To stretch your quadriceps at the hip, the idea is to do the opposite movement to flexion, i.e., extension. You can perform extension moves at the hip while standing, lying on your side, lying prone (on your stomach) and kneeling. Even basic stretches done at a pain-free level where you can feel a small bit of challenge, and that are held continuously for approximately 30 seconds may translate to better posture and less back pain.
It’s well established that about eight in 10 people in the U.S. will experience back pain at some point in their lives. And while the causes of such pain often vary, say physical therapists and other medical professionals say that increasingly, in a world that accommodates a more sedentary lifestyle, the blame for low-back pain can often be traced to an area a little lower in the kinetic chain: the hips.
I call it the true hip flexor stretch as I want you to truly work on stretching the hip flexor and not just torque your body into hip and lumbar extension.  It’s very easy for the body to take the path of least resistance when stretching.  People with tight hip flexors and poor hip extension often just end up compensating and either hyperextend their low back or stress the anterior capsule of the hip joint.

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Kneel on your mat with thighs perpendicular to the floor and tops of of your feet facing down. Place a yoga block between your feet. Bring your inner knees together. Slide your feet apart so they are slightly wider than your hips, and press the tops of your feet evenly into the mat. Slowly sit down on the yoga block. Use your hands to turn the top of your thighs inward. Allow the backs of your hands to rest on your thighs. Hold for at least 30 seconds.
That’s a problem. “Elongated periods of sitting sends messages to certain muscles to stay turned on, which keeps other muscles turned off,” says Beachbody fitness expert Cody Braun. “This creates an imbalance, which can immobilize your hips.” Your hips are built to move in almost any direction, explains Braun, and when they’re stiff, they don’t just make exercise more difficult; they also make you more prone to pain in surrounding joints — including the oft-troublesome lower back.

The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions — for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus (which is worthwhile, but rated very, very R17). The first sign of the cancer that killed him in 2011 was steadily worsening back pain. It’s always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of history’s most famous gladiator. Back pain didn’t seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first! It was many long months before he was diagnosed — not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.
Premkumar et al present evidence that the traditional “red flags” for ominous causes of back pain can be quite misleading. The correlation between red flags and ominous diagnoses is poor, and prone to producing false negatives: that is, no red flags even when there is something more serious than unexplained pain going on. In a survey of almost 10,000 patients “the absence of red flag responses did not meaningfully decrease the likelihood of a red flag diagnosis.“ This is not even remotely a surprise to anyone who paid attention in back pain school, but it’s good to have some harder data on it.
Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, typically affects one side of the body and can cause pain in the back of the right or left hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.

Hip hikers (also known as the pelvic drop) are great exercises to get your gluteal muscles working in a weight bearing position. To do the exercise, stand sideways with one foot on a step and the other hanging off. Keeping both knees straight, lower down your pelvis on one side so your foot moves toward the floor. Both knees should remain straight; the motion should come from your hip joint. Once your pelvis is lowered down, slowly raise it back up to the starting position. Repeat the exercise for 10 repetitions.
5. Feel free as a bird. Open up those hips with yoga’s pigeon pose! Start on all fours with hands below the shoulders and knees below the hips. Bring the right knee forward until it touches the right hand and place the leg flat on the ground across the body (the right foot is now on the left side of the body, parallel to the front of the mat). Drop left leg to the ground, and extend it back with toes turned under. Keep the hips level, inhale, and walk hands forward. Exhale, and fold the torso over, lowering elbows to the floor. Stay in this position for 5-10 breaths before coming back up to switch sides.
Gait analysis studies in the elderly show that they typically have a shortened step length. Whether that is a result of tight hip flexors or due to reduced balance, the propensity to walk with shorter steps will itself lead to tightness in hip flexors and anterior joint structures. Hip stretches may be a relatively easy preventative strategy for the elderly with gait abnormalities and may help to prevent falls.

There are thousands of low back pain books — what’s special about this one? The problem is that 90% of doctors and therapists assume that back pain is structural, in spite of mountains of scientific evidence showing … exactly the opposite. Only a few medical experts understand this, and fewer still are writing for patients and therapists. Supported by 462 footnotes, this tutorial is the most credible and clarifying low back pain information you can find. Ships with a free copy of PainScience.com’s trigger point tutorial! Buy it now for $19.95 or read the first few sections for free!
Gait analysis studies in the elderly show that they typically have a shortened step length. Whether that is a result of tight hip flexors or due to reduced balance, the propensity to walk with shorter steps will itself lead to tightness in hip flexors and anterior joint structures. Hip stretches may be a relatively easy preventative strategy for the elderly with gait abnormalities and may help to prevent falls.
The big idea of classification-based cognitive functional therapy (CB-CFT or just CFT) is that most back pain has nothing to do with scary spinal problems and so the cycle of pain and disability can be broken by easing patient fears and anxieties. For this study, CFT was tried with 62 patients and compared to 59 who were treated with manual therapy and exercise. The CFT group did better: a 13-point boost on a 100-point disability scale, and 3 points on a 10-point pain scale. As the authors put it for BodyInMind.org, “Disabling back pain can change for the better with a different narrative and coping strategies.” These results aren’t proof that the confidence cure works, but they are promising.
Good points on isolating the single joint hip flexors and avoiding compensations. I am curious about your perspective (and others) on why this is less likely to stress the anterior capsule? I tend to add trunk side ending before finalizing the stretch to bias the psoas. The stretch you have outlined seems like an iliacus and ant. capsule biased stretch. Thoughts? If I really want to protect the anterior capsule, I’ll also add a slight amount of hip internal rotation.
Lay on your back on your mat and pull your knees to your chest. Place your hands on the inside arches of your feet and open your knees wider than shoulder-width apart. Keeping your back pressed into the mat as much as possible, press your feet into hands while pulling down on feet, creating resistance. Breathe deeply and hold for at least 30 seconds.
Resisted hip flexion: Stand facing away from a door. Tie a loop in one end of a piece of elastic tubing and put it around the ankle on your injured side. Tie a knot in the other end of the tubing and shut the knot in the door near the floor. Tighten the front of your thigh muscle and bring the leg with the tubing forward, keeping your leg straight. Return to the starting position. Do 2 sets of 15.
The hips are the fulcrum point for all lower-body movements. Weak hips can cause an antalgic gait, leading to knee, foot and ankle problems that can keep you off the field and out of the game. Although building your legs with compound exercises like Squats and Lunges is important, you need to set some time aside to focus on your hip muscles by performing hip-specific strengthening exercises. Incorporate these hip-strengthening exercises into your routine to make sure your hips stay strong and injury free.
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You may hear a clicking noise when you move your hip, but that sound is not necessarily a hip flexor issue. Siegrist says the clicking isn't generally the hip flexor alone and often comes from a moving part, like the joint. "Maybe there is a loose body in the joint or loose cartilage at the edge of the hip joint that is mechanically getting irritated,” she says.
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