By Hannah Alderfer, BA, CPT, FMSC
Have you ever thought about the complexity of what it takes to sit, stand, walk, run, or perform a variety of other movements involving your hip joint? The hip joint is quite complex and it can also be the cause of a lot of pain if not taken care of. You aren’t alone if you’ve ever had to deal with hip tightness, low back pain, knee pain, or bad posture. All of these things can be a result of imbalances and tightness in the muscles surrounding the hips. Some of the main culprits involved are the iliopsoas, piriformis, and iliotibial band. It’s not always easy to determine what sets off the problem to begin with, but by working to stretch, strengthen and release each of these areas, you are more likely to feel and move better!
First, let’s see what each of these muscles do! The iliopsoas is actually two muscles that come together and attach onto a bony prominence on your femur called the lesser trochanter. Its main function is to lift the leg (also called flexion). Next, the piriformis is a deep hip muscle that overlies the sciatic nerve and helps you externally rotate (outwardly turning) your leg. When it becomes tight, it can compress the sciatic nerve and cause symptoms very much like sciatica. Lastly, the iliotibial band is actually a long tendon attached to a small muscle on your hip called your tensor fasciae latae, which performs the movements of hip flexion and abduction (abduction occurs with any side stepping or side lifting of the leg). The IT band then connects all the way down to your knee joint. Now that you have a better idea of where these muscles are located and what they do, let’s see why they can create so much trouble.
Most people spend the majority of their day in a seated position, which makes the iliopsoas tight and short. Or they perform exercises such as walking, running or biking, which involves lots of hip flexion. When this happens your pelvis is pulled forward into anterior tilt. Over time this causes the piriformis to be tight and can also affect the IT band, leading to the problems I’ve already mentioned. If you are struggling with hip, back, or knee pain, then try some of the stretches and self-myofascial techniques below for relief.
Kneeling Hip Flexor Stretch: First make sure to tuck your tailbone (or bring your hips back to a neutral position). You might already start to feel the stretch at this point. Then shift your body forward to deepen the stretch. Hold for 30 seconds on each side.
Lying Hip Flexor Stretch: Lying on the end of a table or bed with your legs hanging off the edge, pull one knee to your chest, keeping the other leg relaxed and draped off the edge. Hold for 30 seconds on each side.
Standing Piriformis Stretch: Place one leg on a counter or table with your knee bent. Keep your standing leg facing straight forward. Push your tailbone to the wall behind you or try to keep your back as flat as possible. Then gently bend your standing leg at your knee to deepen the stretch. Hold for 30 seconds on each side.
Iliotibial Band Stretch: Using a stretch strap, band, or towel, lie on your backside and wrap the strap around the arch of the foot. Keeping the knee straight, gently pull the leg up and across the midline of the body, trying to keep the same side hip down on the floor and the opposite leg facing upward. Hold for 30 seconds for each side.
Hip Flexors: Lie on the foam roller so that it is halfway between the side of your leg and the front (it should be right below your hip bone). Then roll slowly from your hip bone down toward your knee and back, using your forearms and opposite leg to move along the roller. Roll for 60-90 seconds on each side.
Piriformis: Sit on the foam roller and lean back with your hands behind you supporting your weight. Lean to one side so that just one side of your glutes is on the foam roller. Lift the same side leg across the opposite side and roll from the top of your hip bone down to your butt bone (or ischial tuberosity). Roll for 60-90 seconds on each side.
IT Band: Come to one side and place your bottom leg on the foam roller starting at your hip bone. Then bring your top leg in front to a bent position so that you can use that leg to help push as you roll along the other leg. Roll from the hip to the knee slowly. If that becomes comfortable, stack both legs and roll through the bottom leg from hip to knee. Roll for 60-90 seconds on each side.
Solutions for Tight Hips