Did you just kill leg day? Are you a rucker or a runner? Does your job require you to sit most of the time? Chances are high that for any of these reasons (along with any number of others), you've found your range of motion lacking in your hips. You may even feel how tight they are in your movements, or found that your low back is suffering due to the pull from your consistently static position (sitting) or through constant activation (training). One thing is for sure: I see the consequences of tight hips day in and day out with fellow athletes as well as clients. I make recommendations consistently on what should be done to ameliorate the problem, but felt it best to share everything in a full-on recovery series covering different areas of the body starting with this very prominent issue. Let's get started.
HIP MUSCLE ANATOMY
Before we get into the nitty gritty about what you can do to loosen up and strengthen your hips, let's get a visual about what the muscles are so we can pinpoint trouble areas.
The iliopsoas (that is, the iliacus and psoas together which share a common insertion point in the hip complex) is very commonly the region that is most often the "tight" hip flexor. This grouping attaches to the top of the hip and to the spine and is a common trigger of low back pain. Because the psoas attaches to the spine, this muscle also plays an integral role in lumbar spine stabilization.
The tensor faciae latae (TFL) inserts onto the IT band, so if you have had tight IT band problems you also need to take care of this area of the hips as it's also going to be terribly tight.
If you've ever had sciatic pain, you may have impingement from a tight piriformis as the sciatic nerve passes through this muscle. The piriformis stabilizes the hip join and lifts/rotates the thigh away from the body. It allows us to walk, shift weight from one foot to the other, and maintain balance.
The gluteus maximus is one of the strongest muscles in the human body and is one of the primary movers in running. The gluteus medius is a dynamic pelvic stabilizer, meaning it holds the pelvis in a neutral place during strides -- this muscle gets tight particularly in female athletes. The gluteus minimus assists the piriformis in external rotation of flexed thighs, assisting in balance.
The adductors are fan-like muscles in the upper thigh that pull the legs together when they contract and help stabilize the hip joint. They are part of the grouping generally called the groin muscles: adductor magnus, adductor longus, adductor brevis, pectineus and gracilis. Men in particular often have chronically tight groin musculature.
An additional hip flexor which is often forgotten is the rectus femoris, which is one of the anterior quad muscles. Its origin point is attached to the pelvis, making it a hip flexor which must be addressed in any treatment of tight hips.
Each of the many muscles in the lumbo-pelvic hip complex has a slightly different function which you may or may not be able to pinpoint in your daily movements. Together they allow the flexion of the hip joint, the rotation of the pelvis and the extension of the lumbar spine and are an important part of injury prevention and daily activity, regardless of whether you are an athlete.
TESTING YOUR RANGE OF MOTION
Let's assess the flexibility of your lumbo-pelvic hip complex. The Thomas Test is quick and easy.
Your first task once you've identified what's tight is to release the tension locked up in those areas. You may not be able to perform all of these initially, so start with the movement you can execute with the best form. As you progress with daily work on the same areas, your flexibility and range of motion will increase and you can progress to more challenging stretches.
KNEELING HIP FLEXOR STRETCH
LUNGE WITH OVERHEAD REACH
LIZARD POSE (UTTHAN PRISTHASANA)
LOW LUNGE (ANJANEYASANA)
PIGEON POSE (EKA PADA RAJAKAPOTASANA)
RECLINING PIGEON POSE (FIGURE 4 STRETCH)
STANDING FIGURE 4 STRETCH
STANDING PIRIFORMIS STRETCH
BOUND ANGLE POSE (BADDHA KONASANA)/BUTTERFLY STRETCH
RECLINING BOUND ANGLE POSE (SUPTA BADDHA KONASANA)/RECLINING BUTTERFLY STRETCH
YOGI SQUAT (MALASANA)
SIDE LUNGE (SKANDASANA)
FIRE LOG POSE (AGNISTAMBHASANA)
FIRE LOG POSE, PIGEON VARIATION
FROG POSE (MANDUKASANA)
STRAIGHT-LEG SUPPORTED BRIDGE (SETU BANDHASANA VAR.)
SQUATTING INTERNAL ROTATIONS
SUMO SQUAT HOLD
SMR: HIP FLEXORS
STRENGTHEN AGAINST INJURY
Once you've gotten the knots worked out of your muscles and upped your flexibility, you'll need to strengthen your muscles in order to prevent future injury.
GLUTE BRIDGES & SINGLE-LEG GLUTE BRIDGES
This glute bridge variation makes you work hard to achieve full hip flexion. You'll find you have much more glute activation.
CLAMSHELLS WITH RESISTANCE BAND
SIDE SHUFFLES WITH RESISTANCE BAND
SUPINE KNEE LIFTS WITH RESISTANCE BAND
This movement activates the psoas. It is crucial that you keep your spine flat against the ground when you perform this movement.
STRAIGHT LEG RAISES
SIDELYING ISOMETRIC LEG RAISES WITH RESISTANCE BAND
LATERAL LUNGES WITH SAME-SIDE ROTATION
ROTATING PIVOT LUNGES
DEEP AB BREATHING
TIGHT HIP MYTHS
I couldn't finish out this article without addressing some common misconceptions about tight hips. Let's go over what they are.
MYTH #1: TIGHT HIPS ARE ALWAYS BAD
Although the hips are often the source of many pains and injuries to the low back and legs, and although I frequently recommend the above stretches and exercises to clients and fellow athletes to assist in correcting these pains, a certain degree of stiffness is required for specific forms of movement. Runners, for example, require a degree of tightness in the hips coupled with leg mobility to propel themselves forward economically. For them, although some stretching is good to prevent excessive tightness, the strengthening exercises are more important to stabilize the hips.
MYTH #2: STRONG BUTT MEANS STABLE HIPS
One does not necessarily equal the other. The muscle that is most prominent in the glute complex is the gluteus maximus, but it's the gluteus medius that provides stability.
MYTH #3: I NEED TO OPEN UP MY HIPS
The hip joint's primary purpose is stabilization, however many types of athletes require a good range of motion as well. For weightlifters, if their hips are too tight they can't sink into a deep squat. For runners, overly tight hips shorten stride length and can slow up their pace. As with all things, finding a happy medium is the key.
MYTH #4: TIGHT HIPS ARE STRONG HIPS
Muscles can become tight from overuse and repeated contraction, but also from being under-utilized and weak. Both a long-distance runner and an office worker with sedentary lifestyle may suffer equally from excessively tight hips.
MYTH #5: TIGHT HIPS ARE THE ROOT OF ALL MALADIES
Actually, quad dominance is more often an issue for weightlifters, runners and cyclists. When there is a discrepancy in quad vs glute strength the quads take on the task of stabilizing the hips in place of the glutes. Over time this pulls the pelvis out of alignment, strains the hamstrings and IT band and can lead to any number of issues in the low back and knees that wreak havoc on performance. Weightlifters, runners and cyclists: work on the above strengthening exercises and on releasing the tension in those quads! I'll be covering legs in another installment of this recovery series.
Everyone's been there: you've just started up a new physical activity or killed a particularly tough workout, and a day or two later your body's caught on to what you did and gets tight and achy. This is called delayed onset of muscle soreness (DOMS) and it's the bane of program adherence. So what can you do? Let's start by learning a little about our enemy.
What is DOMS?
Another theory is that DOMS is caused by metabolic stress; still another states that it may even be a mild form of rhabdomyolysis which is caused by muscle proteins spilling into the blood. Some sources suggest it may even be genetic or neurological. The long and short of it is that experts cannot agree on WHAT causes it exactly, though physical or metabolic stress does seem to exacerbate it.
Note that DOMS is different from acute muscle soreness, which occurs during or immediately after a workout. Acute muscle soreness is often described as a burning pain, and is caused by a buildup of lactic acid in the muscles. This type of soreness resolves itself fairly quickly and can be prevented in the same ways as DOMS.
How Can I Prevent It?
Consistency is Key
While it is true that in the long term you need to change up your workout in order to reduce chances of hitting a training plateau, consistency in movement is how your body improves at those movements. You have to let your body adapt to the new activity in order to reduce how sore you get when performing those exercises.
Engage in Proper Warm-up and Cool-Down Routines EVERY TIME
EVERY TIME you train, you need to allow yourself a proper warm-up and cool-down sequence. With a proper warm-up you ready your muscles for the stresses you are about to place on them. In doing so, you may avoid generating quite so much of the micro-trauma previously mentioned. A cool-down is less effective to this purpose, but aids in keeping the muscles limber and gradually dropping your body temperature so that your muscles do not seize up. This study suggests that warm-up and cool-down together have an additive effect on prevention of DOMS.
Hydration helps stave off fatigue, aids in digestion, and is crucial to muscle protein synthesis. If you are dehydrated following a workout, this process which rebuilds the muscles will be slowed and therefore recovery will be delayed.
Caffeine Can Help
Research has been shown that caffeine taken before your workout can cut post-workout pain down by almost 50 percent. Just be sure to hydrate properly between that and your training!
Eating To Prevent Soreness
I'll be covering pre- and post-workout nutrition in depth at a later date, but as related to muscle soreness, here's what you need to know pre-workout:
Eating foods rich in branched-chain amino acids (BCAAs) or taking a BCAA supplement before a workout has been shown to reduce incidence of muscle damage and increase muscle protein synthesis. Taking 5g or more at least an hour before exercise is the amount which studies show to be most effective.
While your pre-workout meal will depend on how much time you have between eating and training, a good rule of thumb is to ingest a mix of carbs and protein before and after your work out. The carbs boost your glycogen levels, which are your body's main source of energy. If you run out of glycogen, you may experience hypoglycemia (low blood sugar). As a response to hypoglycemia, the body will produce catabolic hormones such as cortisol which break down muscle tissue in order to convert it to glucose to fuel the work. The protein you ingest increases muscle protein synthesis, improves muscle recovery and helps with muscle growth.
Okay, So I'm Sore. Now What?
Even though movement hurts, you can seriously reduce your recovery time by engaging in active recovery. This can be something as simple as a walk or slow jog for 20 minutes, doing some gardening or even cleaning the house.
Rest is important for recovery, but the boost in circulation and production of endorphins even during light exercise will help reduce the sensations of soreness. The movement also helps to keep your muscles from getting stiff. Muscle stiffness can make the soreness that much more intense, so engaging in active recovery is a good method by which you may more quickly recover.
Focus on Form
Proper form reduces incident of injury, and if you are experiencing muscle soreness you are more likely to "cheat" on your form. This can lead to worsening the soreness as well as injury.
Avoid Eccentric Movements
Eccentric training is a slowed-down version of any exercise where the muscles are being lengthened under a load: the downward motion of the arm during a biceps curl for example. While eccentrics can seriously boost your training gains, if the muscles involved are very sore it may be wiser to back off this type of training for a few days (at least for the sore parts) -- that is, you should avoid taking more than 2-3 seconds on the downward motion of the arm during the aforementioned biceps curl.
Roll It Out
Foam rolling has been shown to improve recovery from DOMS. This can be done as a preventative measure or after you are already sore -- tension and soreness can be cumulative.
Ibuprofen and Arnica Gel
Here's something most people don't know: arnica gel or cream is show to be just as effective as ibuprofen in easing pain according to this study -- and it doesn't have the negative damaging effects of NSAIDs. All the same, ibuprofen is a time-honored staple in reducing muscle soreness. It has been studied time and again and shown to work as well.
Deep-tissue massage does not eradicate DOMS, however what it does do is increase the blood flow to the sore muscles, which speeds up the removal of the chemicals producing soreness. It is shown to be most effective within 48 hours of exercise. You can perform self-myofascial release (SMR) and some trigger point therapy using a foam roller and lacrosse ball if you aren't able to see a massage therapist.
Compression clothing has been shown to assist with recovery, however there are not standard protocols for things such as the length of time the garments are to be worn. Compression therapy such as the use of Normatec boots after a race increases circulation and helps massage sore areas, thereby assisting in recovery as outlined in those sections above.
Eating for Rapid Recovery
Replenishing your body after you've hit your workout is crucial. Within an hour -- preferably that first 30 minutes -- after your training you need to ingest a combination of carbs and protein in a 3:1 ratio for the reasons listed above in the prevention section.
Eating foods rich in branched-chain amino acids (BCAAs) or taking a BCAA supplement has been shown to reduce incidence and intensity of DOMS.
Omega-3 fatty acids are natural anti-inflammatories that can help dial back soreness. Take them in supplement form or eat foods rich in Omega-3s to boost your recovery.
Tart cherry juice was shown to assist in reducing muscle damage, inflammation and oxidative stress according to this 2010 study. Add some to your post-workout smoothie or drink it straight for max benefits. Even if it's not the best muscle recovery aid, it has numerous other benefits due to the high antioxidant count.
Other anti-inflammatory foods such as watermelon (see studies from 2013 and 2017), pineapple, ginger, and curcumin as found in turmeric are additional natural selections for faster recovery.
It's safe to say that there are studies swinging every which way about what causes DOMS and how to recover quickly. The below are two topics which are (at the time of my writing this article) pretty often bandied about -- moreso than the above content.
Stretch To Alleviate Stiffness
Stretching does not directly affect DOMS, but it does assist with alleviating muscle stiffness which can worsen the pain of muscle soreness. Stretching efficacy as a recovery modality has been debated in more recent years, but dynamic stretching (stretching which involves movement) is a form of active recovery and therefore I personally recommend it.
Ice It? Heat It?
The old advice is to ice up after training, but more recent studies have shown that icing does not have a clear effect on DOMS and primarily treats pain temporarily. It also inhibits the inflammatory response and reverses it to a certain degree, which may even be causing more harm than good as the inflammation is part of the body's natural repair process. Heat increases circulation, and moist heat in particular such as a steam sauna has been shown to assist reduction of DOMS.
Take a Hot (Epsom Salt) Bath
Epsom salt (magnesium sulfate) baths are an old remedy -- but studies have shown that magnesium supplementation in any form has marginal restorative benefits. It's most likely the moist heat from the bath that relieves the soreness more than the Epsom salts themselves.