When I do a deep knee bend like a sumo squat I get a popping in the outside of my left knee. It feels like a big tendon or ligament is slipping per something. It isn’t painful peer se but I’m afraid if I do it a lot it will be. Is that a relatively common symptom for a guy with tight flexors, it bands, etc? Should I just push through it or have it checked out?

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.


The better you understand anatomy and biomechanics the more effectively you can program exercise for clients who need correction and/or to restore balance between the right and left sides of the body. There are 11 muscles that flex the hip joint. Each of these muscles also has other abilities for movement. For example, tensor fasciae latae also internally rotates the hip and abducts it. Whereas sartorius abducts but externally rotates the hip. The muscles in the human body all overlap each other in their abilities, making it the machine of many movements that it is.
Grade III (severe): A complete tear in your muscle that causes severe pain and swelling and you can't bear weight on that leg, making it difficult to walk. You've also lost more than 50 percent of your muscle function. These injuries are less common and may need surgery to repair the torn muscle. They can take several months or more to completely heal.
The iliotibial band is a thickening of the fascia lata, the deep fascia of the thigh. Think of it as a thick long ligament like structure that connects the hip to the lower leg along the outside of the thigh.  Tightness in the iliotibial band can cause patellofemoral pain, trochanteric bursitis, and friction syndromes at the knee. This is a hip stretch I commonly prescribe to runners and people suffering from knee pain.
This stretch opens the abductors and deeply opens the hips and lengthens the adductors while improving balance. Stand straight, holding the back of a chair at your left side. Lift your right knee into your chest, and grab hold of your foot with your right hand. Slowly straighten your leg up along your side, into a standing split. Keep your hand on your foot and lean your torso to the left. Hold this pose for 30 seconds before alternating sides.
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.
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.

Any/all of these will indicate that the client or athlete is attempting to compensate for the weak or under-active muscles. The TFL cramp is a classic illustration of synergistic dominance. A muscle cramps when attempting to shorten in a disadvantageous position. With the hip flexed above ninety, the TFL is already shortened and unable to produce the necessary force to hold in a position of poor leverage. The attempt results in cramping, much like a hamstring cramp in bridging when the glutes are under-active. The same effects are often seen when attempting hanging knee ups (an exercise we almost never do, as it teaches compensation), except the cramp or strain is in the rectus femoris.

The hip flexors often get deemed as tight. You can stretch the hip flexors as a group by doing hip extension. This may not get to the root of the issue though. As we just learned, each hip flexor participates in the motion differently depending on the position of the femur. Carefully add internal or external rotation and abduction or adduction when extending the hip to stretch hip flexion. It’s a good place to start when wanting to create a more effective stretch.
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."
How to: Sit down with your knees bent and feet flat on the floor in front of you (a). Place your right ankle on top of your left thigh and flex your right foot (b). Put your hands behind your body, fingertips facing away from your body and begin to press your hips toward your heels until you feel a stretch through your outer left hip. Keep your back tall and chest open (c). Hold for six to eight breaths, then repeat on the other side.
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