Last month, I talked about the unique complexity of the shoulder, and how a problem there can produce effects throughout the upper body. Well, the hips are just as complicated, and pelvic dysfunction can be just as far-reaching. Your erectors, glutes, hamstrings, abdominals, quadriceps, hip flexors, and more all interact at this junction, and a problem with any one of them can lead to debilitating immobility and weakness in lifting and in life.
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!
Get down on floor and bring your feet together in front of you, bending your knees out to the side. Sit down into your hips, while keeping your back tall and core tight, and push your knees down to the ground. You can place your hands on your feet or the floor behind you, whatever you need to keep your back tall. If your hips are really tight, gravity might be painful enough for you, no extra pushing required.
It's easy to compensate in this position by hyperextending your lower back, but it's crucial that you don't. Instead, I want you to focus on squeezing your glutes and hamstrings, which will push your hips forward into a full-on "schwing." If your right foot is back, you should feel an intense stretch on the right front side of your hip. Hold it for a long time, like a minute or two, and then switch sides.
The sartorius originates at the ASIS and proceeds to traverse obliquely and laterally down the thigh to eventually insert at the anterior surface of the tibia, just inferomedial to the tibial tuberosity, as part of the pes anserinus. In addition to flexing the hip and knee, the sartorius aids in the abduction of the hip. It is innervated by the femoral nerve (i.e., the posterior division of L2 and L3).
Now that we smoothed out that old tissue and dislodged a few fossilized nasties, let's see what we can do about improving extensibility. The couch stretch is one of the most effective movements you can do for opening up your hip to the end range of motion. Adopt a kneeling position in front of something that you can use to hold your foot up (i.e., a couch). Your back knee should be completely flexed, meaning your heel is as close as possible to your butt.
There’s much more happening behind the scenes when the hip flexes! Learning the attachments of the 11 hip flexor muscles is the best way to begin getting a handle on what’s happening when personal training clients complain of tight hip flexors or seem to have referred back pain from an imbalance in the muscles. You’re then able to design and suggest stretches and exercises that are specific to the issue at hand when you understand the form and function of these muscles. Here’s a few thoughts for you when doing that…
Grade II (moderate): A larger tear in your muscle that makes it difficult to move and causes a moderate amount of pain, especially when you move the affected muscle, swelling, and tenderness. You may have 5 percent to 50 percent loss of function and you may be limping. You can't go back to sporting activities until the tear is completely healed. These injuries can take anywhere from a couple weeks to a few months to heal, depending on how bad they are.
Grade II (moderate): A larger tear in your muscle that makes it difficult to move and causes a moderate amount of pain, especially when you move the affected muscle, swelling, and tenderness. You may have 5 percent to 50 percent loss of function and you may be limping. You can't go back to sporting activities until the tear is completely healed. These injuries can take anywhere from a couple weeks to a few months to heal, depending on how bad they are.
Hey Sunny! I’m so sorry you’ve been experience hip pain since your C-section! I hope these help! :) I actually have an exercise program to help women recover properly from C-sections (mainly rebuilding their core and pelvic floor) if that sounds like something you might be interested in, let me know! I’m wondering if we could get your strength balanced some of that hip pain would go away? Thanks so much for your comment!
Athletes with relative shortening of the hip flexors and accompanying weakness of hip extensors will exhibit decreased hip extension at terminal stance phase or “toe off.” Athletes who lack hip extension may also exhibit related limitation in great toe extension. Often these athletes will show decreased wear under the great toe aspect of their shoe sole and relative increased wear under the more lateral toes. These athletes may also demonstrate increased hip flexion at initial contact or “heel strike” in an effort to make up for the shorter stride length caused by limited hip extension. In patients with knee instability this will contribute to hyperextension or “giving way” of the knee.13
5. Feel free as a bird. Open up those hips with yoga’s pigeon pose! Start on all fours with hands below the shoulders and knees below the hips. Bring the right knee forward until it touches the right hand and place the leg flat on the ground across the body (the right foot is now on the left side of the body, parallel to the front of the mat). Drop left leg to the ground, and extend it back with toes turned under. Keep the hips level, inhale, and walk hands forward. Exhale, and fold the torso over, lowering elbows to the floor. Stay in this position for 5-10 breaths before coming back up to switch sides.
This stretch targets the glutes while opening the hips and groin. Start standing up straight; bend your left knee, and bring your foot up behind your hips. Attach a resistance band around your raised foot and hold the ends of the band with both hands. Raise your arms up and over your head as you straighten your bound leg out behind you. Attempt to pull your leg down toward the floor against the resistance of the band. Perform this exercise for 15 seconds before alternating legs.
Lie on your back with your feet flat on the floor and knees bent. Cross your right ankle over your left knee. Keeping your lower back pressed into the floor, pull your left knee in towards the chest by threading your hands between your legs and pulling gently on your left thigh. Think about keeping your right knee open to really stretch your hip. You’ll feel a little extra lovin’ in the outside of your hip with this one! Repeat on the other side.

Working in the pelvic region is not easy for many therapists and clients. There are cautions and borders that need to be addressed and talked through before addressing these muscles. There are emotional and comfort aspects about working in the lower pelvic region. Some clients find this area too personal or private to allow the therapist's hands in this area. Other considerations are the internal organs such as the intestines, uterus, kidneys, and bladder. As the iliacus and psoas travel under the inguinal ligament and insert into the lesser trochanter of the femur, there is also the femoral triangle, which needs to be worked around. Body positioning can be useful to help access these muscles in a less invasive way while protecting the comfort of the client.
I like to think of myself as a powerful, modern Highland warrior, or maybe a Viking. Had I been born 1,100 years ago I would have leapt first off the longboat to battle hundreds of enemies with a giant axe, or so the fantasy goes. But, it didn't take strength coach Matt Wattles long to put a pin in that balloon. All he had to do was ask me to raise my toes all the way up to his hands, and in an instant, I felt like a senior citizen with a hip replacement. That movement was hard.
The rectus femoris is one of the quadriceps muscles. The rectus femoris arises from the front of your hipbone, runs through the middle region of the front thigh and attaches to the top of the kneecap. In addition to hip flexion, the rectus femoris straightens, or extends, your knee. This dual function increases the vulnerability to strain injuries. Stretching exercises to maintain flexibility and balanced training to equalize your quad and hamstring strength reduce the likelihood of rectus femoris strains.
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.
Tight hip flexors can result in lower back pain, hip pain and injury.  A lot of strain is put on those muscles during activities that involve sprinting and kicking.  For example, runners are more prone to hip flexor injuries because of the small, repetitive movement during running.   But even if you’re not an athlete, hip flexor injuries can occur during everyday activities (for instance, slipping and falling or running to catch a bus).  When those tight muscles are suddenly stretched beyond what they are accustomed to, you might also experience pain in the upper groin region, typically where the hip meets the pelvis.   
How to: Lie on your back with your right knee bent and foot flat on the floor (a). With your left leg fully extended, press into your right foot to shift onto your left hip. This is your starting position (b). Then, squeeze your right glutes to press your left hip open until you feel a stretch, pause, then return to start. That’s one rep (c). Perform six to eight reps, then repeat on the opposite side.
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