Understand Your Hip Flexor Muscles

Hip Flexor Rehab

May 11, 2020May 12, 2020
by Bart

What are my Hip Flexor Muscles?

The hip flexor muscles include your Iliacus, Psoas Major, Rectus Femoris, and Sartorius. The Iliacus and Psoas Major are the primary hip flexor muscles lifting your thigh up, with the Rectus Femoris and Sartorius assisting but are more important with their actions at the knee.

Hip Flexor Anatomy

Iliacus

The Iliacus starts its attachment at the front of the lumbar vertebrae (lower back) and the inside of the pelvis and runs down the pelvis and attaches to the top of the femur (thigh bone). The Iliacus muscle along with the Psoas Major’s primary job is to lift the knee up and forward. It’s the Iliacus that can become very tight through years of running or sitting a desk or doing a lot of driving. Many times, this can be the start of lower back pain for people.

Psoas Major

The Psoas Major attaches at the spine and runs through the pelvis area to the front of your hip connecting to the femur (thigh bone). The Psoas Major and Iliacus together are known as your iliopsoas.

Hip Flexor Strains

Hip flexor strains have a large range of pain based on the severity of the strain. A severe hip flexor strain can have a debilitating effect whereas a minor strain may only show up during certain movements or exercises. The biggest problem with hip flexor strains is the length of time it takes to heal since the hip flexor muscles never get to “shut off” to rest. The hip flexor muscles are constantly firing even when standing doing nothing as they keep you balanced and upright. As we know the number one rule of recovery is rest however the hip flexor rarely gets a chance to rest.

Symptoms of Hip Flexor Strains

Pain or weakness when walking or going up stairs or pulling your knee towards your chest
Pain that gradually developed in your hips over time
Tightness or stiffness after sitting for extended periods of time or after sleeping
Any swelling, inflammation or bruising on the front of your hips or the upper groin area
Pulling sensation in the front of the hip or thigh through to the upper groin area

Hip Flexor Injury Prevention

The best way to prevent hip flexor injuries is to use a proper warm-up including hip flexor range of motion exercises along with active flexibility exercises. Before you begin you need to target your specific hip flexor weaknesses by testing your hip flexor muscles. You can try both the Thomas Test for tight hip flexors and the standing knee hold test for weak hip flexors.

Exercises to Strengthen Weak Hip Flexors

Forward & Backward Lunges

Start in a standing tall position with your feet shoulder width apart. Step forward with your right leg and your right heel should make contact with the ground first then your foot finishes facing straight forward. Slowly lower your body until your right thigh is parallel with the floor and your knee goes forward to your foot but not past it. Press into your right heel to stand back up to your starting position. Now you will step backward with your right leg slowly lowering until your left thigh is parallel with the floor. Press into your right toes to stand up and step forward back to the original starting position.

Glute Bridges

Start lying on your back with your arms either out to the sides or down by your thighs. Bend your legs at 90 degrees with your hips bent at 45 degrees to keep your feet flat on the ground. Squeeze your abdominals, lift your toes off of the ground so you are only pushing through your heels. Lift your hips to the ceiling and hold that position for 3 seconds before lowering your hips to repeat the exercise. Hold your last rep at the top working up to a 60 second hold. Once you can complete a 60 second glute bridge hold you can move on to a more advanced version extending one leg straight out to hold and perform single leg lifts.

Mountain Climbers

Start in a plank position on your hands and toes. Bring your right leg towards your chest inside your arms while keeping your hips flat. From this position alternate bringing one leg towards your chest while extending the other leg out to straight. Start slow maintaining a tight core and keeping your hips down. Once you are efficient at this exercise you can increase your speed and the number of reps to build up your hip flexor strength. Another variation for a carpeted floor is to put furniture sliders under your feet and slide them back and forth or you can use fuzzy socks on hardwood floors.

Lying Leg Raises

Start lying flat on your back with your arms down by your thighs. Contract your abs and lift both legs straight and together up to a 90 degree angle. Then slowly lower your legs to 6 inches from the ground. Repeat the repetitions without touching the ground. Another variation of this exercise is to scissor your legs working up 100 reps.

Single Leg Squats

Start seated on a bench or the edge of a chair. Extend your right leg in front of you off of the ground and stand up on your left leg. Lower to the starting position to complete the rep. Repeat on the other side.

Stretches for Tight Hip Flexors

Spiderman Lunge

Start in a plank position on your hands.
Bring your right leg up to place your foot on the ground outside of your hand.
Gently place your left knee on the ground.
Hold this position pushing your hips into the ground and start turning your core to the right pushing the hip flexor towards the ground in different positions.

Spiderman Lunge Advanced

Start in the Spiderman stretch with your right leg forward.
Pick up your right arm and reach towards the ceiling allowing your body to open up and twist into the left hip flexor even more. Remember to relax and breath through this stretch.

Frog Stretch

Starting position for this stretch is on your elbows and knees.
Let your knees slide out to the sides while maintaining a bend in your knees more than 90 degrees with your feet closer to each other being narrower than your knees.
Once you are in the frog stretch position you will want to push your hips and butt backwards towards your feet increasing the stretch in your groin and hold for a complete breath.
Then move your hips forward to increase the stretch in your hip flexors and hold that for a full breath. Try to slide your knees out further and repeat for 5-10 breathes in each position.

Pigeon Pose

This is a yoga pose that is a great stretch to help with loosen and decrease hip pain.

This stretch starts in a plank position on your hands and feet.
Bring your right foot forward until your knee is on the ground in-between your hands and place your right shin on the ground with your foot tucked into your leg.
Slide your left leg backwards as you lean forward extending your arms out in front of you with your body lying on the right knee. If this is too intense you may have to stay upright until your body is loose enough to extend your leg back and lie forward.

Lying Quad Stretch

This stretch is named as a quad stretch however will stretch both your hip flexor and quad targeting whichever muscles are tighter.

Start this stretch by lying flat and face down on the floor.
Bend your right leg towards your butt as far as possible.
Reach straight back with your right hand and grab your right ankle and pull your heel towards your butt. If you experience any knee pain STOP. (Make sure your heel is straight towards your butt and you are not pulling your leg out to the side twisting your knee.) If you cannot reach back and grab your foot you can put a band or towel around your right ankle and use that to pull with your right hand.
Once in this position you try to lift your right knee off of the ground to place more stretching into the hip flexor making sure your left hip does not lift off of the ground causing stress on your lower back.

The Licorice Lunge

The Best stretch for your hip flexors ever! If you were to only commit to 1 stretch a day for your hip flexors this would be that stretch! Introducing the “Licorice Lunge”. This is an advanced hip flexor stretch and you may have to work up to this stretch.

You are going to start this stretch with your right knee up against a workout bench or wall with your foot extended up the wall.
Bring your left leg into a lunge position.
Sit upright in the lunge position putting both hands on your left knee.
Slowly rock back and forth to loosen this position before we get into the stretch.
Sitting upright again perform a pelvic tilt by curling your butt under and pressing your hips forward.
With a pelvic tilt and pushing your hips forward and downward you will slowly lift your right arm up as high as possible to open the entire right side of your hip flexor.

Foam Roll Hips

Your hips can get foam rolled everyday as long as it doesn’t cause any pain. I personally like to foam roll my hip flexors before I workout in the mornings. However anytime of the day is beneficial as long as there is consistency. The top 4 foam rolling exercises I recommend for your hips are listed below.

Psoas Roll

Start by lying flat in a prone (face down) position on your forearms with the foam roller under your right hip only.
Begin to roll up and down over your right hip flexor
As you roll continue to turn your body outward hitting the hip flexor muscles from different angles and sides
Remember if you find “hot spots” stop and just rest and relax into them as best you can for up to 30 seconds to try and release those tight areas.
Repeat the rolling on your left hip.

Goddess Roll

Lay in a prone position on your forearms with the foam roller under both of your hips.
Engage your core to protect your back as you start bending both knees to 90 degrees with your feet facing the ceiling. Once in that position make sure your feet are together.
Roll from above your hips to 6-8 inches above your knees pressing your hips down into the roller

Foam Roll Adductors

Laying in a plank position with your right leg out to the side at 90 degrees with you right knee also bent at 90 degrees
Place the foam roller under your right groin running perpendicular to your right thigh
Foam roll your adductors by moving side to side on your right groin
Then move the foam roller out towards your knee and roll your quad while you are there.

Foam Roll Glutes/Piriformis

Start by sitting on your foam roller with your hands on the ground behind you to support yourself.
Cross your left leg over your right knee to stretch your glutes and positioning your piriformis to be rolled out.
Leaning onto your left glute begin to roll up and down. Then move your body out to the side to side to cover your Glute Maximus, Gluteus Minimus and Piriformis from all angles.

Hip Flexor Mobility Sequence

Start this hip flexor mobility sequence lying on your back on the floor. Bend your knees at 90 degrees with your feet flat on the floor preparing for a glute bridge. Raise your hips up and pull your knee in for 3 reps on each side keeping your hips up.
Staying in the same starting position as the glute bridge you will cross one leg and raise your hips up. Perform 3 reps on each side pushing your knee away from your body.
Now lift one leg straight for a 45 degree angle glute bridge and do 3 reps on each side.
Next you flip over to all four’s position on your hands and knees. Make sure your hands are under your shoulders and your knees are under your hips. To perform the Birddog you fully extended one arm and the opposite leg out. Then reach underneath your body crunching the elbow and knee together doing 3 reps per side.
Now you lift up to all fours on your hands and feet. Bringing one knee to the opposite elbow tucking it under the body for 3 reps on each side.
Starting in a push-up position bring one leg forward outside your hand. You are in a lunge with a straight back leg. Rock your opposite hip to ground 3 times each side.
Sit-up up in a half kneel position to rock forward and back in a lunge 3 times on each side. Now to stretch out the inner thighs or adductors. You will do this by kneeling upright and extending one leg out to the side with the toes and knees facing up. Sit back until your butt hits your heel then drive you hips forward. Maintain the extended leg knee and toes facing upright toward the ceiling, 3 reps on each side.

In Conclusion

The hip flexor muscles can get tight and weak through years of elongated sitting or driving times and repetitive exercises like distance running. Your hip flexors need to be strengthened or stretched on a regular basis to to help prevent lower back pain, hip flexor pain and/or any hip flexor injuries.