Tight Hip Flexors

Tight hip flexors are one of the most common things that patients complain to me about. The all too familiar tightness in the crease where your legs meet your body. A quick google search shows how common an issue this is!

Tight hip flexors get blamed for lower back pain, hip pain, inability to engage core muscles, reduced stride length, and the latest economic crisis.

And to an extent, the tight hip flexor may be contributing to all of those things (maybe not the economic crisis). However, like anything in life, it is often not as simple as the hip flexor being tight. And before you even get out of the gate, it may not actually be the hip flexor in the first place. 

There are other parts of the body that can refer to the front of the hip.

A list of things that could potentially refer into the front of the hip. 

1. The hip joint itself (surprise surprise).

2. Joint or nerve from the lower back.

3. Nerve that travels through the front of the leg

4. Inguinal hernia

5. Bursa (sack of fluid that protects and lubricates hip)

I have often had patients complaining of stubborn hip flexor tightness that isn’t going away despite the amount of stretching they are performing. And when I have taken the time to assess them, it was actually one of the structures listed above. 

As you can appreciate, you want to make sure you are not barking up the wrong tree before you throw an aggressive stretching routine at feelings of tension in the front of your hip. You really want to nail down the diagnosis to make sure you are treating the right bodypart and not wasting your most precious resource…TIME!

Now for the sake of this article, let's assume that you actually have tight hip flexors and that there is no other condition involved in the background. Great. Most people’s go-to-solution is to stretch the hip flexors within an inch of their lives and hope that this is going to fix it. And to be entirely fair, yes this does make logical sense. If something is tight, it must be too short for what I need. If it is too short, I need to stretch it to lengthen it. 

However, there are alot of reasons why you may have tight hip flexors beyond them being “short”. And if you are not addressing these other reasons, then your tightness is going to return.

And here is the secret: your hip flexors may be tight because of weakness!! They may not be able to keep up with the demands of life or your favourite activity, and are tightening up due to fatigue or attempting to create mechanical advantage for itself to keep chugging along (the body is super good at coming up with alternative solutions AKA compensating). 

I have also seen in some patients that the hip flexors are sufficiently strong enough. However, the hip flexor is overworking because of weakness through the glute medius due to instability. I had a martial arts patient from a striking background who would get progressively tighter hip flexors as their training session progressed and they would eventually have to stop training due to cramping in their hip flexors. When assessed, they had really low glute medius strength, so their hip flexors were compensating to create stability of their base leg when kicking. Fortunately, they responded beautifully to strength work. 

I don’t want to make out that stretching is something that should be completely avoided. Sometimes stretching is the answer. Patients who have a long history of desk work and mostly sedentary lifestyles can respond really nicely to hip flexor stretches. However, care is necessary to make sure they are actually truly stretching their hip flexors and not irritating other structures accidentally. 

And this is where having a solid physio on your side can assist in assessing you, figuring out what your problem is, why the problem is there in the first place, and how to get you to where you want to be. A good physiotherapist is like a guide to ensure that you can get to your destination as fast as possible and keep you doing what you love. 

If what has been written resonates and aligns with your goals, we at Top Performance Physio Chatswood would love to assist you on your journey.

Happy Training!