London Running PT

I keep stretching my hip flexors, but they’re still tight – Where am I going wrong?

This was a statement from a recent patient. It’s something I hear a lot, so thought I’d put out a quick post to explain…

Let’s have a quick look at the hip flexors, so we know where they are: 

Why are tight hip flexors a problem for runners?

Firstly, tightness in the hip flexors can lead to a lack of hip extension. Hip extension is where we get our thrust in running. Secondly, as a compensation to a lack of hip flexion, it generally means the pelvis tilts anteriorly during the second half of stance. This means that your glutes and hamstrings are going to struggle to work efficiently, and the anterior tilt, means no pre-stretch on the hip flexors to help with the subsequent knee drive. Both of these issues are not great for runners, so having mobile hips, that work independently of a stable pelvis is essential.

Why do we get tight hip flexors?

“You are what you do all day”

Usually, muscles get tight for 2 main reasons:

1) They are overloaded. They are being asked to do too much for their current level of conditioning. Imagine that new class you go to at the gym, and the instructor has a squat fetish! Next day your quads are seriously tight as a consequence of overloading them

2) If the muscle is kept immobilised, in a shortened position, for long periods. Hip flexor tightness is more related to the latter, in recreational runners. Who’s the bad guy in this story?… Step forward Mr Chair!…hang your head in shame!

In modern society, we tend to sit for long periods of time. These static postures, not only play a part in some back and neck issues, but also in shortening muscles, such as hip flexors. A typical story I hear in clinic is: wake up, sit to eat breakfast (if you’re lucky,) sit on the train/tube/car to commute into work, sit all day at your computer, sit on the train/tube/car to commute home, sit to eat your dinner and, if you’re really lucky, sit to watch TV for 30 mins – then repeat the next day and the next and the next. It’s a phenomenal amount of time spent in one position.

You can see that the sitting posture shortens the hip flexors, so if they stay in this position for long periods of time, they’re going to stay shortened. You could stretch every day, but if on the other side of the scale is 15 hrs of shortening, what’s going to win?

This imbalance is why, my patient’s hip flexors, were still tight after daily stretching. 

What to do about it?

Readdress the balance! 

Don’t throw away the chairs just yet. We don’t need perfection, just a little better. Intuitively, if we are shortening for 15 hrs a day, we need to limit the amount of time we spend sitting. Some people are lucky enough that they have a job that keeps them upright and moving anyway, but for the office workers, this is more of a challenge.

One way to get around this, is with a sit-stand desk.  It’s important to note the movement is the real key here, not necessarily that standing is better than sitting. You can stand in one position, for many hours, and cause as much problems as sitting, but the sit-stand desk gives you an option for movement. Sit for a bit, stand for a bit, sit for a bit… you get the picture. They’re not only a good idea for hip flexors, but also patients with desk related neck and back issues.

There are many different options of standing desk out there, and at various prices. This is the one I use in clinic.

How to run faster - VARIDESKPRO

This is the VARIDESK pro, and is towards the cheaper end of the scale for sit-stand desks. Despite being on the cheaper end of the scale, it’s still a quality bit if kit. I was worried it would be a bit flimsy, but it’s actually really sturdy and feels well made. Moving from standing to sitting, and vice versa, takes no effort at all. You just press the two handles at the side and move it where you want it. Going from sitting to standing takes about 3 secs! The only things to note with this desk is, if you’re using a lap top, like me, you won’t need the pro version. You would be better off with the slightly cheaper standard VARIDESK option. This doesn’t have the keyboard stand, as you don’t need it for laptops. I would highly recommend this sit-stand desk.

There are many different options to have a look at, if you’re interested in a sit-stand desk, ranging from a few hundred pounds to a few thousand. As always, have a look around and find one which suits your needs.

Stretching/Mobility work

Don’t give up on the mobility work. If you don’t regularly use a joints full range of motion, you will lose your ability to go there. Coupling a good mobility programme, with less sitting, is a winner for hip flexors.

Just a little word on stretching, whilst I think if it… When you are doing your stretches, the “stretch” that you feel, is actually a muscle contraction. Sounds weird, I know, but all muscles have little receptors called muscle spindles. Their job is to assess stretch in muscles, it’s a protective thing. So if you lengthen a muscle, by moving apart its origin and insertion points, you will get to a stage where the muscle spindles report back to the brain, or spinal cord, and says “that’s enough movement, thank you, any more and we might be injured”, so at that point the muscle will contract to prevent further motion. The contraction is what we perceive as a “stretch”. Stretching, or mobility work, helps improve range of motion, not by elongating the muscle necessarily, but by convincing your muscle spindles, and brain, that’s it’s safe to allow more movement before a protective muscle contraction. The more you use a range of motion, the more confidence the brain will have that it’s safe for you to use this range. If you haven’t used a range for a long time, the muscles spindles and brain will say, “hang on a minute, we haven’t been here for a while, be careful”, and therefore muscles contraction will come on earlier in the range, and you will get the perception of tightness (hope that makes sense).

Here’s a couple of great hip flexor stretches. If I could give you one piece of advice when stretching hip flexors: Do not forget the posterior tilt!

Go to 2mins into this Kelly Starrett video for the sofa stretch

I really like Kelly Starrett’s mobility work. He tends to work for 2mins at a time, and tries to get all areas and planes of motion. I think this is a good guideline for your mobility work: 2 mins at a time and explore all ranges!

Here’s another option from James Dunne at Kinetic revolution

I hope this article has improved your understanding of mobility work (stretching), and you have few ideas on how to increase the range of those hip flexors. Any questions, as always, don’t hesitate to let me know.

May 27, 2015

1 Responses on I keep stretching my hip flexors, but they're still tight - Where am I going wrong?"

  1. Howdy! I’m at work browsing your blog from my new iphone 4! Just wanted to say I love reading your blog and look forward to all your posts! Carry on the outstanding work!

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