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Woman Bridging

Hip Flexors and Hamstrings

Do your legs feel tight, or cramp up after golfing, gardening, exercise or pickleball? I’m certain you’ve heard about the benefits of stretching, but did you know that stretching the wrong muscles can actually be harmful? For happy hamstrings it is important to look at the length-tension relationship between the hamstrings at the back of the pelvis and the hip flexors at the front of the pelvis.

One of our hip flexor muscles is called the psoas muscle. It is one of the largest muscles in the body and is the only muscle to link our lower back to our legs. The psoas often contributes to back pain when it is tight, shortened, or unbalanced. It is the key to loosening tight hamstring muscles. The psoas hip flexor is the Ying to the hamstrings’ Yang.

The hamstrings on the other hand, flex the knee and assist with hip extension. When shortened and over-active they will draw the pelvis down at the back into a posterior pelvic tilt causing the low back to flatten out. The flattening of your lower back often causes an exaggerated curve in your upper back which leaves you at risk for injuries to the upper extremities. There is often little or no curve in the low back of people with chronically tight hamstrings.

Hamstring strains are a huge issue for older adults. As we age, our lower body often shows signs of stiffness and decreased range of motion before our upper body. If we understand proper alignment of the body however, we may be able to prevent a few injuries. It may seem obvious to stretch a muscle that feels tight but just for a moment, think of an elastic band. If the rubber band is stretched as far as possible, it will seem tight. The same is true of an overstretched muscle. Sometimes a muscle such as the hamstring may feel like it is tight when it is actually overstretched. A truly tight muscle is shortened meaning the actual length of the muscle is reduced. This is where stretching gets complicated and why randomly stretching can create problems. If we stretch a muscle that is over-stretched (think of that tight rubber band) it will tear more easily.

There is a right and wrong way for you to stretch and strengthen your body and it’s largely based upon your postural alignment. Let’s think about a teeter-totter. Imagine the board of the seesaw representing your hip bone and being in perfect balance, level to with the ground. That is what happens when the force on one
side of the joint is the same as it is on the other; the muscles are completely balanced. If the hip flexors are tighter or stronger than the hamstrings however, the board or the hip will tip forward. This creates an anterior pelvic tilt, and the result is a lengthening of the hamstrings and an exaggerated curve in your low back. If the hamstrings are the dominant muscle or are tight, they will pull the back of the hip (or the board of the seesaw) towards the ground. This is known as a posterior pelvic tilt and will cause flattening in the low back. So, what happens when you’re in this flawed postural alignment and decide to pick up a bag of mulch? If you answered with “a pulled hamstring,” you are correct. It may not happen every time, but if you’re in a flawed alignment long enough, chances are it’ll catch up to you over time.

So how do we apply these concepts to prevent injury? One easy way to check your posture is to start with your feet, shoulders, and back against a wall. If your posture is correct when you reach behind and place your hand in the small of your low back it should fit perfectly. If, however, you notice that your low back is flat against the wall and there is no or little space for your hand, there is a good chance you will benefit from a hamstring stretch and hip flexor strengthening program (Plan A below).

If you reach back and the arch is exaggerated and larger than your hand, there is a pretty good chance that the hip flexors are tight and you will benefit from the hip flexor stretching and hamstring strengthening program (Plan B below). To further verify this conclusion, try lifting one leg towards your chest with the knee bent. If you can hold your knee above hip height for more than twenty seconds your hip flexors are strong. If the knee drops below 90 degrees in less than 20 seconds, the psoas or hip flexors may be weak and in need of strengthening. Remember to always stretch the tight muscle before you strengthen the weak one. That’s just the long and short of it.

Plan A: For participants with “Flat Backs”:
1. Hamstring Stretch Knee Bent: This stretch is important because it targets the knee side of the hamstring. Start this exercise lying on your back. Next bring your thigh up and hold behind the knee. Make certain to keep the knee as close to your chest as possible and hold as you straighten the leg. Push the heel towards the ceiling as you pull the toes towards your nose. Hold for 30 seconds.

2. Straight Leg Lift: Start by lying on your back with one leg propped up (against a doorway) and the other on the floor. Lift the leg on the floor up to the same height as the supported leg and lower with control. RPT 10-15x each leg


Plan B: For participants with exaggerated low back curve:
1. Hip Flexor Stretch: Start by lying on your stomach. Next lengthen one leg out and flex the foot on the extended leg. Bend the extended leg imagining you have an orange behind your knee, and you want to juice it. Encourage your heel to come as close to your bottom as possible. Next, become heavier on the front side of the hip then imagine sliding the bent knee away from your head to create length in the front part of the hip. Hold for 30 seconds.

2. Bridging: Start by lying on your back with knees bent. Think of staying level though the shoulders as you squeeze your buttocks and lift. If you really want to recruit your hamstring muscles lift your toes and really press into the heels during bridging. Hold for a 5 count. Rpt 10-15x

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