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<p>These bad boys, like our abd/adductors that we spoke about last week require 1:1 ratio with their antagonist buddies, the hip extensors.<br></p>
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<p>Yet our hip flexors can very underused AND under trained, in fact often totally ignored in our exercise programming.<br></p>
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<p>Unless of course you’re a Crossfitter! These guys use them a lot in their ‘toes to bar’ for example. <br></p>
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<p>However individuals, possibly like yourself, who do not do CrossFit OR those who might find toes to bar an advanced move (like me), well we’re going to explore other ways to condition them ;)<br></p>
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<p>It’s quite possible that the underuse of hip flexor training could be due to perceived risk. </p>
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<p>This is linked to a common complaint &amp; our hip flexor attachments. <br></p>
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<h2><strong>Hip Flexors &amp; Low Back Pain</strong><br></h2>
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<p>Low back pain (LBP) is still on the rise &amp; frustratingly common, to the point of a seemingly complete acceptance from many that LBP is NORMAL!<br></p>
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<p>Many simply accept it as part of their day to day chat, brushing any major concern aside, or at least any fervent attempts to address it, because ….”<em>well hey we ALL have LBP, right…</em>?!”<br></p>
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<p>WRONG <br></p>
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<p>It’s common but NOT <em>normal</em><br></p>
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<p>So you may be wondering how the hip flexors in the front of the hip can create a concern about LBP… unless of course you understand their attachments &amp; force production.<br></p>
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<figure class="wp-block-image is-resized"><img src="https://mail.google.com/mail/u/1?ui=2&amp;ik=f04949745e&amp;attid=0.1.2&amp;permmsgid=msg-f:1630253690920560958&amp;th=169fd3182d16e93e&amp;view=fimg&amp;sz=s0-l75-ft&amp;attbid=ANGjdJ97flSaSvndxAMEYjrUyBCpjHrw8zzo_25m0CZprfYl7q4073wnaQ38AaTMxr3wsQD_HoFIRT-u2pFf8O-2rC7UpfkMpgoJFluemRSrca2cJ2GPY4NlVhXubAQ&amp;disp=emb" alt="" width="540" height="513"/></figure>
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<p><br></p>
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<h2><strong>The Anatomy Of The Hip Flexors </strong><br></h2>
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<p>Specifically the large iliopsoas muscle attaches to the transverse processes of your lumbar vertebrae 1-4 - see image above.</p>
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<p>Thus resulting in a shear force upon the lumbar spine when they contract.<br></p>
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<p>This may well be contributing to our LBP but please note; it’s only one example NOT a definitive cause for yours.<br></p>
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<p>Now IF the hip extensors contribute to a ‘co-contraction’ balancing out this shear force<br></p>
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<p>OR<br></p>
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<p>If the force is low <br></p>
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<p>OR<br></p>
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<p>If you are in good intrinsic Biomechanical shape</p>
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<p>This won’t be the issue <br></p>
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<p>BUT <br></p>
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<p>If you are experiencing LBP there maybe some fear avoidance of hip flexor loading/strengthening </p>
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<p>OR </p>
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<p>A risk when hip flexor loading (case dependant) <br></p>
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<h3><strong>How &amp; When?</strong><br></h3>
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<p>So how do we know how &amp; when to exercise our hip flexors? <br></p>
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<p>Well there is a simple method of periodisation to </p>
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<ol><li>Prepare your pelvis </li><li>Condition (strengthen) them safely </li></ol>
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<p>We can also test them ! <br></p>
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<h2><strong>The Modified Thomas Test</strong><br></h2>
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<figure class="wp-block-image is-resized"><img src="https://mail.google.com/mail/u/1?ui=2&amp;ik=f04949745e&amp;attid=0.1.1&amp;permmsgid=msg-f:1630253690920560958&amp;th=169fd3182d16e93e&amp;view=fimg&amp;sz=s0-l75-ft&amp;attbid=ANGjdJ_SSQDvpXLy8D98j1g_QXU30WGBym-lMeoVpNOWpWVqqZVrMxK_hyMCulhiHKqN2UwylPjqzBzat-6MoAwsHaE_jMntYDfVRNQft8Hd_3AI2EYQLQiulcxx75w&amp;disp=emb" alt="" width="644" height="471"/></figure>
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<p>*Image taken from Brentbrookbrush.com<br></p>
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<p>So this pelvic function test will identify the integrity of the hip flexors &amp; is much more objectively measured by someone else, like a Biomechanics Coach, click here to go and find your local Biomechanics Coach.<br></p>
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<p>But a quick &amp; simple observation you could try for yourself would be to lie on a bench or plyo box. </p>
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<p>Make sure your bum crease is at the very edge of the bench/box.</p>
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<p>With one knee hugged to our chest, allow your other leg to lower down. <br></p>
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<p><em>Note: if you have long legs &amp; your foot touches the floor this may skew the test </em><br></p>
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<p>Now try to position your top leg/thigh so that it’s as close to your chest as it can go WITHOUT tipping your pelvis back posteriorly<br></p>
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<p>Once here you can then either try &amp; gauge if your knee is lower than your hip <br></p>
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<p>OR<br></p>
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<p>Balance your phone at the side to film how low it drops <br></p>
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<h3><strong>The Thomas Test: The Result </strong><br></h3>
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<p>If your lateral condyle (nobbly bit on outside of your knee at the front of the crease) &nbsp;is below your greater trochanter (big bony bit at the centre of your lateral hip) you passed </p>
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<p>If not then we need to prepare your hip flexor BEFORE loading it <br></p>
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<p>OR <br></p>
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<p>If there is an asymmetry then we need to prepare the higher knee side as this one has come up as positive for a limitation <br></p>
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<p>Go on off you go test em….&amp; let me know <br></p>
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<p>How did you do????</p>
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<p><br></p>
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<h3><strong>What Should You Do Now?</strong><br></h3>
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<p>So if you came up as high / positive then we should probably apply an anti spasm to your hip flexors first </p>
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<p><br></p>
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<h3><strong>Hip Flexor Anti Spasm </strong><br></h3>
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<p>Now this muscle ‘state’ is not clinical &amp; can be present without discomfort as it’s simply an adaption, possibly to sitting a lot <br></p>
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<p>If you have any amount of discomfort please seek face to face professional help <br></p>
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<p>More often than not stretching is prescribed for ‘tight’ hip flexors. However stretching may be too aggressive for this type of muscle state <br></p>
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<p>So we are going to apply an anti spasm known as ‘<em>post contraction sensory discharge’</em> Ribot-Ciscar et al (1991) <a href="https://www.biomechanicseducation.com/1333-2/" target="_blank" rel="noreferrer noopener" aria-label="(See a quick explanation here) (opens in a new tab)">(See a quick explanation here)</a><br></p>
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<p>Lie on your side, position your top foot in front of your bottom thigh. Lie your head down on your bottom arm - relax.</p>
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<p>Slightly bend your bottom foot back but keep that hip open without stretching it.<br></p>
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<figure class="wp-block-image"><img src="https://mail.google.com/mail/u/1?ui=2&amp;ik=f04949745e&amp;attid=0.1.3&amp;permmsgid=msg-f:1630253690920560958&amp;th=169fd3182d16e93e&amp;view=fimg&amp;sz=s0-l75-ft&amp;attbid=ANGjdJ-G4fhMLazEoPcBjJGNNxoXLHs4mzb1KNCtYHhRsYZ9qP8ZiED9JrkuGW_6LdzVm9hevMfo6YdVuclIWMIPCBA658rcHk3Rz5ZEERjnZ_k8VNIXI1a0jb6DZwk&amp;disp=emb" alt=""/></figure>
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<p><br>Now push the bottom thigh into the other foot with 20% of your maximum effort. Hold for 20 seconds &amp; repeat 4 times. If necessary do the other side (I suggest you always do both sides as good practise to avoid creating another asymmetry)<br></p>
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<p>Re-test in the bench/box<br></p>
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<p>How did you do??</p>
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<p><br></p>
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<h3><strong>Periodisation Programme </strong><br></h3>
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<p>Once you feel happy that your hip flexor function ROM is improved or ok we should consider firstly working the antagonist. <br></p>
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<p>WHY??</p>
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<p><br></p>
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<h3><strong>Reciprocal Inhibition </strong><br></h3>
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<p>One of the first things we are taught as L2 gym instructors is that all muscles work in pairs. The agonist (the prime mover) will influence the antagonist (the opposite muscle) through what’s known as the law of reciprocal inhibition. This law stops us hurting ourselves as it means both muscles cannot pull or contract isotonically at the same time.<br></p>
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<p>IF your hip flexors we’re in a sub-clinical adaptive state of constant contraction, or spasm, then this would influence the function hip extensor group or the antagonist.<br></p>
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<p>BUT WAIT……!? Weak Glutes???<br></p>
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<p>SOOOOOOOOOO this may challenge some preconception about the term ‘weak’ being used for this glute problem epidemic<br></p>
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<p>Anyhoooooooo….</p>
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<p><br></p>
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<h3><strong>Antagonist Conditioning </strong><br></h3>
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<p>At this point doing strength work on your hip extensors will do 2 things </p>
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<p>1). Strengthen your hip extensors </p>
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<p>2). Aid the improved function in the hip flexors via the law of reciprocal inhibition </p>
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<p><br></p>
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<h3><strong>Hip Extensor Exercises </strong><br></h3>
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<p>Glute Bridges</p>
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<p>Squats</p>
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<p>Deadlifts</p>
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<p>Good Mornings</p>
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<p>To name a few….</p>
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<p><br></p>
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<h3><strong>Back To The Front….</strong><br></h3>
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<p>….of your pelvis, for hip flexor conditioning or strength work…...<br></p>
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<p>Progressive programming might be prudent here in terms of bringing the strength back gradually since the muscles may well have been ‘coping’ up to now, so we might want to start at low level stuff<br></p>
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<p>Supine toe taps - neuromuscularly easy since the base of support is large. Also if we start with one foot on the floor &amp; with knee bent lift &amp; lower the other one this gives a short lever but we can progress to an extended leg for a longer lever &amp; harder follow on.<br></p>
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<p>The rules are simple here but possibly require more focus than we realise to truly achieve.</p>
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<p>Your Spine should not lift, nor lower, during any part of the movements. To test yourself rest your finger tips under your lumbar spine &amp; be sure that the pressure does not change on your hands while lifting, lowering &amp; moving your legs <br></p>
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<p>Harder than it sounds eh?!<br></p>
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<p><strong>Ok let’s explore progressions...</strong><br></p>
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<p>Dead bugs come in a variety of interpretations but the above exercises could be defined as a regressed dead bug. <br></p>
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<p>My understanding of dead bugs is that while supine, both arms &amp; legs move around to challenge ‘the trunk’.</p>
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<p>Part of that trunk will be your hip flexors due to their involvement here. Yet these are still neuromuscularly relatively simple albeit can be progressed &amp; regressed with lever length alterations. </p>
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<p><br></p>
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<h3><strong>Prone Hip Flexor Loading</strong><br></h3>
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<p>Progression maybe done prone, for less base of support / neuromuscular feedback (ie 3-4 points of contact). For example mountain climbers where you bring the knee toward the hip (hip flexion) then switch legs.</p>
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<p><br></p>
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<h3><strong>Increase Of Instability </strong><br></h3>
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<p>Use of a stability ball would double the muscular effort, should your place your toes on top of one &amp; draw your knees to your chest, rolling the ball with you. </p>
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<p>Known as a jack knife this is pretty advanced for many IF done properly with the spine completely stiff &amp; still.</p>
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<p><br></p>
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<h3><strong>Hanging Variations</strong><br></h3>
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<p>Then there are the hanging variations like knee raises performed either in a Roman chair which is easier (back is fixed to pad) than hanging from a free bar (only contact is the hand grip)<br></p>
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<p>So please understand there are of course thousands of variations to hip flexor training &amp; this is simply a few suggestions. </p>
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<p>The main focus being on preparation &amp; periodisation of hip flexors.<br></p>
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<p>They are the only ones you will ever have so let’s look after them! <br></p>
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<p>As always any questions hit me up at <a href="mailto:Rachel@biomechanicseducation.com">Rachel@biomechanicseducation.com</a></p>
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<p></p>
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<h2>Would You Like To Be Able To Reduce Your Clients Risk Of Injury &amp; Help Them Get Even Better Results?</h2>
<!-- /wp:heading -->

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<p>Then <a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://biomechanicseducation.clickfunnels.com/biomechanics-coach-l4-low-back" target="_blank">click here to find out more about our Biomechanics Coach Diploma</a> and how it could help you become an even better personal trainer. Our diploma now includes a Level 4 Low Back Pain Qualification as well!</p>
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