Hip pain Archives - Fit & Bendy

How to Have a Strong Flexible Psoas for Healthy Hips

A strong flexible psoas muscle is fundamental to a healthy back and mobile, balanced hips. The psoas attaches all along the lumbar spine in the lower back then swoops down under your internal organs to attach to the top inside of the femur. It is the only muscle connecting the upper and lower body, and it has multiple jobs including spinal support and movement, hip stabilization, and internal rotation and flexion of the thigh.

The Iliopsoas

Despite its extremely important role in our mobility (the psoas plays a part in anything we do from the waist down) it is often neglected. Part of this is because the psoas runs deep under other muscles and guts, so it’s hard to touch it or have a strong awareness of what it’s up to. It’s also because sitting too much, as most of us do, makes the psoas squashed, weak, and tight.

The Consequences of a Tight, Weak Psoas

Many people have issues strengthening and stretching their psoas and experience some kind of sub-optimal consequences. If you experience back spasms (“throwing your back out”), snapping hip syndrome, SI joint pain, sciatica, or myriad other issues, it’s good to take a close look at your psaos health.

My own psoas was very unhealthy during my years as a dancer and contortionist. It was chronically tight, which I found extremely frustrating. I over-stretched it and it spasmed on a regular basis. It wasn’t until I learned how to feel my psoas, which took some concerted work over a period of months, and strengthened it, that I was able to finally get it to relax and my hip flexibility and back health improved.

How to Have a Strong Flexible Psoas

The routine in this video is basically the format that I used to create a strong flexible psoas. I progressed slowly. It took me many months to be able to move through the exercises that I show in half an hour. In the beginning I kept offloading the work to the other hip flexors (see this post on hip flexor anatomy if you want to know who they are).

So you may want to just start with the first exercise, the foot slide on an elevated surface, and stick with that until you have a sensation of where the psoas is and how to use it, then progress slowly at the pace that works best for you.

This is not the most glamorous, social media-worthy work but it has changed my life to have a better relationship with my psoas, and I hope it changes yours too.

Viva el psoas! Hail the psoas! Psoas forever!

Tight Hip Flexors? Try These Lunge Variations for Better Results

The humble lunge is a staple of flexibility training designed to target the front of the hips. With lunges, small details in alignment and positioning can make a huge difference in outcome, and we can use that to our advantage.

Understanding how lunge alignment emphasizes different muscles in the hips can help you target the muscles that really need the stretch.

Get to Know the 6 Primary Hip Flexors

First, let’s define our terms. There are multiple hip flexors, but six of them do most of the work and are our primary focus when we talk about stretching. These are the psoas, iliacus, pectineus, tensor fasciae latae, sartorius, and rectus femoris. To learn more about each of these muscles, where they live and what they do, please check out this blog post on hip flexor anatomy.

Once you know where your muscles are and how they work it’s much easier to delve into the mysterious habits of your own hips.

Find Your Square Lunge

Before tinkering with our lunge position, let’s start by finding a lovely, square lunge. The hips are square when both hip bones and the pubic bone are on the same plane, so the hips are not twisting, one hip bone is not higher than the other, and the pubic bone is not behind the hip bones. Your back leg should be coming straight back behind you, and your front leg straight out in front.

You can read more about square hips and why they are important in this blog post on square splits. And this workout video has some great basic lunges so you can get the hang of it.

I’m compelled to remind you (and myself) that doing square lunges means that you will not go as deep into the stretch. They may feel awkward if you are used to letting the pelvis do its own thing. If you like to arch your back or if your hips aren’t used to supporting this position, a square lunge could feel more like a workout than a stretch. It’s ok. Keep doing it anyway, it will get easier over time. I promise it’s worth it.

This square lunge gives a pretty even stretch across the front of the pelvis, not targeting any specific hip flexor but not leaving anyone out. If you allow the pelvis to tilt or twist or the back to arch you will start to skip some of the hip flexors (usually the tightest ones that most need the stretch). For you naturally bendy people this is especially important to keep your pelvis healthy. After years of extravagant over-stretching, this is now my pelvic theme song: Hip to Be Square…

Emphasize the Satorius and Rectus Femoris

The satorius and rectus femoris are the two muscles that cross both the hip joint and the knee joint. That makes it very easy to emphasize them in your lunge: just bend your knee. You can either do this in the traditional couch stretch, with your shin up against the wall, or by just reaching back and grabbing your foot and bringing it in towards your butt.

I don’t teach this lunge variation in my beginner/intermediate videos because it can be so hard on the knees, but there is a more gentle version of this stretch in the Happy Hips workout.

However you do it, please put some nice padding under your knee and stop if you feel any knee pain. And of course, keep those hips square.

Emphasize the Tensor Fasciae Latae

The TFL attaches to the outside front of the hip, so in order to emphasize that muscle you will want to externally rotate your back leg. The tricky thing here is to rotate the thigh bone but keep the hip bones square. For most of us, that means that the amount of external rotation will be quite small, so if you look back and the back leg has barely moved off center, don’t worry.

The front leg can externally rotate a little bit too, if that helps with the balance.

The TFL can be targeted a little more by shifting the pelvis slightly off center in the direction of the back leg, and leaning away from the hip. That means if my left leg is back and I am stretching my left hip, I will slide my pelvis slightly to the left and lean slightly to the right. No twisting in the hips though, both hip bones pointed straight ahead like headlights on a foggy night.

For you visual learners please check out the video at the end of this post!

Emphasize the Psoas and Iliacus (Iliopsoas)

These deep hip flexors are often both tight and weak because most of us sit too much, and these muscles hate sitting. When they work well, they are our most powerful hip flexors and stabilizers, but when they are tight they can lead to a very cranky pelvis, back spasms, and tight hips.

This lunge is one of my favorites because the iliopsoas difficult to target but terribly important. If this lunge variation feels challenging… yay! You’ve found something that could be very useful for improving your hip health.

To emphasize the psoas you will internally rotate your back leg. The front leg still comes directly forward and the hips stay square. Just like with the TFL lunge, the hips slide out to the side in the directly of the back leg, and the body leans opposite. Again, check out the video below for a visual.

Keep in mind that if your iliopsoas muscles are very tight, it might be challenging to get them to stretch. If you don’t feel a stretch, don’t be discouraged. Keep playing with the position, building the strength in the supporting muscles, and working into the lunge over time. When I first started it, this lunge felt like a lot of work with no payoff but it’s made a massive difference in my hip functionality over time.

The Sets and Reps for Lunges

A lunge is a mixture between a passive static and an active stretch. I do a million different variations to get the results I want in a particular session.

Lunges with the knee on the floor tend to be more passive, and unless you have knee issues I recommend these if you are just starting out with square lunges and lunge variations. An emphasis on static passive stretching and isometric contraction of the supporting muscles can be a very effective way to start to shift hip alignment.

I recommend doing all 3 lunges, 3 sets of 30 seconds each (9 lunges total on each side). Over time you can vary the number of sets of each lunge variety according to what your body needs most. For example I only do 2 sets of quad/sartorius stretching but 4 sets of iliopsoas stretching because that’s where I am most tight.

Feel the support from the butt muscles and torso muscles, building strength and control. Alignment is more important than depth. You can build depth over time but it is very hard to fix alignment once you are deep.

Happy hips come from consistent investigations into pelvic alignment and imbalances. The better you know your hips, the better you can tailor your training to your body’s needs.

Happy Bendings everyone!

Got a Bendy Back and Tight Hip Flexors? Try this Short Workout

Five years ago I wrote a blog post titled The Curse of the Bendy Lower Back that laid out many of the difficulties facing people with a naturally bendy lumbar spine. One of the most unpleasant consequences is shortened, weak, painful hip flexor muscles.

This phenomenon has been well documented. In 1979 Dr Vladimir Janda coined the term “Lower Crossed Syndrome” to describe the postural condition where the back arches and the pelvis tilts forward. This results from and further contributes to tight muscles in the lower back and the front of the hips, and lengthened muscles in the abdominals and glutes/hamstrings.

At the root of the problem is inefficiency. Our bodies are designed to move from a stacked spine where the S-curve rests directly on top of a vertical pelvis and very little muscle is required to hold us up. When our spine is not neatly stacked the muscles and connective tissue have to work much harder to hold us up, resulting in angry, resentful, tight muscles.

In the case of the bendy lower back, the spine pulls the pelvis into a forward tilt (and sometimes the pelvis pulls the spine). This makes the back muscles have to work very hard to hold up our upper bodies, and compresses our illiopsoas, the largest and deepest set of hip flexor muscles. It also aligns us in a way that makes it our quadriceps muscles over work and makes it harder to use our abdominal muscles and glutes. Left unchecked over time this creates chronic postural problems, tightness, and pain.

I’ve had a pretty severe case of Lower Crossed Syndrome for most of my life. I do exercises every day to counter its effects and it has decreased my back and hip pain and increased my hip mobility. I’ve also seen these exercises help other people with the same issues, so if you’re in the same boat, perhaps they will prove useful for you too!

The video below contains specific exercises that I find useful, but here are some guiding principals that can help you design your own workouts and adapt your current workouts to make sure that you aren’t reinforcing your imbalances.

1. Know Your Dominant Muscles and Try to De-emphasize Them

For many folks with bendy back issue, the quadriceps muscles are bossy as hell. When designing your exercises, find ways to reduce input from the quads in favor of the illiopsoas, glutes, hamstrings, and core muscles. Basically, anyone but the quads. It may mean going lighter with your effort in order to find those quieter, shyer muscles.

2. Just Because a Muscles is Tight Doesn’t Mean it’s Strong

The back and hip flexors do not want to lengthen. They may feel tight as a bridge cable, but that doesn’t mean those muscles are good at contracting either. Often those muscles are just stuck at one length, not getting shorter or longer. When that happens, I recommend working on contracting the muscles first, before trying to stretch them. It is easier to make a muscle contract than relax, and once you get them to contract they gain some confidence and are more amenable to relaxing and stretching.

3. Just Because a Muscle is Long Doesn’t Mean it’s Weak

Those glutes and abs may be stuck in a long position, but that doesn’t mean they aren’t strong in a long position. When I was doing backbends all day my abs were very strong, they just didn’t want to get shorter. The key to making sustainable change was to get away from the crunches that I was used to and find exercises that forced me to use my abs when they were in a shortened position, with my spine in forward flexion. This resulted in lots of shaking, and some sustainable improvement in my bendy back issue. Putting a squishy ball or pillow under the hips for ab work is a great way to start.

4. Changing Posture is a Daily Practice

Posture doesn’t change overnight. It’s likely you’ve had this posture imbalance for much of your life so doing exercises once in a while isn’t going to make a noticeable difference. Changing posture and maintaining that change means doing exercises to address the imbalance almost every day, possibly for the rest of your life. But hey, at least you’ll always have something to do.

For my fellow hyperlordotic (bendy lower back) friends, I hope that some of these tips and exercises are useful for you. I know many of you may be dealing with back and hip pain, and all I can say is that there is hope for relief with consistent dedication to this small, undramatic, exercises.

Happy Bendings!

2 Exercises to Address Knee Pain in Middle Splits

Middle splits can be beastly. Often we push too far too fast, going past our body’s limits without the proper strength and control. Sometimes this means that we just hate middle splits, but it can also lead to pain and injury if we push too hard.

One of the most common places to feel pain from middle splits is in the knee joint.

There are a few common reasons why this position can have a profound effect on the knees:

1. A lot of folks do not have strong knees when they are completely straight, as they are in middle splits. Even if your knees are strong in a bent position, you may not have worked to strengthen them in full extension.

2. The muscles and fascia along the inside and outside of the knee joint (the sartorius and gracilis on the inside and the IT band attached to the gluteus maximus and tensor fascia latae on the outside) are also hip muscles. That means that hip position affects knee position and if something is pulling at the hip, and the hip is tight, that pulling can radiate down to the knee. If the knee is unstable, it is easily pulled out of alignment.

3. Knees are designed for movement the sagittal plane (forward and back, like when you kick a ball), and a very small amount of rotation, but not at all for side to side. Generally if you see a knee moving sideways, like a pendulum, you’re going to worry about it. The force on the knee joint during middle splits is a shearing force, along that sideways plane. Knees don’t like it and need extra reinforcement to withstand it.

To counteract these effects and protect the knees, one of my first go-to approaches is to practice engaging the knee stabilizing muscles in the quads and hips while finding full extension of the knee.

The two exercises shown in the video below both emphasize the work of the outer quad (the vastus lateralis) and the outside butt/hip muscles (gluteus maximus and TFL) that connect to the knee via the IT band.

I find this approach effective because middle splits put the the inner thigh muscles under a lot of tension, particularly in folks with tight hips. This pulls the knee inwards, bringing it out of alignment. Learning to use the outside butt stabilizes the knee and provides support for the hip, facilitating some ease and lengthening for the inner thighs.

These are great exercises for anyone with knee pain in normal life too. The side butt-to-knee connection is vital to maintaining lower limb stability and prevents the dreaded knee valgus (when the knee collapses in) on squats and lunges.

Some important things to keep in mind when trying out these exercises:

1. Start slow. It’s important to feel the muscles in your outside butt and quads doing the work. If they aren’t used to working like this they may fatigue very quickly and try to outsource their work to other muscles. Keep the work gentle enough, and short sets, to target the desired muscle groups.

2. Straighten your legs all the way when there is no weight on them. The knees are most vulnerable when they are fully extended, especially for us lucky noodles with hyperextended knees. You want to build strength in this position while they aren’t burdened with the extra job of holding you up.

3. If you have knee pain during these exercises, or if these exercises don’t help your knee pain, then it’s important not to keep doing them anyway. Take the time to continue to investigate, and seek out professional help if needed. There are many possible causes of knee pain and these exercises are not going to address all of them, alas.

Check out the video below for the exercises. A band or strap is useful but not necessary to get the most out of this mini-workout.

Be kind to your knees, friends. They are crabby little beasts and when they are out of sorts they can make your life less pleasant!

What is the Difference Between a Straddle Split and a Middle Split?

The straddle split and the middle split are similar, and there can be some confusion between the two. However the relationship with gravity makes these two splits feel very different, especially for newer benders. Knowing the difference is very important for ensuring proper form and developing the strength, flexibility, and control in your lower body.

The primary difference is in the position of the pelvic bones. Pay attention to the alignment of those bones and you will know whether you are in a straddle or a middle split.

The Straddle Split

In a straddle split, the pelvis is in “anatomical” position. This means it is aligned as if you were standing up, with the three bones in the front of the pelvis—the hip bones and the pubic bone (anterior superior iliac spine and pubis)—facing forwards.

The bones at the base of the pelvis are on the floor. These “sit bones” (ischium if you want to get formal about it) take the weight of your body so that you are not supporting yourself with your legs.

The legs move apart to the extent that they are able. If your straddle has the shape of a small slice of pizza or if your feet are so far apart that they are behind your hips, it’s still a straddle.

It is also still a straddle split if you are leaning forward. That means that if you start to lean forward and the only way that you can get your chest towards the floor is by allowing your sit bones to come up off the floor, you are losing your form. Wherever you move your torso, you want to have the strength and control to keep that pelvis in the same alignment. That separation between the pelvic position and the torso is part of the gift of training straddle splits.

The Middle Split

In a middle split the entire pelvis rotates 90 degrees forward.

Now those sit bones are not on the floor, they are facing back behind you. Your hip bones and pubic bone are now facing the floor. The body is usually aligned parallel to the floor, however you will see middle splits with a backbend that brings the body back to vertical. Either way, it’s still a middle split because of the pelvic position.

In this position the relationship with gravity means that your legs are now supporting your body weight unless you are flexible enough to get to a 180 degree split. This is why the middle split is so challenging for newer benders.

The inner thighs are receiving contradictory messages to “relax” and lengthen, and to hold you up. They may get confused and start to scream. This is why, for so many folks, middle splits are unpleasant and even emotionally draining. A careful ramp-up is necessary to avoid misery and potential injury.

Graded Training is Required

If middle splits are your goal, start by getting comfortable in your straddle splits. The work of learning how to control your hips in this position, anchor your legs while moving your torso, and develop the strength in your butt and inner thighs, will prepare your body to start training middle splits with more awareness and capacity for that stand-off with gravity.

For a visual on the difference between straddle and middle splits, please check out the video below. If you would like a graded set of workouts to get comfortable in your straddle and middle splits, our Video Club Membership includes a series of four workouts to get you there!

Jean-Claude Van Damme doing a box split between two trucks.

Pro Tip: There is a third type of split that looks similar called a Box Split. This type of split is common among martial artists and was made famous in the 80s by Jean-Claude Van Damme who famously used it to suspend himself between two walls or moving trucks. In the box split the sit bones face the floor, the hip bones face forward, and the inner thighs face the floor.

I do not do or teach this split, not because it isn’t awesome, but because it is inaccessible to a lot of people based on the structure of the pelvis. For many humans, particularly those whose pelvises are prepared for childbirth, the head of the femur is sits too deeply into the pelvic socket to achieve the box split and pushing into it can dislocate the hip. However, if you find a good coach and wish to train it safely, it is pretty bad ass!

Hip pain

Category: Hip pain