PHYSICAL THERAPIST

PHYSICAL THERAPISTPHYSICAL THERAPIST

Addressing minor hip stiffness today can prevent more serious injuries in the future. Among the most scrutinized muscles in the realm of fitness are the hip flexors – a group of three muscles located in the upper thigh. There’s often confusion surrounding whether these muscles are weak or tight, and they often receive undue blame for performance issues both inside and outside the gym. To dispel some of these misconceptions, we’ll turn to the expertise of Physical Therapist Dr. Bo Babenko, PT, DPT, who will clarify the distinctions between weak and tight hip flexors and offer guidance on how to address any related issues.

Before delving deeper, let’s briefly explore the anatomical intricacies of the hip flexors and the advantages of training them.

THE ANATOMY OF HIP FLEXOR MUSCLES

 

The hip flexor muscles serve as vital connectors between the upper and lower body, spanning the hip joint from the lower spine to the inner thigh. They play a crucial role in stabilizing the lower back and facilitating hip flexion. Comprising three key muscles— the iliacus, the psoas major, and the psoas minor—they contribute significantly to various movements and functions.

The psoas major and minor are elongated, robust spindle muscles that originate from the thoracic and lumbar regions, specifically from T12 to L4 laterally of the lumbar spine. They insert onto the femur through the iliopsoas tendon. Primarily, their actions involve hip and trunk flexion, and they provide assistance in lateral thigh rotation.

On the other hand, the iliacus muscle has a triangular shape and originates from the iliac fossa and the lateral aspect of the sacrum. Its insertion point lies at the lesser trochanter of the femur. The muscle fibers of the iliacus merge with the lateral fibers of the psoas major, forming the iliopsoas, which functions as a hip flexor. Its primary roles include hip and trunk flexion, contributing significantly to various movements and activities.

BENEFITS OF HIP FLEXORS EXERCISES

You may not frequently notice the activity of your hip flexors, but when they’re functioning optimally, you can anticipate three benefits without conscious effort:

  1. ENHANCED HIP MOBILITY By strengthening and mobilizing your hip flexors, you unlock your hips’ complete range of motion. This improvement aids in maximizing the effectiveness of your leg exercises, resulting in better hip extension and more substantial gains in your glutes.

INCREASED SPEED Insufficient strength or flexibility in your hip flexors can impede your ability to achieve robust hip extension, ultimately hindering your speed. Strengthening and enhancing the mobility of your hip flexor muscles can significantly improve your capacity to generate power and propel yourself off the ground swiftly.

POTENTIAL ALLEVIATION OF LOW BACK PAIN

The hip flexor muscles play a crucial role in stabilizing the back and connecting the lower and upper body. When these muscles are tight and weak, they may exacerbate lordosis (excessive curvature) in the lower back, leading to anterior pelvic tilt and increasing susceptibility to lower back discomfort.

INDICATIONS OF TIGHT HIP FLEXORS

“The hip joint region can be complex; it’s essential to assess adjacent areas. Pain in the front of the hip should prompt examination of the groin, hip joint, and lower back. Typically, discomfort in the hip flexors manifests when lifting the leg, as in high knee movements, restricting activities like lunges, squats, and running.

Moreover, difficulty or excessive arching of the lumbar spine during lunges, particularly with an upright torso, may indicate tight hip flexors,” elucidates Babenko.

 EXERCISES TO RELIEVE A TIGHT HIP FLEXOR

Before incorporating any exercise into our programming, it’s crucial to ascertain whether the length of the muscle is a factor. A genuine “tightness” issue can be assessed using what’s known clinically as the “Thomas position”: lying on your back with one leg hanging down. If your thigh bone doesn’t drop below parallel to the floor, it indicates a tight hip flexor.

To distinguish between the hip flexor and the quad, we can manipulate the degree of knee bend.

Hip flexors often exhibit weakness, which can be easily evaluated through manual muscle testing. In my practice, a straightforward 60-second single-leg balance with a 90-degree knee bend in the elevated leg serves as a reliable test.

In addressing tightness in the hip flexors, I’ve observed significant success by encouraging individuals to spend time “smashing” their quads and hip flexors, even delving into the abdominal region, as suggested by Babenko.

A SPECIAL MESSAGE FROM THE DOCTOR

For women: Even if you’re not experiencing any symptoms, it’s advisable to seek out a “pelvic health PT” to assess the condition of your pelvic floor, as this could impact various areas around the hip, including the hip flexors.

Neglecting a pelvic floor examination by a qualified professional is akin to neglecting dental check-ups for your teeth! I firmly believe this is an overlooked area that many women are unaware of,” explains Babenko.

MARATHON RUNNERS SHOULD BE DOING MORE SPLIT SQUATS. HERE’S WHY

To enhance your running prowess, you’ve got to lace up those shoes and hit the pavement regularly. Running frequently is the key to improving your skills on the track. Likewise, building strength requires a commitment to lifting weights. By engaging in both activities, you’ll unlock the true magic of running. Some marathon enthusiasts shy away from strength training, fearing it will bulk them up and slow them down. They often mistakenly believe that running alone is enough to fortify their leg muscles.

However, strength training plays a crucial role in the marathon runner’s regimen. It not only reinforces muscles and joints but also contributes to faster race times and reduced injury risks. Contrary to popular belief, it’s a misconception that strength training hampers performance. Numerous strength exercises can elevate your running game, but one exercise stands out as non-negotiable for serious marathoners: the split squat.

In the following discussion, we’ll delve into why split squats are indispensable for marathoners, both in their preparation for the marathon season and during the season to safeguard against injuries.

SPLIT SQUAT BENEFITS

Keep these benefits in mind next time you’re tempted to skip your leg workout:

  1. Address Imbalances: Unlike bilateral squats where your dominant side compensates for the weaker one, split squats target each leg individually. This helps strengthen imbalances between legs, reducing injury risks and enhancing running performance. Given that running primarily relies on single-leg movements, training accordingly is crucial.
  2. Efficient Muscle Engagement: Split squats require more effort and recruit additional muscle fibers compared to traditional squats. With a reduced support base, your hip abductors and adductors work harder to stabilize your hips. This engagement is especially beneficial for maintaining stability during single-leg activities.
  3. Core Strength and Stability: By destabilizing your body, split squats prompt your core muscles to engage, promoting better balance and lifting posture. Consider split squats as a subtle yet effective way to strengthen your core—an essential component for overall strength and injury prevention.

MUSCLES WORKED BY SPLIT SQUATS

Here’s an explanation of the primary muscles targeted by the split squat, offering marathoners a clearer understanding of why this exercise is beneficial for their strength training regimen:

Glutes: During the split squat, the glutes are heavily engaged as they work to propel you upwards from the bottom position of the squat by extending the hips.

Hip Abductors: The gluteus medius and minimus, located on the sides of the hips, play a significant role in stabilizing the hips and maintaining balance in the split stance. Additionally, they aid in keeping the knee properly aligned, which enhances running efficiency and reduces the risk of knee injuries.

Adductors: These muscles contribute to hip flexion and extension, ensuring proper knee tracking for better running economy.

Quadriceps: While the quadriceps are activated in all squat variations, the split squat places additional emphasis on the working leg, resulting in more intense engagement and muscle-building benefits for the quads.

HOW SPLIT SQUAT BENEFITS MARATHON RUNNERS

While most of a runner’s time is dedicated to pounding the pavement, incorporating a couple of strength training sessions each week can yield significant benefits for marathoners.

ENHANCED RECOVERY The principle is simple: the stronger and better-conditioned you are, the quicker and more efficiently your body can recover. While much attention is given to how exercises like split squats can improve race times and overall performance, the importance of post-exercise recovery is often overlooked.

Recently, I observed a few of my marathon clients who completed the Honolulu Marathon after integrating split squats and other glute exercises into their training regimen. Remarkably, they experienced only minor soreness three days post-race. Though this anecdote is singular, it underscores the value of strengthening your legs for improved recovery.

IMPROVED LOWER BODY COORDINATION & EFFICIENCY Regularly incorporating split squats and other lower body power exercises can enhance your running coordination and power, leading to greater efficiency in your stride.

DECREASED INJURY RISK Strength training plays a vital role in reducing the likelihood of overuse injuries. By engaging in strength exercises, you stimulate the remodeling of bones through the tension placed on ligaments and tendons, ultimately promoting collagen production. This robust protein is crucial for strengthening tendons and ligaments, thereby decreasing your risk of injury.

Additionally, since the quadriceps serve as shock absorbers during each foot strike, strengthening them can help maintain knee health during prolonged running activities.

AMPLIFIED GLUTE STRENGTH Many runners exhibit well-developed hamstrings but lack significant gluteal strength due to the hamstring-dominant nature of running. Incorporating exercises like split squats can effectively activate and strengthen the glutes, providing runners with a more powerful engine to propel them forward and distribute the workload more evenly between the glutes and hamstrings. This increased muscular strength is particularly valuable for enduring the demands of a 26.2-mile marathon.

HOW TO DO THE HAND-SUPPORTED SPLIT SQUAT

 

Position the working leg adjacent to the squat rack. Lightly grasp the rack with your fingers and thumbs while holding a heavy dumbbell in the opposite hand. Assume your preferred split stance, with the front foot pointing forward and gripping the ground. Gradually lower yourself until your weight or knee makes contact with the floor, maintaining a slight forward lean. Push back up through your front foot to return to the initial position. Reset and repeat the exercise, then switch to the other side. Aim for two to four sets of 10 to 15 repetitions on each side for optimal results.

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