Hip Flexor Strain – Causes and Treatments

Hip flexors and runners: the misunderstood muscles

What better way to kick start your fitness routine than with some professionals runs, and for the ambitious lot, half or full marathons.

After your quick Merv Hughs warm-ups and your Rocky Balboa bounce to get the body going  you quickly start a light canter; have you experienced that dreaded tight feel in your hip flexors, perpetual fear of pulling a muscle, pain as you hit the hot bitumen as you glide to a stop with as much grace as an elephant on skates?

Then as much as you demonstrate your repertoire of stretches and releases on the sore and affected areas nothing helps. Any relief you get from the so-called advanced stretches you learned from hot yoga only give you point in time static relief. When you again start your canter it all goes wrong again!!!!

No its not time to throw those shoes away or think about leg replacements…..it’s just your hip flexors and they need some help.

So what really causes hip flexor tightness and pain during running?

We often instinctively seek treatment to the area that we feel discomfort and conclude that the area is the source of the problem.

Problem 1: I feel tight in my hip flexors during a run.

Solution: Stretch and or Release

Problem 2: I have pain and I think I pulled a muscle in my hip flexor

Solution: Treat muscle with rest and/or ice

Now in most cases, the above solution may help, in a lot of situations running will aggravate the same injury.

We need to change the perspective and look at running in a more holistic manner. Running requires our whole body system to be working in unison- with optimal hip-lumbopelvic control and good trunk and arm movements stacked on top of the lower body.

MUSCLE TALK

The hip flexors are a group of muscles that plays both the role of a stabiliser and the creator of hip movements. Deep hip flexor muscles stabilise the hip joint into the pelvic socket to bring your leg/thigh forwards through the swing phase when running. When it is tight or when we over-activate this muscle group, each specific hip flexor muscle is unable to perform its role efficiently. So hip flexors that are stabilisers get weak from disuse, and global phasic hip flexor muscles get tight/fatigued and are prone to strains and injuries from overuse.

FACTORIAL

Many factors can cause hip flexor issues in runners. These include:

1. Recreational runners, who mainly sit most of the day at work, are predisposed to tightness in their hip flexors due to postural issues from prolonged sitting.
2. Tight hip flexors often then create altered alignment of the pelvis, commonly anteriorly tilting the pelvis, causing an exaggerated arch through the low back. When the pelvis is not in its neutral alignment, our hip extensors ie the gluteal muscles are then inhibited and becomes weaker, affecting one’s running efficiency, thus increasing the demands on one’s hip flexor muscles ( hence the feeling of chronically tight hip flexors)
3. Weakness in the gluteal muscles, will create poor lateral stability of the hip-pelvic region. One commonly seen pattern, known as the Trendelenburg gait or ‘hip drop’. This, in turn, will create increased workload to the other lower limb muscles, including your hip flexors, quadriceps, hamstrings and calves, which can increase the risk of muscle strains and other conditions like knee cap pain.

FIX ME

Hence, in tackling the hip flexor issues when running, we need to not only stretch the hip flexor muscles but also any other lower limb muscles that may be financially tight ( glutes, hamstrings, ITB, quadriceps, hip adductors), to enable us to achieve neutral alignment of our lumbopelvic-hip complex. Once we can achieve good postural alignment, we can then access the appropriate muscles when running.

The next stage to treatment often involves core and gluteal muscles strengthening, to alleviate overloading our hip flexors when running. However, specific exercises to promote hip-pelvic dissociation and strengthening of our hip flexor muscles during swing phase of running needs to be focused on.

So with all the complex systems working to allow you to have an enjoyable and effective session, its no wonder how our daily activities can adversely affect our enjoyment of it.

So next time you run or exercise and the discomfort or tightness stops you cantering like a Group One filly at the Melbourne Cup remember…

Don’t fear, your PHYSIO is here!