The tensor fascia lata (TFL), quadriceps, and sartorius muscles comprise what I call the big three hip flexors. These muscles are often overlooked in rehabilitation with more focus placed on a fourth hip flexor, the iliopsoas. In my opinion, though, these three hip flexors cause much more damage due to their size, the fact that they alter pelvic and knee mechanics, and their involvement in just about everything we do with our legs.

Sit on the ground with your legs straight out in front of you. Bend both knees to bring your feet together, heel to heel and toes to toes. Using your hands, “open” your feet like you are opening a book. This will cause the knees to lower toward the floor. You can also use your arms to put gentle pressure on your knees to push them toward the floor and intensify the stretch. Keep your back straight and don’t huch forward. Breath deeply.
There is no simple orthosis for the management of isolated paralysis of the hip flexor muscles. While the hip guidance and reciprocating gait orthoses mechanically assist hip flexion (see p. 115), neither is prescribed solely for this purpose. Rather they are prescribed for patients with extensive bilateral lower limb paralysis who also require orthotic support around the knees and ankles.
Another way to look at it, if you stretched a short and tight muscle and it regained length, it shouldn’t get tight again, should it? Whereas if the muscle wasn’t technically “tight” but rather holding excessive tone in order to keep your spine from looking more like a losing game of Jenga, stretching it will just give more opportunity for low back pain, and quickly lead to the muscle tensing up again to defend the spine. This is the problem with conventional hip flexor stretches.
To stretch your quadriceps at the hip, the idea is to do the opposite movement to flexion, i.e., extension. You can perform extension moves at the hip while standing, lying on your side, lying prone (on your stomach) and kneeling. Even basic stretches done at a pain-free level where you can feel a small bit of challenge, and that are held continuously for approximately 30 seconds may translate to better posture and less back pain.
Start in a runner’s lunge with right leg forward, right knee over right ankle and back leg straight. Walk right foot over toward left hand, then drop right shin and thigh to the floor, making sure to keep right knee in line with right hip. Allow left leg to rest on the floor with top of left foot facing down. Take a moment to square your hips to the front of the room. Hold here, or hinge at hips and lower torso toward floor, allowing head to rest on forearms. Hold for at least 30 seconds, then repeat on opposite side. You want to feel a moderate stretch in the outside of the right thigh, but if this pose hurts your knees or feels too uncomfortable, stick with Thread the Needle.
When these muscles are under constant tension because of ergonomics and habitual postural positioning, they may become tight and shortened. This can result in pulling forward on the lumbar vertebrae, creating hyperlordosis and causing the pelvis to tilt anteriorly. This is commonly seen in people who maintain a seated position for a prolonged period such as office workers, computer programmers, and others who find themselves sitting at a desk for hours every day. It is important to provide education on proper ergonomics, movement, and self-care to these individuals.
To work these tissues, start by locating your iliac crest. Sounds like a rare bird species, but it's the top bony part of your hip that sticks out by your beltline. If you're using a lacrosse ball, simply move into a plank position on the ground and lay on the ball so that it presses into your hip just below the crest. Move side-to-side slowly, so the ball moves back and forth laterally several inches at a time.
Beverly Hosford, MA teaches anatomy and body awareness using a unique method that involves a skeleton named Andy, balloons, play-doh, ribbons, guided visualizations, and corrective exercises. She is an instructor, author, the NFPT blog editor, and a business coach for fitness professionals. Learn more about how to align your business with her coaching guide, Fitness Career Freedom and your body with her Fundamentals of Anatomy Course.

You're more likely to get a hip flexor injury if you've had one in the past, you don't warm up properly before engaging in athletic activity, your muscles are already tight or stiff, or your muscles are weak from being overused. If, while exercising, you try to do too much at once in too short an amount of time, you can also put yourself at risk for a hip flexor injury.


This stretch targets the abductors, opens the hips, and stretches the outer length of the legs and hips. Begin on all fours, with your palms flat on the floor and your toes raised behind you. Extend your right leg straight out to the side, resting your right foot flat on the floor. Press your hips down toward the floor to increase the stretch. Hold this pose for 30 seconds before releasing and performing with the other leg.
Think about keeping your head over your heart, and your heart over your hips, and don’t allow an excessive curve in your back. Keeping this correct posture will ensure you’re doing the stretch right. Squeeze your glutes as tight as you can, keep your back tall, and lean forward slightly. One to two inches should be enough! You should feel this in the front part of your hip on the leg that’s underneath you. Switch legs after 30 seconds or so; repeat as desired.
Unilateral exercises like step-ups and single-leg toe touches are particularly effective at strengthening the glutes, while walking lunges, lateral lunges, air squats, and jump squats will zero in on all the muscles surrounding the hips. Whether you’re at the gym or heading out for (or back from!) a run, these five moves will strengthen and open your hips, keep them loose long-term, and not only make you a better runner, but make running feel better to you.
Work on strengthening all of your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to all of them.
Hey Martha! Thank you so much for your comment! You’re right, if you’re flexing the hip it’s hard to stretch it! The last three you mentioned are so helpful for focusing on the adductor group, although yes, they aren’t helping stretch the rectus femoris in those positions. I was trying to include a variety of stretches to include every hip flexor muscle. I’m very curious about the lying hip flexor stretch now, though. It’s been a go-to with every trainer I’ve worked with, and I’ll have to look into this more. What are your favorite hip flexor stretches for patients? Thank you!
There is no simple orthosis for the management of isolated paralysis of the hip flexor muscles. While the hip guidance and reciprocating gait orthoses mechanically assist hip flexion (see p. 115), neither is prescribed solely for this purpose. Rather they are prescribed for patients with extensive bilateral lower limb paralysis who also require orthotic support around the knees and ankles.
There is no simple orthosis for the management of isolated paralysis of the hip flexor muscles. While the hip guidance and reciprocating gait orthoses mechanically assist hip flexion (see p. 115), neither is prescribed solely for this purpose. Rather they are prescribed for patients with extensive bilateral lower limb paralysis who also require orthotic support around the knees and ankles.

The sartorius supports the more powerful iliopsoas and rectus femoris in accomplishing hip flexion. This long, narrow muscle arises from the front of your hipbone, crosses your front thigh and inner knee and inserts at the top of your shinbone. The unique position of the sartorius enables it to support other leg motions, including knee extension, leg rotation and outward thigh movement. Sartorius strains, which commonly occur in runners and hurdlers, usually occur where the muscle arises at the hipbone. Pain and leg weakness are common symptoms. As with the other hip flexors, stretching and strengthening exercises serve as good preventive measures.
Widen your knees ever so slowly until you feel a stretch in your inner thighs. Make sure your ankles are in line with your knees, your hips stacked over your knees, and your feet and calves should be grounded and toes pointed out. Relax your shoulders, and if you’re able to, lower down to your forearms. If you have a yoga block, resting your chest on it will help you release your hips.
If you’re lucky, you won’t notice your hips are tight until you’re trying to do the Half Pigeon pose in your yoga class. But if you’re not so fortunate, your tight hips are making themselves known every time you so much as walk to the bathroom or sit on the couch—expressing themselves in the form of lower back pain and muscle stiffness. Tight hips can even shorten your stride, slowing your 5K goal time!
3) The athlete or client will use the rectus femoris to create hip flexion. This is the mysterious “quad pull” seen in sprinters or on forty-yard dash day in football. In this case the etiology is the same as above, only the culprit is now the rectus femoris, not the TFL. It should be noted, that most “quad pulls” or “quad strains” are limited to the multi-joint rectus femoris. Soreness will generally be near the insertion point of the rectus femoris into the quadriceps at about the mid-point of the thigh. The psoas and iliacus are to the anterior hip as the glute is to the posterior hip. A weak glute max will cause synergistic dominance of the hamstrings and extension of the lumbar spine to compensate for hip extension. This will lead to back pain, anterior hip pain (another Sahrmann point: use of the hamstring as the primary hip extensor changes the lever arm of the femur and can cause anterior capsule pain), and hamstring strains. On the literal opposite side a weak or under-active psoas will cause back pain from flexion rather than extension, TFL strain and rectus femoris strain.
Located deep in the front of the hip and connecting the leg, pelvis, and abdomen, the hip flexors— surprise, surprise— flex the hip. But despite being some of the most powerful muscles in our bodies (with a clearly important role), it’s easy to neglect our poor hip flexors— often without even knowing it. It turns out just working at a desk all day (guilty!) can really weaken hip flexors since they tend to shorten up while in a seated position. This tightness disrupts good posture and is a common cause of lower back pain. Weakened hip flexors can also increase the risk of foot, ankle, and knee injuries (especially among runners) Hip muscle weakness and overuse injuries in recreational runners. Niemuth, P.E., Johnson, R.J., Myers, M.J., et al. Rocky Mountain University of Health Professions, Provo, VT. Clinical Journal of Sport Medicine, 2005 Jan; 15 (1): 14-21.. So be sure to get up, stand up every hour or so! And giving the hip flexors some extra attention is not just about injury prevention. Adding power to workouts, working toward greater flexibility, and getting speedier while running is also, as they say, all in the hips The effect of walking speed on muscle function and mechanical energetics. Neptune, R.R., Sasaki, K., and Kautz, S.A. Department of Mechanical Engineering, The University of Texas, Austin, TX. Gait & Posture, 2008 Jul; 28 (1): 135-43..
Start in a runner’s lunge with right leg forward, right knee over right ankle and back leg straight. Walk right foot over toward left hand, then drop right shin and thigh to the floor, making sure to keep right knee in line with right hip. Allow left leg to rest on the floor with top of left foot facing down. Take a moment to square your hips to the front of the room. Hold here, or hinge at hips and lower torso toward floor, allowing head to rest on forearms. Hold for at least 30 seconds, then repeat on opposite side. You want to feel a moderate stretch in the outside of the right thigh, but if this pose hurts your knees or feels too uncomfortable, stick with Thread the Needle.
While each muscle functions slightly differently, their overall combination allow them to flex the hip joint, anteriorly rotate the pelvis, and extend the lumbar spine. Due to its’ attachment on the vertebral bodies of the lumbar spine, the psoas also plays an important role in lumbar spine stabilization (1), an often forgotten function of this muscle.
Sit on the ground with your legs straight out in front of you. Bend both knees to bring your feet together, heel to heel and toes to toes. Using your hands, “open” your feet like you are opening a book. This will cause the knees to lower toward the floor. You can also use your arms to put gentle pressure on your knees to push them toward the floor and intensify the stretch. Keep your back straight and don’t huch forward. Breath deeply.
Imagine not being able to climb stairs, bend over, or even walk Changes in hip joint muscle-tendon lengths with mode of locomotion. Riley, P.O., Franz, J., Dicharry, J., et al. Center for Applied Biomechanics, University of Virginia, Charlottesville, VA. Gait & Posture, 2010 Feb; 31 (2): 279-83.. All pretty essential if you ask us! But that’s what our bodies would be like without our hip flexor muscles. Never heard of ‘em? It’s about time we share why they’re so important, how your desk job might be making them weaker (ah!), and the best ways to stretch them out.
To complete this stretch, take a knee in front of a wall so that the toes of the leg you have raised are pressing against the wall. Place that same hand against the wall. Reach behind you with your other hand and grab your leg that’s sitting on the floor by the ankle, and bend it back towards your body. Hold this position and lunge forward towards the wall to complete the stretch. Hold this stretch for 10 seconds, then repeat on the other side of your body.

Another way to look at it, if you stretched a short and tight muscle and it regained length, it shouldn’t get tight again, should it? Whereas if the muscle wasn’t technically “tight” but rather holding excessive tone in order to keep your spine from looking more like a losing game of Jenga, stretching it will just give more opportunity for low back pain, and quickly lead to the muscle tensing up again to defend the spine. This is the problem with conventional hip flexor stretches.
The hip flexors in particular can be troublesome little cusses. These muscles are crucially tied to the functionality of everyone from elite athletes to senior citizens, but working them can make anyone feel silly. After all, you never see videos of Ronnie Coleman walking with his arms extended in front of him like a zombie, attempting to raise his toes up to his hands.
The iliopsoas is another powerful hip flexor that begins in two distinct regions proximally. The iliacus has a broad origin, arising from the inner table of the iliac wing, the sacral alae, and the iliolumbar and sacroiliac ligaments. The psoas originates at the lumbar transverse processes, the intervertebral discs, and the adjacent bodies from T12 to L5, in addition to the tendinous arches between these points. Distally, the two large muscular bodies converge to become one distinct structure—the iliopsoas—and subsequently jointly insert at the lesser trochanter of the proximal femur. The nerve to the iliopsoas (i.e., the anterior division of L1 to L3) supplies the iliopsoas muscle.
The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to  postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.
If you have a stiff, tight or painful hip then www.HipFlexor.org will unlock your hip flexors and restore movement the way it should be. Unlocking your hip flexors instantly breathes new life, energy, and strength into your body! I experienced immediate results. I've been able to loosen up my hips, decrease back tightness, and even workout harder. With so many people suffering with hip pain out there, this program is a great tool for anybody that wants to reduce pain while improving strength, performance, and overall health. Hip flexibility, mobility and strength is one of the most important things you can do to keep your overall body healthy. The video presentation and visuals in the exercise program give me confidence that I am doing the exercises correctly which for me is key with no personal trainer. The website is very complete in listing the possible causes of tight hip flexors and other factors that can lead to the issue. It has detailed, descriptive information regarding the anatomy of the hip, causes of such injuries, and a very progressive and well-explained exercise and stretching schedule that will assist to re-balance the hip and pelvic region, safely stretch and strengthen the muscle group. Best of luck to you! :) Report
One of the biggest dangers to your health is constantly sitting for long periods of time which can cause physical and emotional damage. 10 key moves that will help loosen your hip flexor and unlock the power within your body. There is an easy to follow program to unlocking your hip flexors that will strengthen your body, improve your health, and have an all day energy..... https://bit.ly/2HYTPrJ Report

Sit on the ground with your legs straight out in front of you. Bend your right knee so that the sole of your foot is against your left inner thigh. Keeping your back straight (and not rounded), reach your hands toward your left foot so that your torso is completely over your left leg. If you can’t reach your foot, rest your hands on your leg. Relax your shoulders and let them “drop” toward the floor. Repeat with the other leg.
To test the flexibility of the hip flexors, specifically the iliopsoas, the Thomas' test10 is used. The patient lies supine and flexes one hip, pulling one knee to the chest. If a hip flexion contracture is present, the contralateral straight leg will rise off of the table. The modified Thomas' test (Figure 12.11) may be preferred. With this variation, the patient sits at the end of the examination table with the knees flexed to 90 degrees. Next, one knee is pulled tight to the chest. The patient is instructed to lie down while maintaining the knee against the chest. If a hip flexion contracture is present, the contralateral leg will rise off of the table. If a rectus femoris contracture is present, the contralateral knee will extend.

Now the catch with hip flexion is that most of us sit in chairs and end up in a position of passive hip flexion and knee flexion (bent knees) and retain that position for many hours a day.  We know now that our bodies process the movement or lack thereof and adapt to the shape that we most frequently inhabit, for better or worse.  If you primarily flex the hips and knees and never fully extend them, you may have chronically short or weak hamstrings, limited range of active hip flexion and limited range of active hip extension, for starters!
The patient generally presents with leg stiffness, weakness in the hip flexors, and impaired foot dorsiflexion in the second through fourth decades, although symptoms may be apparent in infancy or not until late adulthood. The gait disturbance progresses insidiously and continuously. Patients may also have paresthesia and mildly decreased vibratory sense below the knees and urinary urgency and incontinence late in the disease. On neurological examination, generally there are no abnormalities of the corticobulbar tracts or upper extremities, except possibly brisk deep tendon reflexes. In the lower extremities, deep tendon reflexes are pathologically increased and there is decreased hip flexion and ankle dorsiflexion. Crossed adductor reflexes, ankle clonus (Video 82, Cross‐Adductor Reflex; Video 84, Sustained Clonus), and extensor plantar responses are present. Hoffman's and Tromner's signs, as well as pes cavus, may be present. Occasionally, slight dysmetria may be seen on finger‐to‐nose testing in patients with long‐standing disease.
Sit on the floor with your legs straight out in front of you. Bend your left knee so that your knee, shin, and foot are on the floor, parallel with your pelvis. Bend your right knee and place it on top of your left ankle so that your right knee is above your left ankle and your right ankle is above your left knee. To intensify the stretch, place your hands in front of your legs and very slowly walk them out as you lean forward. Stay relaxed and breathe. Repeat with the other leg.
It’s a common issue, says Prevention advisor Rob Danoff, director of family and emergency medicine residency programs at Aria Health in Philadelphia. "For people who sit a long time at work, the hip flexors and rotators become tight, and the gluteal muscles become weak," he says. "This combination negatively affects our ability to walk, maintain proper posture, and the stability of our spine."
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