A Treatment for Tight Hip Flexors That Works Better Than Stretching

Foam rolling is great, but it's not enough to remedy tight hip flexors and anterior pelvic tilt. You also need to breathe properly. Check it out.

It's no secret that many people deal with cranky hip flexors. From constantly sitting or from overtraining the front sides of our bodies, tight hip flexors work to pull us into what's called anterior pelvic tilt—a forward shifting of the pelvis that exaggerates the curve of the lower spine.

With more awareness of this issue, athletes are using foam rollers, PVC pipes and lacrosse balls, along with stretching techniques to alleviate hip flexor tightness and fix resulting postural issues.

But is gaining greater mobility in the hip flexors as simple as using a foam roller for a few minutes after each workout? Maybe not.

I do think we are going about stretching our hip flexors all wrong. Let me explain.

First, we need to understand that the body is connected by fascia, which is a general term for connective tissue. It is everywhere and it connects everything. Fascia is comprised primarily of collagen (the same stuff that's in tendons, ligaments and skin). It is made to resist mechanical stress, but it's also extremely flexible, robust and adaptable. Fascia is also extremely strong. So the idea that stretching or applying a moderate amount of pressure through a piece of foam will actually make physical changes to the fascia is suspect.

But many athletes swear by foam rolling. I personally feel better when I do my foam rolling routine.

Second, we need to look at the anatomy of the hip flexor group. The psoas is a long muscle that attaches to the last thoracic and all lumbar vertebrae, as well as to the inside of the upper femur. An important thing to note with this muscle is that although it is commonly categorized in the "hip flexor" group, it can also pull on our lower back. I would argue that the psoas is a lumbar stabilizer more than a hip flexor.

The diaphragm is our primary muscle for respiration (or at least it should be). This dome-shaped muscle attaches on the lumbar vertebrae, the inside of the lower half of ribs, and the xiphoid process of the sternum. It is the only muscle in the body with attachments on itself via a central tendon. The diaphragm is the most important muscle in the body, but without getting too in-depth, just notice that it shares similar attachments as the psoas.

In most anatomy textbooks, every muscle is clearly delineated and has a clear role. We could only dream of the human body operating that simply. What we often fail to realize is that the body is so interconnected, that almost nothing acts in isolation. And this is where our fascia come into play.

The psoas major muscle and the diaphragm have very strong fascial and mechanical ties. Tight hip flexors can affect our breathing, and improper breathing can adversely affect our hip flexor health. When we have improper breathing patterns (when we use accessory muscles in our neck and upper chest to inhale instead of using our diaphragm), our ribs are pulled up. When our ribs are pulled up, our low back arches. When our low back arches, our psoas muscle shortens. And when a muscle is consistently shortened, it tends to stay short.

In addition, poor breathing mechanics can play a role on our nervous system in ways of which most people are completely unaware. When we are extended (think big breath of air, chest up), nerves in the the backside of our body crank up our sympathetic nervous system. This is the half of the autonomic nervous system responsible for "fight or flight"—that is, getting us jacked up when threat is detected or when we try try to squat a small truck.

This position is perfectly acceptable. But only on occasion. And certainly not when we are trying to relax our muscles so we can increase mobility.

So that raises the question: Will a few minutes of hip flexor stretches or foam rolling overcome 23-plus hours of poor breathing? Probably not.

I'm not telling anyone to abandon their SMR or stretching routine. It's still valuable and important. I'm saying that it takes more. Not more foam rolling, but a more global approach. Understand that if you cannot maintain proper rib position and proper breathing mechanics, then stretching will be a tough lesson in futility. Our nervous system is too smart. It's too protective. It's not nearly as gullible as we think.

How to Correct Your Breathing

Many of us sit for a vast majority of the day. The seated position is brutal for our hips. But just as brutal is our crappy breathing and  the 22,000-plus repetitions that we perform every day. Each breath we take pulls our ribs up, puts our diaphragm in a poor position, puts our hip flexors in a shortened position, and puts our nervous system on alarm.

To fix your breathing patterns, lie on the floor or a table with your feet either on a wall in a 90-90 position, or with your feet on the ground with your knees bent. I recommend placing a small ball or foam roller between your knees as well. If necessary, place a towel or small pad under your head to help keep a neutral cervical alignment.

Place one hand on your stomach and one on your chest.

When you inhale through your nose, your ribs should track out and expand instead of moving up and toward your head. The hand on your stomach should rise, followed by the hand on your chest.

The real key, however, is exhalation. A full exhalation is necessary—getting all the air possible out of your lungs. Once you get to this fully exhaled position, pause.

Count 1, 2, 3, 4, 5 seconds.

Inhale through your nose again.

When you exhale fully and then pause, your diaphragm and ribs have no choice but to operate as they are designed to.

Complete as many breaths as you like, and do this as many times per day as you feel necessary, but at least do 3 sets of 5 breaths.

Keys to success

  1. Reach your knees toward the ceiling.
  2. Feel your left low back on the floor.
  3. Exhale as fully as possible after each breath.
  4. Pause

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