Do you often feel like the front of your hips are tight, so much so that it causes you pain in the front of your hips?

This is can be a common sensation we hear from those who sit at a desk for 8-10 hours to those who like to squat a lot. Generally, the solution that has been given to these people is to attack the hip flexors with some aggressive stretching. Usually with one of the below exercises. 

If you are someone who does these stretches and it helps momentarily, before the pain comes back, our experience tells us something else might be going on. These stretches aren’t hitting what might be the underlying problem. 

So, are you in fact experiencing true hip flexor tightness?

First let’s take a look at the muscles that are considered the hip flexors. Notice where these muscles attach.

When you bring the femur up it will put these muscles in a shortened position not a position where it is being lengthened, or stretched. Also, most of the time we are bringing our femur up and keeping it in a relaxed position. Meaning our femur is up but it is resting (i.e. sitting at work), therefore not engaging or contracting the hip flexors. This may allow the hip flexors to become weaker in a shorter position. If our hip flexors aren’t working a majority of the time in these shortened positions it can cause weakness in the hip flexors. When the hips flexors are then called upon to work the fatigue and weakness can cause the sensation of tightness in the hip flexors. 

How do we test if we actually have tight hip flexors?

A common way to test for tight hip flexors is the Thomas Test. Now this is a quick test to determine if the hip flexor group is in fact tight. When performing this test there are a few things we look for.

First, perch on the end of a table. Next lay back as you bring one knee in toward the chest. Be sure not to pull too hard just hold the leg up. The other leg will be completely relaxed on the table as you see here.

When performing this test there are a few things we look for.

Does the thigh sit higher and not rest on the table?

If the thigh is not sitting on the table, this may indicated shortened hip flexors, but if the thigh sits flush on the table as seen here then shortened hip flexors may not be the issue.

Does the whole leg rotate out?

This may indicate a shortened TFL or lateral hip.

Is the tibia able to get perpendicular to the floor? Does the tibia rotate out?

If the tibia is not able to be perpendicular to the floor there may be quad tightness and mild hip flexor tightness. If the tibia rotates out there may be hamstring tightness.

Based on these findings we can say with some confidence if the hip flexor group is “tight” or not. More often than not the thigh sits right on the table and the hip flexors are in fact NOT tight. 

So what gives, why do my hips feel tight and painful then?

One reason for the tightness is in fact that the hip flexors are weak. We know that lack of movement causes muscles to become weak. If you are not using your hip flexors at different ranges of motion, specifically at higher ranges of hip flexion, it would stand to reason that the hip flexors would be weak within these ranges. Higher hip flexion can be seen in sitting, squatting deep or performing a high step. All movements where you may feel “tight” hip flexors despite the muscle moving into a shorter position. 

How often are we working on the strength in our hip flexors?

If you feel like you have hip flexor tightness have your clinician test your mobility/flexibility at these muscles to determine if there are in fact shortened muscles. If not try some of the exercises in the video below to start strengthening to see if that helps eliminate the “tightness”.