A group of women performing a hip flexor stretch in a fitness class.
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Dr. Jessica Warnecke

Tight, painful hips? Dr. Jessica will see you now

Dr. Jessica Warnecke

Do you ever feel like your hip flexors – the muscles running from the front of your hips to the top of your thighs – are the tightest, most annoying part of your body? If you stretch and stretch but you just can’t get rid of that annoying tension, you are not alone!

One of the most common questions I get from active women is how they can reduce hip flexor “tightness”. Frankly, it’s something that most of us don’t do a very good job of addressing. So let’s talk through why these muscles feel tight and what you can do about it.

What are hip flexors and what do they do?

Your hip flexors are a group of muscles (psoas, iliacus, rectus femoris and sartorius) that run from the front part of your hip, inside the pelvis and down near the groin region. Each muscle has a slightly different starting and ending point: the psoas starts all the way up (and back) at the top of your lumbar spine; the iliacus runs inside the pelvic crest (the curved tops of your pelvis); while your rectus femoris and sartorius muscles start on the front of the pelvis and attach around the knee.

What do these muscles team up to do? Your hip flexors enable you to lift your knee towards your torso, stabilise your core, extend your spine, and tilt your pelvis forward (AKA bending over). They’re crucial for stability, walking, running, kicking and swivelling your hips and torso.

Are your hip flexors tight or weak?

A general rule for most muscles: if they feel chronically tight, then they’re also weak!

In your hip flexors, weakness can be caused by prolonged sitting (if you work at a desk all day, you know the feeling), altered breathing patterns, decreased dynamic core stability, and running with poor form.

So if no amount of stretching seems to be helping your hip flexors loosen up over an extended period, you will most likely benefit from strengthening them. There are a few things you can do to test how strong and flexible your hip flexors are.

Have you heard of the Thomas Test?

This is a physical examination named after British orthopaedic surgeon Dr. Hugh Owen Thomas. It can be used to test for a number of things, including the condition of your hip flexors. Here’s how to do it:

Step 1: Start sitting upright and pull one knee to chest
Step 2: Lie down trying to keep knee close to the chest and opposite thigh straight

Your hip flexors are tight if:

  • Your bent knee can’t stay close to your chest.

  • Your straight thigh can’t get flat on the bench.

  • Your lower back arches up off the bench.

  • Your straight-leg knee can’t bend to 90 degrees.

Other signs your flexors may be weak:

  • if you feel like your pelvis tends to tilt forward when you’re not moving (at rest).

  • if you find it hard to keep your spine neutral when doing core exercises.

  • if you get frequent clicking/popping when you raise your leg (especially when straight, as in leg lift or leg flutter exercises).

How do you build strong & flexible hip flexors?

There are three elements to a well-functioning muscle:

  1. Muscle flexibility is the ability of a muscle to lengthen through a range of motion – if you do the Thomas test above, how flat does your upper thigh get in relation to your trunk?
  2. Muscle mobility is the ability of the joint to actively move through a range of motion – if you’re kneeling or in a lunge position, how far can you move your hip forward without your lower back arching?
  3. Muscle strength is the ability to resist pressure or move through force and be capable of doing what your body needs it to do – if you’re doing resistance band marches, step-ups or running, how soon do you get tired and lose form?

Dr. Jessica Warnecke pulls one knee to her chest to demonstrate a Thomas Test.

Your yoga sessions with Michelle Cassidy on FIT are a fantastic way to open and strengthen your hips.

To perform at your best, you want all three elements to be firing, and the good news is that working on mobility and strength in your hip flexor muscles is an efficient way to improve flexibility.

How do you do this?

Step one: warm up! If you’re feeling tight, you won't have a full range of motion, so a workout will only work your muscles within that smaller range. If you warm up your muscles and joints first with dynamic stretching, you will increase your range of motion and be able to strengthen more of your muscles.

Step two: strengthen your glute and core muscles. This will provide extra support to your flexors and give them a workout at the same time. If you’ve already completed the Booty Challenge or Abs to the Core Challenge on Emily Skye FIT, you have a head start on this step! Emily has created the perfect workouts for you in FIT with moves such as glute bridges and raises, kettlebell swings, frog pumps, lunges and planks. When doing these moves, be sure to keep your torso stable and your core and glute muscles engaged.

How do you maintain strong hip flexors?

There are three factors you need to stay on top of to maintain strength in your hip flexors and keep that tight feeling at bay.

1. Your workouts
Make lower-body workouts – including moves such as lunges, squats and straight leg raises (focused on core stability and slow leg movement) – a regular part of your routine. You can also add a few of these moves (plus stretches like the knee-to-chest stretch) onto the start of your full or upper-body workouts. Aim to work your hip flexors 3-4 times a week, then as the exercises get easier and you don’t feel so fatigued or tight, working your flexors 1-2 times a week should maintain strength.

2. Time spent sitting
If you have a desk job (or TV habit) that means you spend much of your day sitting, I highly recommend alternating from sitting to standing every few hours. You could use a standing desk or just walk around the room for a few minutes. Also, make sure your chair has good lumbar support, your hips are higher than your knees when sitting, and your feet are comfortably on the floor.

3. Your form
If the sensation of tightness in your hip flexors sets in after doing a lot of running or explosive moves such as burpees or box jumps, work on your technique. Good form is crucial to ensure you’re working muscles correctly and other muscles aren’t overcompensating.

Dr. Jessica Warnecke
Physical therapist

Dr. Jessica Warnecke is a physical therapist based in Austin, TX, who is dedicated to keeping you moving at your best in every stage of life – from pregnancy to peak fitness and strength. As well as holding a BS in Exercise Science and a Doctorate Degree, Jessica is a Board Certified Orthopaedic Clinical Specialist and a certified Postpartum Corrective Exercise Specialist.

Dr. Jessica Warnecke
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