Why are my hip flexors always tight?

A common thing I hear from my patients or folks in the community is that they feel like their hip flexors are always tight. Many times they say "no matter how much I stretch, they just never loosen up!".

So the question becomes, are your hip flexors really "tight"? As in, is that muscle shortened? Why does it feel that way? And why doesn't stretching help?

The sensation of muscles being "tight" can mean a few things. Yes, some times the muscles really do tighten up a bit, particularly in people who are in sitting positions for long periods of time. In these cases, sometimes stretching the muscles can provide some short term relief. However, with most patients I treat it just isn’t that simple!

So why do the hip flexors feel so tight?

There can be quite a few reasons hip flexors feel “tight”, and for most people there may be more than one of these things contributing. Let’s dive in.

1) It could be due to the hip flexors and/or core muscles actually being weak. When there is weakness in the abdominal stabilizers, the hip flexors will often kick in to help stabilize. Another symptom I commonly see in this scenario is that the hip flexors “pop” during core exercises. (This popping sensation is not something to be afraid of, however it is good feedback that you aren’t using your core muscles as effectively as you could be).

When there is weakness in the hip flexors, they will often feel tight as they try to find stability. Sometimes simply adding in some hip flexor strengthening exercises can significantly reduce the sensation of hip flexor tightness. However, if some of the factors below are involved I recommend addressing these first, then strengthening.

2) Reduced visceral mobility can cause the hip flexors to guard. Our organs need to move, and restrictions in the organs can cause reflexive guarding in surrounding muscles. For example, the kidneys have direct fascial connections to the psoas (part of your hip flexor muscles), so reduced mobility in the kidneys can directly affect the hip flexors. There are many other organs in the abdomen and pelvis that also can be restricted and can affect the hip flexors and nerves in the area as well.

3) Nerve restrictions. Restrictions in the viscera, fascia, and/or muscles in the abdominal cavity can restrict how freely nerves are able to move. Sometimes the tightness we perceive as hip flexor muscle tightness may actually be nerve restrictions. Our hip flexor muscles may also guard around existing nerve restrictions. In this case, improving nerve mobility can reduce the sensation of hip flexor tightness.

4) Your posture and breathing can affect your hip flexors. The psoas muscle connects from your diaphragm and lower thoracic/upper lumbar spine, down into your pelvis where it joins your iliacus muscle, then crosses the hip joint onto the lesser trochanter of the femur. Being in postural positions where the muscle is lengthened or shortened for prolonged periods of time can affect the hip flexors and make them feel “tight”, therefore movement throughout the day is key in improving hip flexor tightness.

Our diaphragm is an important breathing muscle, and breathing is a great way to tap into our parasympathetic (“rest and digest”) nervous system. If we aren’t breathing well into our diaphragm or managing pressure well in our core, our hip flexors may feel guarded. Breathing exercises can help relax your nervous system and reduce this sensation of tightness.

As you can see, there are quite a few reasons your hip flexors could be tight! If you’ve tried stretching your hip flexors and can’t seem to find relief, I highly recommend seeing a physical therapist to assess why your hip flexors are tight and address the root cause.

Want to learn more about how we assess and treat tight hip flexors at Absolute Kinetics? Set up your free 15 minute phone consult here.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS