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
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.
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.
The psoas, our primary hip flexor, is usually the weakest of the five flexors, and the other four hip flexors have to work more as a result. To test if this is the case for you, lift one knee well above 90 degrees and hold it there, ensuring that you do not compensate by moving your pelvis or leaning forward. If holding this for more than a few seconds is painful or impossible for you, your psoas suck. You are going to have serious trouble squatting to parallel or lower if these muscles can't do their job properly.
The more than 20 muscles that make up your hips are responsible for stabilizing your pelvis, moving your legs from side to side, and shortening to draw your knees toward your chest every time you sit down, run, jump or pedal, explains Kelly Moore, a certified yoga instructor and co-founder of Mindfuel Wellness, which brings health and wellness initiatives to companies throughout Chicago.