How to Restore Hip Flexibility and Strength

July 18, 2018

Tight hip flexors are probably the most common muscle imbalance in America. That’s because the average American spends a full 13 hours of their day sitting down, according to a survey commissioned by Ergotron. With an average of 8 hours dedicated to sleep, the average American only dedicates about 3 hours a day to physical activity. All that sitting leads to problems, not the least of which is overly tight hip flexors.

While the common logic is that tight muscles only matter to athletes, it couldn’t be further from the truth. Tight hip flexors can cause all sorts of problems in the everyday person, including:

Bad posture
A protruding belly (regardless of weight)
Higher risk of injury
Increased anxiety levels

And for athletes, it’s even worse. Tight hips lead to muscle imbalances. When an athlete’s muscles aren’t working like they should, other muscles overcompensate to pick up the slack. Not only does this greatly increase injury risk, but it also means that these athletes will be unable to perform at their best.

Fortunately, tight hip flexors aren’t permanent. Dedicated stretching and strength training can restore proper range of motion in the hips. Below is a list of some of those stretches.

Anatomy of the Hip

To understand how all the stretches and exercises in this article come together, it’s important to first understand how the hip works.

The hip has 3 main movements:

Flexion and Extension – Moving the leg backward and forward.
Abduction and Adduction – Moving the leg out to the side and in towards the other leg.
Rotation – Moving the foot left and right and moving the straightened leg towards the toes.

The hip has 5 basic components:

Bones – The main bones of the hip are:
- Ilium – the large wing-like bone on either side of the hip.
- Ischium – the lower and back part of the hip bone. The ischium has three parts that come together to form the rounded bottom of the hip.
- Pubis – the area where the other bones of the pelvis connect.
Articular Cartilage – Smooth, white tissue that cover bones where they come together to form joints. It acts as lubrication.
Muscles – The hip has 20 muscles altogether, but this article will just focus on the 4 most relevant to hip flexibility:
- Iliopsoas –The psoas major muscle and the iliacus muscle are so similar in location and function that they are often grouped into one.
  - They flex the trunk of the hip while other muscles keep the legs steady (such as when sitting up from a lying down position).
  - They also laterally rotate the thigh at the hip, which turns your foot and knee outward.
- Rectus femoris – Part of the larger group of leg muscles called the quadriceps femoris, which are located on the front and sides of the thigh. Its primary function is extending the knee, which has to pull on the hip bone to do. It is the only muscle that can flex the hip.
- Sartorius – A long, bandlike muscle found on the anterior (inside) side of the thigh. It is so long that it can act on both the hip and knee joint.
  - At the hip, it flexes, abducts, and laterally rotates the thigh with help from some other hip flexors.
  - At the knee, it helps to flex the leg.
- Ligaments and Tendons – Bands of tissue that connect bone to bone and muscle to bone.
- Synovial Membrane and Fluid – A membrane that covers and lubricates the hip joint.

Static Stretches to Improve Overall Hip Mobility and Flexibility

Hip Flexor Stretch

Kneel down on your left knee and put your right foot in front of you. Your right hip and knee should roughly make a 90º angle.
- If this hurts your knee, feel free to put a pillow under it.
Put your left hand on your left hip and gradually push your hip forward. Your left hip should end up in front of your left knee.
Make sure you keep your chest up and that you don’t bend forward at the hips.

Visit this page for a visual representation of the stretch.

Hip Rotator Stretch

The hip rotators are much more functional than one might expect. They function to rotate the pelvis on the weight bearing thigh. Hip rotators are used in activities such as swinging a golf club, dancing, running, and tennis, but they also activate during simple activities like walking.

Internal Rotators

This stretch should be performed while sitting in a chair.

Cross your left leg over the right. Your left ankle should lay across your right thigh.
Using your left hand, gently push down on your left thigh until you begin to feel resistance.
Tilt forward at the hips. Make sure your chest is up and your back is straight.
Hold this position for about 30 seconds, then repeat on the opposite side.

Visit this page for a visual representation of the stretch.

External Rotators

This exercise should be performed while sitting in a chair.

Cross your left leg over the right so the left ankle sits just past the right thigh.
Grab your left knee with both hands and pull it back and to the right. If it helps, think of it as pulling your knee towards your right shoulder.
Tilt forward at the hips slowly. Make sure your chest is up, your back is straight, and make certain you aren’t hunching.
Hold this position for 30 seconds.

Visit this page for a visual representation of the stretch.

Lying Hip Rotations

Lie on your back with both knees bent upward and both feet flat on the ground.
Lift one foot up and cross the ankle over the opposite knee.
Swivel your knee back and forth, keeping your ankle on your opposite knee and your other foot flat on the ground. Keep in mind that only your bent leg will be moving in this stretch.
Repeat for the opposite leg.

Watch this video for a visual representation.

Standing Piriformis Stretch

While standing with your back against a wall, walk your feet forward about 2 feet from the wall. Then, lower your hips at a 45-degree angle towards the floor.
Lift your right foot up and put over your left knee. The outside of your right ankle should be touching your left knee. You should feel a stretch in your glutes.
Hold for about 30 seconds, then switch legs.

Butterfly Stretch

Sit on the floor and put your feet together so that the pads of your feet are pressed against one another.
Grab hold of your feet with both hands and press them into the ground. At the same time, bend at the hips to bring your groin closer to your heels.
Hold for 30 seconds.

See this video for a demonstration.

Traveling Butterfly

Sit on the floor with your back straight and your legs stretched straight out in front of you.
Place your hands on the floor slightly behind your hips.
Use your hands to press into the ground and simultaneously lift your hips up off the ground and forward towards your heels. You will wind up in the butterfly position with your arms supporting your weight.
Return to starting position and repeat the stretch 5 times.

See this video for a demonstration.

Hamstring Stretch

Sagittal Plane

Prop your leg up on a bench or chair, making sure to keep it fully extended.
While keeping your core tight, lean forward slightly until you feel a stretch in your hamstrings.
Hold this position for 30 seconds.

Transverse Plane

This stretch is the same as the sagittal plane stretch, except that you rotate your leg from side to side once you have leaned forward. You should feel a different part of your hamstring stretch as your leg rotates from the inside to the outside.

See this video for a demonstration.

Hip Adductor Stretch

Assume lunge position by kneeling on your left knee and placing your right foot in front of you.
Slide your right foot out to the side and put both hands on the floor to stabilize yourself.
Keep your right knee straight and lean your body forward, keeping your hips relaxed all the while.
Hold for 30 seconds, then repeat on opposite side.

Leg Swings

Stand up straight while holding onto a chair, counter, or something of a similar height for balance, making sure to keep your feet pointed forward.
Bring your left leg in front of your right one, then extend your left leg out until it is about parallel with the floor. Make sure this is a smooth motion, and be sure not to kick.
Repeat 10 times and then switch sides.

See this video for a demonstration.

Supine Hip Rotation

Lie down on your back with your knees bent and your heels on the floor.
Rotate your feet and knees out towards the floor, then in towards each other.
Repeat 10 times.

See this video for a demonstration.

Dynamic Stretches/Exercises to Improve Hip Mobility and Strength

Reverse Active Straight Leg Raise

Lie down on your back and bring your legs up, keeping them straight. Your back and legs should make as close to a 90º angle as possible.
Using a strap or band, keep one leg straight up while slowly lowering the other to the floor. Keep your core tight during this process because that’s what stabilizes the spine and pelvis.
Repeat 5 times on each leg.

Single Leg Hip Lift

Lie down on your back with both feet planted flat on the floor. Your knees and calves should roughly make a 90º angle.
Raise your right leg up straight so that only your left foot is touching the floor.
Using your glute muscles, bring your back up off the ground while keeping your head and shoulders firmly planted.
While relaxing the glutes, slowly lower the butt and back towards the ground again. Repeat 5 times, then switch legs.

See this video for a demonstration.

The Psoas March

While lying flat on your back, put your knees and feet together. Then, bring them up off the ground so only your glutes, back, shoulders, and head are touching the floor.
Slip a resistance band around both feet.
Take turns extending each leg until it is completely straight. Repeat 10 times for each leg.

See this video for a demonstration.

The Goblet Squat

Pick up a dumbbell or kettlebell so that you are using your hands to hold it slightly under your chin.
Spread your legs to slightly past shoulder width and, breaking at the hip, descend into a squat position.
Pause at the bottom of the squat, then, with a tight core, use the glues and legs to bring your body back up to standing position.

See this video for a demonstration.

Strength Training for the Hip and Pelvis

While these stretches will improve your hip mobility, strength training is another excellent way to improve mobility and decrease the chance of injury. With that said, here are some strength exercises that will primarily work the hip flexor muscles:

Bridges
Split Squat
Lateral Squat
4-Way Mini Band
X Band Walk
4-Way Cable Hip
Lateral Lunges
Rotational Lunges
Lateral Step Up
Rotational Step Up

Let Beacon Help You Recover

Beacon Orthopaedics and Sports Medicine encourages everyone to live healthier lives, and stretching will help you achieve that goal. However, care should always be taken both during the act of stretching as well as when planning a stretching regimen. Beacon recommends consulting a specialist before beginning any type of exercise program. It’s possible that attempting to fix issues on your own will make them worse, not better if you have a more severe injury.

Dr. Steve Hamilton specializes in hip conditions and treatment options and can help you develop an effective plan for both strengthening your hip flexor muscles and protecting them from injury. If you think tight hips might be prohibiting you from living an active lifestyle, or if you are suffering from a hip injury, schedule an appointment with Dr. Hamilton online or by phone today.