Improving Hip Extension

October is National Physical Therapy Month. Over the next few weeks, I will be talking about ways to improve your hip mobility. This week will focus on improving hip extension. This is my first attempt at a video piece, and I hope to get better at teaching the exercises as I go along. I welcome any feedback to help me get better.

I am in my car and sitting a lot these days. While I do get in and out frequently, I find my hip flexors are getting shortened and I am having a harder time assuming a clean ½ kneeling position. I notice it especially when transitioning from ½ kneel to stand and back down in the Turkish Get Up. I either hyperextend my back or place my knee too far forward. I also notice that in everyday activities, my back is a bit stiff and I have a harder time reaching overhead to put things away in my cabinets.

 I believe that muscle tightness can be due to a movement pattern and muscle group either over or underworking. I will usually recommend following a stretch or tissue release of one structure with an activation of a different structure. However, I also find that position will feed into stiffness and bodies are meant to move vs be in one prolonged position (i.e. sitting all day long). When we spend too much time in one position, structures will become shortened and feel stiff. It’s important to take these structures through different motions to keep the mobility. Sometimes isolated stretching is beneficial to get out of the same posture.

Since our joints are designed to move in three planes of motion and the muscles that move them control this motion, in order to improve my hip extension, and therefore positioning in the TGU and ½ kneeling position, I need to utilize a 3D movement pattern to effectively stretch.

We call the movement of bringing our knee closer to our trunk hip flexion. The muscles that flex the hip are called the hip flexors. Although it is thought that there is only one muscle there are quite a few muscles that contribute to hip flexion. These are the Iliacus, Psoas, Rectus Femoris, Sartorius, Pectineus, Adductors Longus, Brevis and Magnus and Tensor Fascia Lata. These muscles not only create flexion, but also adduct, abduct, internally and externally rotate the hip.

In the attached video, I demonstrate my current favorite hip flexor stretch. I like to do it first thing in the morning after I’ve been curled up in a ball all night. I start on my side with my knees at 90/90 flexion and my head and trunk in a relaxed/neutral position. I then bring my legs into a ½ kneel position while lying on my side. I alternate each leg forward on both sides. In this position I can get hip extension, adduction and internal rotation. While this is generally more of a static stretch, if I rock slightly forward and back or raise my arm overhead it will elongate and change the stretch while adding a multi-directional component. 

I would encourage you to change your position frequently throughout the day to take your joints through different movements. This hip flexor stretch can help if you are having a hard time coming out of a flexed position. It is normal to feel a nice stretch in the front and side of your thigh and into your lower abdomen. If it is painful ease back out of the stretch. If you are continually stretching and not able to make a lasting change, you may need to be activating a different pattern or actually strengthen your hip flexor pattern instead of releasing it. And as always, if you’re having pain or not making a lasting change I encourage you to get assessed by someone who specifically works with movement dysfunction.