hip pain Archives - Fit & Bendy

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!

Improve Middle/Straddle Splits and Hip Stability: How to Do a Highly Effective Clamshell Exercise

I’ve often said that if I were stuck on a desert island and I could only bring one exercise, the humble clamshell would be a strong contender. This exercise is gold for targeting one of the most important and under-utilized muscle groups in our lower body: the deep butt.

The deep butt are six little muscles that run horizontally under the gluteus maximus, connecting the head of the femur to the pelvis at various points and angles. These muscles (the obdurator internus and externus, the gemellus superior and inferior, the quadratus femoris, and the famous piriformis) are external rotators and are vital to stabilizing your pelvis for positions like middle splits and straddles, as well as for life.

But the gold in clamshells is very much in the details. It’s so easy to swish through a set of clams utilizing non-targeted muscle groups like the obliques, the hip flexors, opposite butt muscles, and even the spinal extensors. The gluteal muscles (gluteus maximus, minimus, and medius) are working but not the primary targets here. The first time I figured out how to get all those other helpers to pipe down and really focus on the deep butt muscles I was shocked to find a tiny range of motion and shaking like I was hefting an olympic barbell. But it was just my thigh bone. So exciting!

How to Set Up for Success

Even Out Your Hip Bones: If you have a difference in the diameter of your waist and hips, which most people do, when you lie on your side your top hip will tip up towards your rib cage making your hips uneven. Use your waist muscles to lengthen that top hip out towards your heels until the top hip bone is directly above the bottom hip bone. This will make it harder for your obliques and back muscles to “help out”.

Slight Lean Forward: Very slightly rotate your pelvis forward as if you were considering rolling forward onto your belly. Lengthen your top knee out just past your bottom knee. Feel like that top leg is lengthening out of the hip socket. You are going to maintain this lengthened feeling and forward tilt throughout the exercise to minimize the participation of the gluteus minimus and medius and hip flexors.

Stack the Insteps of your Feet: Make sure that the feet are stacked one directly on top of the other with the insteps lined up and pressed together. That slight press down with the top foot is going to encourage the external rotators to be more enthusiastic.

Tips for Optimal Execution

Nothing Moves but the Knee: Try putting your top hand on your top hip. Don’t let that hip bone move at all. The only movement is the lifting and lowering of the thigh bone.

Bottom Leg Stays Relaxed: It is so tempting to push that bottom leg down to lift the top leg up, and some amount is inevitable. But really try to keep it as relaxed as possible.

Keep it Small: Most of us don’t have a huge range in our external rotation. If you are doing a giant movement where your knee points towards the ceiling every time you are likely bringing pelvic and spinal rotation into it and no longer isolating those deep butt muscles. Keep it small, keep it honest.

Feel the Burn: For most people this is not an isolation we do every day. Those deep butt muscles should be singing! You probably wont need more than 10-20 reps to get to shaky, crampy, maximum. Feel free to do multiple sets but when you get too tired to isolate, take a break.

For you visual learners check out the YouTube video below!

Pro Tip: The standard way to do this exercise is with the hips at about a 45 degree angle and the feet lined up with the hips but that isn’t the only way to do it. You can emphasize different muscles but doing the same set up with the knees tucked up towards the chest or in full extension with the feet back behind me like you were hanging upside down from a trapeze. These exercises are great for improving hip stability at every angle.

WTFL???? What is the Tensor Fasciae Latae (TFL)

The Tensor Fasciae Latae, or TFL to its friends, is a small muscle in the outside front of the hips that works very, very hard. The TFL is a multi-tasker. It does hip flexion, hip abduction, internal rotation, and it even internally rotates the lower leg through its attachment to the IT band.

The TFL is an important hip flexor muscle

Moving the leg out to the side in parallel inspires the TFL to work in hip abduction with the gluteal muscles

The TFL is also one of the primary muscles working in internal rotation

Because the TFL has so many abilities, it is often overworked. It’s just so easy for other muscles to lay back and let the TFL take over. The TFL is also not one of those sexy muscles that we pay a lot of attention to when we go to work out, so it may not be strong enough to do everything we need it to do.

As a result it is not uncommon for the TFL to get sore and/or tight, contributing to problems in the lower back, hips, and knees. The TFL is also one of the common culprits in what is often interpreted to be a tight IT band. Because the IT band is fascia, and doesn’t stretch, it can’t be tight. For more on “tight” IT bands and my rant about the futility of foam rolling check out this blog post (link).

How do I Find my TFL?

Sitting on the floor with both knees bent and the feet more than hip width apart, let both knees fall to one side. If your hips are very tight you may want to sit on a block to start. Focus on the leg that is internally rotated (the back leg). Place your thumb on your hip bone then move it around to the outside of your hip about 2 inches, then down about 2 inches. Poke around for a lumpy muscle.

As you are poking, begin to sink your right hip back down towards the floor, rotating towards your back leg. You will be able to feel the TFL contracting and shortening under your thumb. If this is unpleasant, then you probably have a cranky TFL.

Poke around the front outside of your hip feeling for the TFL. You should feel it compress and shorten as you sit your butt down and rotate towards the back leg

How do I Release a Tight TFL?

When a muscle is very tight and angry, its usually because it is stressed out. It feels overworked and unappreciated. Sometimes when you start with rolling out or stretching a muscle like this it just gets more stressed out and, while there may be momentary relief, it will just get tighter again when you start to move.

Beginning with a very gentle TFL contraction will help the muscle feel more confident, loved, and appreciated. Here are three very kind TFL exercises to get you started.

Strengthening a Weak TFL

TFL Internal Rotation Exercise

Laying on your back, bend both knees with both feet more than hip width apart. The wider the feet the more difficult the exercise. Put your hands on your hip bones to remind you that the hips will not move at all. One leg at a time, gently internally rotate your femur, dropping the knee in towards the floor. Feel that little TFL gently contract at the end range of motion to push your knee down towards the floor. Remember, keep this gentle or you will start to feel other muscles (glutes, inner thighs, back) and you want just the TFL. Do 10-15 soft, sweet pulses in this position on each leg.

This exercise directly targets the TFL by internally rotating the legs.

TFL Flexion Exercise

Still lying on your back move both legs to parallel, just at hip width apart. Pick up both legs to table top (knee at a 90 degree angle), internally rotate the leg slightly keeping the knee still and moving the foot out, then begin to pulse the knee in towards your chest. It is very important not to let the pelvis move. You may notice that the pelvis wants to tuck under as you pulse. Don’t do it. You are in charge. Do 5-10 pulses on each side.

Combining slight internal rotation with hip flexion really gets that TFL fired up

TFL Abduction Exercise

Lay on your back with your legs together. Your abdominal muscles will be working a bit here to keep your body still so only your legs will be moving. Externally rotate both legs, turning the feet out but keeping the knees straight. Without bending the knees, start to slide the legs apart as far as you can go without twisting the hips or arching your back. You will feel your TFL work as a team with your side butt. Teamwork! Do 10-20 pulses apart in this position. Don’t arch your back, even though that feels very tempting.

External rotation biases the TFL when doing hip abduction (moving the legs away from the center of the body). Don’t worry if you don’t go as far as Natalie when you first start, she’s a pro.

How to Stretch your TFL

Its really easy to miss the TFL when you are stretching your hips. Its in a weird spot on the front outside of the hips and its often so tight and grumpy that your body would just rather skip it. Hopefully giving it a little strength will help it feel more relaxed, but the form on your lunge will still have to be impeccable to get into the right spot.

Start in an upright lunge, back knee down and hips perfectly square and slightly tucked under.
Slightly externally rotate the back leg. It doesn’t have to be much for most people to feel it. Just move that back foot across the body a few inches and that should be enough.
Make sure that when you rotate the back leg you don’t rotate the pelvis, those two hip bones are still in one line.
Gently push the hips forward and slightly out to the side, extending the hip of the back leg. If you don’t start to feel a stretch in that TFL keep checking on your form. Hips must be tucked, square, and the back leg externally rotated to get the right stretch.
Lift the arm up over your head and lean sideways away from the back leg, sticking your hip out to the side a little bit. That’s just a bonus bit of juicy goodness to get a little deeper into the stretch.
Be sure to do both sides and if one side feels tighter, do it again. It’s best to hold the stretch about 30 seconds or so but less if it is very painful. You can do some gentle, soft pulses into the stretch if the muscle needs some movement to help it relax. No momentum.

This delicious TFL stretch is a variation on the square lunge. Be sure to keep your hips square!

What Else Can I do to Relax my TFL?

As mentioned above, the TFL can become overworked because it is compensating for sleepy muscles in other places. Two of the most common muscle groups that could be slacking off are the illiopsoas, and the gluteal muscles.

Check your Psoas

The illiopsoas is also a hip flexor and an internal rotator so a sleepy psoas can heavily overburden that TFL. To test out your psoas strength do the hip flexion movement listed above but with the leg slightly turned out. This should move the work in the inner hip. If that feels difficult, work to strengthen that psoas.

Are the Gluteus Medius and Gluteus Minimus Working?

The gluteal muscles are right up next to the TFL and also attach to the IT band. If you have a sleepy butt then your TFL has to work very hard as a hip stabilizer, and that might make it resentful. To find your glutes do the leg sliding apart exercise mentioned above but with the legs internally rotated. See if you can find that side-butt work. If that feels week the more side butt strengthening should help support your pelvis without so much contribution from the TFL.

Doing the same leg slides into abduction with the legs internally rotated will bias the glute muscles. If this feels weaker than the TFL exercise you may need to strengthen your side butt!

Remember that our muscles are tight for a reason. They are tight because they are trying their best to hold our bodies together and do the work we ask of them. Treating them with kindness and figuring out how to support them is the best way to get them to relax and stop screaming at us so we can be stronger, more flexible, and have less pain.