The Hip Complex and Its Feisty Movers

This subject has been floating around in my head for some time. I have been wanting to tackle some muscles of the pelvis and hip that aren’t spoken enough of (until you’re rehabilitating them due to an injury) and have a tendency to be problematic. A feeling of “tightness” may very well be the first sign that a dedicated set of exercises and consistent routine are in order. For this blog post I’ve chosen three muscles, by far not an exhaustive list. I was inspired to write this from personal experience with clients from my massage and fitness training practice. I’ll dive right into it!

A feeling of “tightness” may very well
be the first sign that a dedicated set of exercises
and consistent routine are in order.

Pectineus; I have a personal beef with pectineus. This muscle has been causing me pain on my right thigh and harbours a trigger point that radiates with a dull ache around my groin. Pectineus can be found in the medial upper thigh (bilaterally), it attaches from the pubis bone to the medial femur (lesser trochanter of the femur) just below the hip joint. This muscle serves to adduct and flex the femur – moves the thigh across the front of the body and toward the midline.

In all my text books it’s listed as a medial (internal) rotator of the hip, however, I’ve noticed it’s being listed as a lateral (external) rotator in recent texts. I did some research and found this paper by the Orthopaedic Research Society, and it seems it was found to do both actions. In the end, it’s primary action is adduction and flexion of the thigh.

If you routinely play soccer, hockey or are in the habit of sitting cross legged for a prolonged time, this muscle gets tense since it’s being chronically overloaded. If you have limitations in this muscle your gait and squatting mechanics are affected and your risk of a groin pull are high (especially in sport activities which involve quick sudden movements).

Pectineus trigger point. Referred pain radiates to the other adductors.

If it feels tight and has a decreased range of motion around the hip joint, following a systematic stretching routine would be beneficial. The first step would be to do a self myofascial release (SMR) more commonly known as foam-rolling. Why? Muscles, tendons, fascia, skin have mechanorecptors that respond to external tension, pressure, and vibration, by relaxing the tone in the muscle thus facilitating a static stretch. When doing SMR you are searching for those trigger points which tend to feel tender, sore or painful. Check out the video below which targets pectineus.

SMR is followed by a static stretch held for a minimum of 30 seconds. The last step would be to activate the opposing muscle group by performing an exercise that recruits it through its full range of motion. For this example, the opposing muscle group are the abductors of the hip; gluteus medius; gluteus minimus; TFL. Performing a hip abduction (moving the leg away from the midline of the body) would be appropriate.




Tensor Fasciae Latae
TFL

This muscle (TFL for short) is a fun one but does not show up in many articles. A strong TFL with proper extensibility will allow you to bust a move like the one above! Okay, not solely on its own but it is vital for pelvic stability.

The TFL is a small superficial muscle located right below the iliac crest, what most people think of as the hip bone, which is the ilium of the pelvis (see photos below). It continues downward to merge with the iliotibial tract (commonly referred to as the IT band) which also merges with the connective tissue of the gluteus maximus. The IT band is a wide tendinous sheet of fascia, think of it as a large wide tendon, it attaches to the lateral condyle of the tibia (shin bone).

Through its connection with the IT band, it assists in knee flexion and lateral rotation of the lower leg. It’s a key muscle in stabilizing the pelvis during ambulation, helping to anchor one hip while the other one rises and swings the leg forward.

TFL trigger point and pain referral areas.

With all this great power comes great responsibility! These muscles get stressed from running on uneven surfaces or having a limb immobilized for an extended period of time. If it’s chronically tight, you might have issues with gait, pain deep in the hip or patella tracking dysfunction via its connection to the IT band. The video below demonstrates a SMR technique for TFL.

Follow SMR with a static hip flexor stretch then an opposing muscle activation exercise – this case hip extensor, glute maximus.

The Psoas
the main bridge between your spine and lower body

The Iliopsoas are a fiesty group. These muscles cause quite the stir! Everyone who sits for an extended period of time may very well have tight iliopsoas or low back pain. Why? The psoas are a major bridge between the spine and lower body. When we sit they are being forced into a shortened position. Overtime the muscles become adaptively short (constricted, looses extensibility) and might compress the lumbar discs leading to pain.

Iliopsoas trigger points. Referred pain can be felt in groin and lower back.

This is where I preach the importance of posture and ergonomics; If sitting for an extended time consider adding lumbar support; a folded towel placed under and across the hips to reduce tension; computer should be placed at eye level; elbows at 90 degrees, wrist neutral; get up every 30 minutes to decrease tension and ease circulation of fluids;

The psoas are comprised of two muscles, the illiacus and psoas major (interesting note, some individuals have a psoas minor). The psoas major originates from the anteriolateral lower vertebrae (T12-L5), travels through the pelvis and inserts at the medial femur below the hip joint (specifically, lesser trochanter of the femur). The iliacus is located in the iliac fossa (for a visual, cup your hand slightly, the fossa would be the cup) and also attaches to the lesser trochanter of the femur. Both muscles flex the hip, laterally rotate the hip and anteriorly tilt the pelvis. Psoas major assists in lateral flexion of the spine, it’s a main lower back stabilizer and allows you to flex your trunk forward when your legs are stabilized. If you’ve ever done a traditional sit up and felt more strain in your hips than your abs, it’s because the psoas completed the action, not the abdominals.

Aside from sitting for an extended period of time, other things that cause strain to the iliopsoas are; running downhill – if you’re into that sort of stuff; trunk rotation with the feet fixed in place; overload from bad postural habits. The iliopsoas are difficult and uncomfortable to perform SMR on. They are located within deep structures, if you’re experiencing tension in your hip flexors, a trained manual therapist would know how to asses them and address them in a safe and effective manner.

The real trick with the iliopsoas is identifying if they are, not just tight, but are they weak? I’ve linked a video below that explains this very well.

I hope this post has been insightful for those experiencing hip tension. Remember every body is unique in its construction. The information on this site is not intended to be a substitute for professional medical advice. If pain is present and tension is chronic see your doctor for the appropriate treatment.

If you’re interested in working with me and would like a convenient totally customized online training routine reach me through my Contact page!

Stand Tall, Breathe Deep!
Corina,

Categories Exercise, health and wellness, Therapeutic MassageTags , , ,

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