Tight hip flexors are a common complaint among individuals. Sitting for too long is the usual suspect, but highly active individuals can experience tightness. Here is a hip flexor test to determine if there is tightness:

• Lie on your back on a table or bench
• Let the lower part of the legs hang off the side at the knees
• Pull one knee up to the chest while keeping the head, shoulders, back, and hips in contact with the table/bench
• The other leg will stay in contact with the table/bench with the knee at a 90-degree angle if the hip flexors are not tight.
• If they are tight, the other leg will come up from the table/bench, causing the knee to come out of the 90-degree angle.
• Perform on both sides because one hip flexor could be tighter than the other

However, if the hip flexors are not tight but still have discomfort and soreness, the most common cause is weak hip flexors.

Why Hip Flexors Become Tight

Figuring out what’s making them so tight varies from person to person. Some individuals are more susceptible to tight hip flexors than others. Here are common reasons why individuals experience discomfort, soreness, and pain:

• Sitting for a long time shortens and weakens the flexors
• A shifted pelvis could be an anterior or posterior pelvic tilt
• Uneven hips can cause tightness on one side
• Poor posture can lead to standing or leaning on one hip
• Sleeping too much on one side
• Running or exercising without regular stretching, especially of the hips

Tight Hip Flexor Symptoms

Many are surprised by how tight hip flexors can affect the rest of the body. This is because of the many different muscles in the hip flexor group. They help lift the leg at the hip, help stabilize the spine, and can affect the neck and shoulder area.

• Tightness in the upper groin/hip area
• Pain/tightness in the glutes
• Tight hamstrings
• Pain/tightness in the lower back when standing up
• Trouble standing up straight
• Pain/tightness in the neck

Releasing Tight Hips

The test is a great way to determine if the hip flexors are tight. Before attempting to stretch the hip flexors, it is key to determine whether the flexors are tight or weak. If the hip flexors are not tight, stretching them will not help. Instead, they need to be strengthened. Individuals can confuse tight hip flexors with weak ones and become frustrated when there is no relief after stretching.

Stretches

Here are some easy stretches for the hip flexors.

Butterfly Stretch

• Sit on the floor with the heels and toes of the feet pressed together
• The weight of the knees as they open and move forward to the floor will stretch the hips
• For a greater stretch, gently press down on the inside of the knees
• Hold for 30 seconds to a minute

Chair Figure 4 Stretch

• Sit in a chair
• Raise one leg and place the ankle on the opposite knee
• Straighten the back and then hinge the torso forward
• The stretch will be felt in the hip and glute
• Hold for one minute
• Switch legs and repeat

Kneeling Hip Flexor Stretch

• Kneel down with one leg bent at 90 degrees in front and the other at 90 degrees underneath
• Keep the back straight
• Squeeze the glutes
• Tuck the pelvis forward
• Maintain this position, lean forward gently into the forward leg
• The stretch will be felt along the hip and front of the underneath leg
• Hold for 15 to 30 seconds
• Repeat 3 to 5 times

These stretches can be done 2 to 4 times throughout the day, keeping the flexors from tightening.

Chiropractic Care To Loosen Tight Hips

If dealing with pain in the hips when stretching or sitting, there could be something other than tight hip flexors or in addition to tight flexors. If exercising or stretching causes discomfort/pain, stop the activities and contact a chiropractor for a possible hip adjustment. Chiropractic medicine specializes in the entire musculoskeletal system.

Massage

Combined with a hip adjustment, massage therapy will help relieve pain and stiffness and improve circulation. Many find relief from a massage after an adjustment, while others receive a massage before the adjustment.

Hip Flexors Cracking

A less common issue with hip flexors is cracking or popping during activity/s. Individuals can experience this while exercising or running, usually caused by a tendon or muscle sliding over the bone. It can be difficult to determine the cause of the cracking/popping without seeing a medical professional. In some cases, it could be gas escaping the hip joint, while in others, it could be an issue that needs to be addressed by strengthening, massaging, and working out the muscle or tendon.

Strengthening Weak Hip Flexors

For those with weak hip flexors that are causing the discomfort, here are some exercises:

Single-Leg Stance

• Stand on one leg
• Keep the thigh of the other leg lifted parallel with the ground and the knee at 90 degrees.
• Hold for 30 seconds
• Switch sides
• Repeat 6 to 8 times

Knee Raises

• Lift each knee as high as possible
• Try to perform quickly but with control in alternating movements
• Continue for 30 to 60 seconds
• Repeat 3 to 5 times

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Body Composition

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Physical activity decreased

Physical inactivity is a primary factor in the progression of sarcopenia. Regular resistance exercise can help maintain muscle mass and help build muscular strength. Individuals that are more sedentary can exacerbate the effects of sarcopenia.

Decreased motor neurons

Aging comes with a loss of motor neurons caused by cell death. This leads to a decrease in muscle fiber numbers and size. This decrease leads to:

• Impaired performance
• Reduction in functional capacity
• Decreased ability to perform everyday chores/tasks

Increased Pro-inflammatory Cytokines

Poor diet and exercise are known to promote and increase visceral fat storage. This type of fat produces pro-inflammatory cytokines, which can accelerate muscle breakdown. Obesity and muscle weakness are associated with high levels of pro-inflammatory cytokines. This is made worse by decreased muscle mass and plays a role in the progression of sarcopenia.

References

Blue Cross Blue Shield. 2015.“A study of cost variations for knee and hip replacements in the U.S.” www.bcbs.com/the-health-of-america/reports/study-of-cost-variations-knee-and-hip-replacement-surgeries-the-us

Centers for Disease Control and Prevention. 2017. “Vital Signs: Prevalence of Doctor Diagnosed Arthritis and Arthritis-Attributable Activity Limitation. The United States, 2013-2015. www.cdc.gov/mmwr/volumes/66/wr/mm6609e1.htm

Spine. 1983. “Hip-Spine Syndrome.” pubmed.ncbi/nih.gov/6623198

Anesthesia & Analgesia. 2005. “Sacroiliac Joint Pain: A comprehensive review of anatomy, diagnosis, and treatment.” pubmed.ncbi.nim.nih.gov/1624408.