Do you have tight hip flexors? I’ve mentioned before that this is something that I struggle with from years of overuse and improper stretching.
In the last two years, my hip flexors (iliopsoas) have bothered me to the degree that I am no longer able to cycle, kickbox, or do heavy squats at all, and can only run and dance a couple of times per week.
Even with months of rest and attempted rehab, my hip flexors are tender when sitting and driving for long periods.
What’s The Problem?
For people who engage in repetitive motion exercises such as running and cycling, as well as people who sit for long periods of time, are susceptible to hip flexor pain.
The hips are flexed by a number of muscles, but when we talk about hip flexors, we mean the iliopsoas group. It’s comprised of the psoas major and minor and the iliacus.
Wise Geek tells us “the muscle is a major muscle in the human body, responsible for stabilizing the base of the spine, allowing the spine to flex, and rotating the hips for a free range of movement.
When kept limber, the psoas function smoothly with the other muscles of the body to support an upright posture and a flexible lower spine and hips.
When the psoas are strained or contracted, it can lead to limitations in free range of motion and an increase of lower back pain. For this reason, people should regularly engage in stretches which will address their psoas muscles”.
The iliacus is a muscle that originates in the hollow of the pelvis, and the whole group comes together at the top of the pelvis.
Two Types of Injuries
The pain can be caused by different things. If the muscles are inflamed, it’s usually Iliopsoas tendonitis.
If the muscles are damaged, as in stretching or tearing, this is called iliopsoas syndrome.
Iliopsoas syndrome needs to be diagnosed by your healthcare provider. If you have pain in the hip and groin area that is unresolved even with a diagnosis, more serious measures may need to be taken such as cortisone shots.
However, there are some things you can do to care for your hip flexors and relieve pain.
Pain Management Techniques
1. Massage. A good massage therapist will have techniques to help the psoas release. You may also want to check out this great video for how to use a partner to help you release.
When you know where to find them, it’s relatively simple to apply pressure to get the hip flexors to release on your own. However, the first time it’s good to have a partner to help you.
Another way to massage an area by yourself is an inexpensive foam roller. You can use a half roller or a full. For my money, I want the full. Yes, it’s a bit less convenient because it moves, but it provides the possibility of many more exercises.
I suggest spending a few dollars more and getting a high-density roller for the most impact. You want as much resistance as you can get in this stubborn area.
The best way to use the roller is to lie on one side and roll from the ribcage to the knee. Starting with the larger muscle groups will reduce the sensitivity a bit when you move to the smaller muscles.
Fair warning, this hurts like a mother. You might swear, or you might cry. I’ve seen people do both. It’s pretty much excruciating, but when it’s over it feels amazing.
After you’ve done the outer thigh on both sides, move to the front. I like to drape one hip over the roller, and use my arms and other foot to balance on the floor as I roll from middle abdomen and mid-thigh.
Now that you’ve done the front of the body, flip over to your back. This can be a bit complicated, but I find it’s best to do one side at a time. It will help release your low back. When you’ve done both sides, then position your whole body over and roll your whole back.
As opposed to your front side, this feels amazing during and after. It’s the perfect way to end your evening routine and get yourself ready for bed.
2. Stretching. There are quite a few options for good stretching of the hip flexors. I often suggest yoga and especially Pilates.
They help strengthen the surrounding muscles, thereby removing some of the strain on the hip. When you have strong abs and lower back, the workload on the psoas will decrease.
Another helpful stretch is to assume a runner’s lunge. You’ll gently press your front hip forward until you feel the stretch. In one variation, you reach the opposite hand to foot overhead to increase the stretch.
A third stretch is good when you’re nice and warmed up after exercise. If your gym has a massage table that’s unoccupied, lay on it supine. Allow one leg to dangle over the edge for 30 seconds, then switch. Repeat 2-3 times on each side.
3. Heat/cold therapy
My favorite thing for this area is a rice pack. You can buy them or make one by filling an old tube sock with rice. These are great because they can be heated in the microwave or tossed into the freezer.
The best relief I’ve found for this area is alternating heat and cold in 15 minute intervals for 1 to 2 hours. While it’s not terribly convenient, it’s helpful.
Biofreeze is my go-to for pain relief when I absolutely need to use those sore muscles. It’s not a treatment, but not a bad stopgap.
I do believe that pain is a signal that something’s wrong, and don’t suggest trying to push through your usual activities until you’ve got a diagnosis and treatment plan. However, when the pain is strong and you’re following your plan, Biofreeze can help in a pinch.
4. Lunges. While we generally think of stretching as the best way to help stretch an area, the hip flexors are a bit unique.
They’re used in every bend, stretch, and twist that we perform all day long, and as such are meant to be worked.
Overhead lunges are probably the best active exercise for the hip flexors. This is basically a regular lunge, but with the arms overhead. You’ll probably want to hold something, such as a small weight plate or medicine ball.
Because the hip flexors assist with stabilization, they’ll become activated with this exercise. Why? When you raise the hands overhead, the psoas goes to work to keep you from falling over.
Reverse lunges are helpful for the opposite reason. Instead of recruiting the hip flexor to work, we’re recruiting the glutes. This allows the hip to relax and stretch.
I hope you’ve gotten some good tips. Something work for you that I didn’t mention? Leave me a comment and let me know all about it!