I can spot them a mile away. They stand with a tilt forward, pelvis forward, definite bent-over posture, scooting their feet in front of them in short, calculated steps. I often empathize how difficult it must be to stand in the position they seem to be locked into. How tall were they before they had their desk job? The lack of movement and extension of the hip has caused, in almost all cases, for back pain to develop and linger. Why do so many accept their posture as the inevitable place they will always be in. It simply is not true. They can change their posture, their alignment, their attitude, and their health. Perhaps this describes you.
I was watching a program on TV with my eleven year old daughter. I noticed a woman, who was speaking.
I mentioned, "That woman has a severe anterior pelvic tilt. She has really tight hip flexors and needs Pilates."
My daughter immediately chuckled, "Is that what you do as a Pilates teacher all day? 'Uh um, excuse me sir! Your parrot's toes are too scrunched up! He needs Pilates!"
We both giggled before I soberly stated, "Pretty much."
It seems silly to an eleven year old, but she does not have enough life experience yet to understand that years of misalignment, accidents, surgeries, pregnancy, and a slew of other environmental and genetic factors can quite frankly jack up your body. Let's dive into one of these issues today, the tight hip flexors. Each person is unique in their story and body make up. Perhaps these tips and exercises can help you with the stubborn back aches you feel.
There are three hip flexors: the psoas major, iliacus, and the psoas minor. A small percentage of the population does not have a psoas minor. There are theories as to why. Some say it is because this muscle does not have connective tissue. If it is not used, it sort of disintegrates within the body. For the purposes of this blog and understanding where some back pain comes from, we will be focusing on the psoas major.
The psoas major originates on the vertebral bodies of T12- L5 and the transverse processes of L1-L5, relatively. I say relatively because there are always unique anomalies from person to person. Some people might have a psoas that originates from T11- L5 or T12- L4. The psoas major then wraps around and downward over the superior pubis ramus at the front of the pelvis and inserts onto the lesser trocanter at the top of the femur bone. This muscle connects your leg to your back. Its action is to bring your leg into flexion by lifting your leg toward your chest or to bring your trunk forward toward your legs. It also anteriorly tilts your pelvis (tilts your pelvis forward) and helps to laterally flex the hip. We need a healthy psoas, the filet mignon of the human body, to walk, run, squat, and bend forward.
What are some ways the psoas major can get tight? One of the biggest culprits is having a job or lifestyle where your sit for long periods of time. Police officers, truck drivers, lawyers, secretaries and teachers are just a few occupations that I can think of that may have a tendency to sit for prolonged periods. Now, having a sitting or desk job does not guarantee you will have tight hip flexors. There are plenty of teachers who stand more than they sit and walk around the room more to balance out the amount of time they sit. There are also individuals who sit with better posture than others. Just because you fit into this category does not mean you have to succumb to the inevitable. There are also more and more people who are opting for standing desks these days. Those choices make a tremendous difference in the health of one's psoas.
Another way for the psoas major to get tight is through hobbies or activities. There are all sorts of sports that lend to tight hip flexors if one is not careful to balance leg and hip action. Some track runners over contract the flexion action of the leg and do not have enough extension of the leg. They may also have tightness in other muscles of the trunk that contribute to tight hip flexors like the quadratus lumborum in the low back or the rectus abdominus. I have seen quite a few clients of mine who enjoy gardening. Prolonged amounts of time on their knees or squatting over to pull weeds has caused tight hip flexors.
Let us not forget that body alignment and posture can also be related to genetics. The way we carry ourselves to some degree is in our DNA. Remember that I mentioned anomalies. We are not all the same. Some of us have shorter psoas major muscles naturally. Let's take a look at some photos of people with an anterior pelvic tilt.
Tight hip flexors can be a cause for or lead to sciatica pain, compression of the lower lumbar, self fusion of lower lumbar vertebrae, or stenosis of the lower lumbar to name a few. It is extremely important to have the tools to help you move toward a more healthy posture. These tools may never fully correct the issue, but it can keep other, more serious ailments at bay and can often alleviate some back or hip pain. If you are experiencing severe pain with any of the following exercises, please seek diagnosis from your doctor, PT, OT, Physical Therapist or other Practitioner. If you have not been cleared to attempt these exercises or stretches, please wait for clearance from your doctor.
The following videos are mobility stretching exercises I use in my Pilates practice. Try all or a few to help you lengthen and strengthen your hip flexors. You may wonder why I mentioned strengthen. Aren't my hip flexors already tight? Yes, however, tight muscles are often weak and under used muscles. Mobilizing our joints is more helpful than mere static stretching. It's similar to when we had a loose tooth as a kid. If the tooth was sticking out slightly away from our tongue, we wouldn't simply pull it in that one direction to loosen the tooth. We would wiggle it back and forth, back and forth until we found the give. The same concept applies to our joints. We need to mobilize. We need to move! You will see what I mean when you watch.