pelvis from anterior tilt.
Kneeling hip flexor stretch - start in a half kneeling position. It helps to have a pad, Bosu ball, or some type of support under the knee that is on the ground to make the position more comfortable and allow you to focus on the stretch. The goal is to allow your center of gravity, hips and torso track forwards in the direction of the front knee and allow the bottom knee to stay behind the hips and torso. It is important to keep the spine and pelvis in a neutral position, otherwise it will not stretch the hip flexor. One simple trick to help keep the pelvis in a neutral position is to flex the glute of the forward leg and brace the core. Another simple cue that can help stabilize the spine, pelvis, and core is to take a PVC pipe in one hand with a vertical position and push the PVC down into the ground. In order to get a greater stretch on the rectus femoris, you can also flex the heel of the back leg up towards the glute.
3-D kneeling hip flexor stretch- this is the same as the kneeling hip flexor stretch described above, but instead of moving forwards and backwards start moving out to the side in a semi-circular motion. An easy way to think about this is like moving the front leg like the hands of a clock. For example, the right leg could work clockwise from 12 o’clock, 1 o’clock, and 2 o’clock. The left leg could work counterclockwise from 12 o’clock, 11 o’clock 10 o’clock and so on. Another variation of this stretch would be to raise the hand above the head with a side bend in the torso or slight thoracic rotation. This will help to open up the T-spine as well as the hip flexors.
Watch the video for a demonstration of some of these variations. While the hip flexors are commonly blamed for a lot of dysfunction, they are not always the root of the problem. If you are experiencing any pain or dysfunction that does not resolve it is always good to seek out medical evaluation to find the underlying cause. Here at Scottsdale Sports Medicine Institute we are dedicated to providing the highest quality of care for our patients and offer many additional services such as stretch therapy to help as the case may require. Don’t hesitate to call and set up your appointment and continue your path to health, wellness, and performance!
Alex Edwards, CEP, CSCS
Disclaimer: Articles are based on real cases seen at Scottsdale Sports Medicine. The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. Please consult your medical professional for individualized healthcare.
Lorenz, D. (2007). A Multi-Plane Hip Flexor Stretch. Strength & Conditioning Journal, 29(2), 68-70.