It is common to develop muscle imbalances around the hip. Hip
stretches are part of a treatment plan to address these. In people that
sit at work for long periods of time hip flexors and rotators can
become tight, and gluteal muscles become weak. This can affect gait,
posture, spinal stability, and movement patterns.
Approximately 15 degrees of hip extension is required to walk normally. If hip flexors are tight then in order to walk, compensatory movement needs to take place through the lower back causing back pain and premature disc degeneration. Like other joints, if we fail to take them through their full range on a regular basis we eventually lose mobility.
What are the Major Muscles
of the Hip?
Why do We do Hip Stretches?
What is Piriformis Syndrome?
The Significance of Tight Hip Flexors in the Elderly
Because the line of muscle action varies relative to the axis of rotation of the joint some muscles will have more than one action depending on the position of the hip.
The hip is a very stable ball and socket type joint with an inherently
large range of motion. The hip contains some of the largest muscle in
the body as well as some of the smallest. Most people lack mobility due
to a relatively sedentary lifestyle. Periods of prolonged sitting
results in tightness of the hip flexors and hamstrings. Tightness in
the muscles and ligaments can created joint forces that result in
arthritis, postural problems,
bursitis, and mechanical back pain.
Positioning of the hip affects pelvic and spinal posture and function so the regular performance of hip stretches will help you maintain a good posture and alignment.
The piriformis originates over the anterolateral surface of
sacrum where it lies close the the sacral nerves S2-S4. It then inserts
into the greater trochanter along with the other powerful external hip
The syndrome consists of the symptoms that result from mechanical impingement or irritation of the sciatic nerve as it emerges from the pelvis. This can be pain, tingling, burning, or numbness that worsens with movement of the hip into adduction, internal rotation, and flexion.
Physical therapy is used to treat piriformis syndrome through freeing up the nerve, increasing mobility, relaxing muscle tone, and increasing the resting length of the piriformis muscle. Hip stretches are one part of a treatment plan.
If you experience some of these symptoms you should consult a physical therapist to rule out other sources of radiating leg pain.
Gait analysis studies in the elderly show that they typically have a
shortened step length. Whether that is a result of tight hip flexors or
due to reduced balance, the propensity to walk with shorter steps will
itself lead to tightness in hip flexors and anterior joint structures.
Hip stretches may be a relatively
easy preventative strategy for the elderly with gait abnormalities and
may help to prevent falls.
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 hip flexors are the psoas major, psoas minor, and iliacus muscles, all of which insert into the lesser trochanter on the femur.
The hip rotators not only rotate the thigh on the pelvis but more functionally rotate the pelvis on the weight bearing fixed thigh. Activities such as swing a golf club, and even just walking require some rotation of the pelvis on the weight bearing leg. While we don't need that much range of motion to walk, activities such as running, dancing, tennis, and many other sports can require more hip rotation.
For a more intense stretch for those of you who are more flexible to begin with you can try these other two hip rotator stretches on the floor:
Floor hip stretch 1
This hip stretch addresses multiple muscles and planes. Tightness around the hip joint and hip muscles is very common among athletes and will restrict full movement and optimum performance.
Floor hip stretch 2
This is a stretch for the hip rotators on the left side while lying
You need a certain amount of trunk control and abdominal strength to do
this exercise. If you find it too difficult because of weakness or
lower back discomfort then try the hip
rotator stretch in sitting.
People with arthritis in their hips will have a lot of difficulty with this stretch. If you experience pain down the front of your thigh or groin pain then seek the advice of a physical therapist. You may have a hip joint dysfunction or other problem that may worsen if not treated appropriately.
The adductors are those muscles situated on the inside of your thighs. Some cross both the hip joint and the knee joint, and some cross only the hip joint. We will refer to those muscles that cross both the hip and the knee joint as the long adductors and those that cross only the hip joint as the short adductors.
Long adductors can also be stretched in sitting. This hip stretch also
includes hamstrings biasing the medial hamstrings, semimembranosus and
The powerful hip extensors, the hamstrings and gluteus maximus can be
stretched as follows. Most of us rarely need to stretch the gluteus
maximus as this muscle is often kept in a lengthened position all day
as we sit; however, as we sit the hamstrings are kept in a shortened
position so often the hamstrings will become tight.
Here are a couple of easier hamstring stretches. For more detailed hamstring stretching see the following page on Hamstring Stretches.
The standing hamstring stretch is valid as an effective method of increasing
hamstring flexibility, but depends on pelvic positioning. If you are
able to maintain a straight lower back while performing this stretch it
is significantly more effective.
The hamstring stretch through the doorway has also been validated in the
literature, and is easier in
terms of maintaining a stable pelvis.
This hamstring stretching method has been shown to be just as effective as the standing hamstring stretch.
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.
To stretch the left iliotibial band stand with your left side facing
a wall or chair.
For more detailed hip stretches for the iliotibial band see my page on the iliotibial-band.