Strength and Stability to fix my nagging, tight hip flexors?
It can feel a little counter-intuitive, I know.
If something feels tight, we instinctively move it.
Loosen up.
Streeeeeettchh.
And you're not wrong!
But what happens afterwards?
Does that tightness come back in 15mins? 1 hour? 2 days?
Sure, you can keep stretching, and stretching…and stretching…and…
You get it.
You've taken the first correct step, but you're not at the finish line yet.
What am I talking about and how the heck does this fix your hip flexors? Stick with me and keep going…
Rule #1 in Physical Therapy: mobility BEFORE stability.
See? You've already done the first step.
You've worked hard to restore mobility. But you're potentially missing the second step: building strength, stability, on top of it.
Why do we even do this?
We start with mobility, restoring healthy range of motion to your hip joint first because you don't want to build a house on top of a wonky foundation (a joint that doesn't have good range).
You want optimal range of motion (mobility) available so when you build and create strength through weight work, you're building strength on top of the entirety of that range.
You want to be strong through the entire range, not just a small part of it.
When you attempt to build strength with poor mobility, you still complete the exercise! But you aren't setting yourself up for success.
There's actually a much higher risk of compensation in this scenario because your body will steal the mobility it needs from a different part of your body.
And a lot of times, it's also forcing other team members (muscles, joints, etc) to do jobs they weren't necessarily made for.
What are signs you might need to work on your hip strength and stability to fix your tight, angry hip flexors?
You'll recognize this list if you read last week's blog (read that HERE, all about that first step creating hip mobility)
Signs You Might Have Tight Hip Flexors and/or Not-Great Hip Strength or Stability
Do you check any of these boxes?
Sore, achey, tight hips (but it's vague and you can't tell wear it's actually tight)
Hip flexors are tight, for sure.
Achey and sore low back (typically more of an ache, dull soreness rather than sharp, shooting, burning, stinging etc. If you have any of those later ones, go get these checked out. Stat.)
Knee pain or history of patellar tendonitis (aching in the tendon right below your knee cap)
or patellofemoral pain syndrome (pain underneath your knee cap)
An unfortunately, returning history of ITB syndrome (that's starting to drive you mad and make you re-think your upcoming increase in mileage)
Occasional FOOT PAIN (this one's new. WHY Foot pain?)
*Incoming mini dissertation*
Foot pain can be a sign of potential hip dysfunction due to how the hip is made: Your hip is made to be mobile with 6 degrees of freedom (moving into flexion, extension, abduction, adduction, internal, and external rotation. Ta-da, 6!)
If a double whammy like mobility and stability are missing from the hips, then the body will "steal" the, from somewhere else. Most often, that somewhere is the foot and ankle, which are designed to be both highly mobile and stable. Our feet naturally "shape shift" or transitions between these 2 states. The catch through, the foot and ankle complex are NOT built to handle the sheer load that the hip can and should!
Hence, foot pain when the foot is being forced to do the hip's job.
All this: Is meant to highlight an important and often overlooked ankle complex + glute connection. If you find this mind-blowing and interesting, check out my blog post section HERE about strong feet and follow that up with the Stronger Feet Workshop.
Back to the regular program…
Why do we use STRENGTH work for tight, aching, sore, fatigued hips?
Short Answer:
It goes back to what we talked about above.
First, create healthy mobility.
Then, to lock those gains in, we build strength on top it to teach our bodies how to operate within this new range.
Once our bodies get used to "living" there, it's much easier to maintain that.
Long Answer:
What the evidence has to say…
"Concurrent strength and endurance training improves the force-generating capacity of the ankle plantarflexors, quadriceps, hamstrings and gluteal muscles…Concurrent strength and endurance training may improve distance running performance by increasing the force generating capacity in the muscles responsible for center of mass propulsion and acceleration of the leg during swing."
What's all that saying and how does this relate to my tight hip flexors?
Quickly breaking this down, this particular quote says:
Doing both weight lifting and endurance work (like running) at the same time increasing your ability to create power from specific muscles like your gastroc, quads, hamstring, glutes.
Doing both of these training programs at the same time can also improve your performance on your long runs because of that increased strength and power in those particular muscles which are responsible for moving your forward and faster during a specific part of your stride, called the swing phase.
I know, still super technical.
So to keep this blog digestible and bite sized, walk away with this:
We know from PT research, using elements of strength training improves hip symptoms and dysfunctions.
The quote above, supports this use of general lower extremity strengthening and states it may even have a positive effect on your overall running performance.
I think we can all agree, if nothing else, if you say goodbye to any limiting hip symptoms like soreness, achiness, tightness, etc...
...then you're going to run faster.
Makes sense, right?
So now that we're out of the weeds on that one..
What are some exercises runners have probably done that don't seem to cut it?
Standard squats
Lunges
Single Romanian Deadlift
Before you come for me!....LET ME CLARIFY…
These exercises are NOT bad!
In fact, I do these on the regular. If I don't, I pay the price and my right knee starts to hurt on my runs.
Then why the heck am I bringing them up?
Because we're runners. And we need to train like it.
Your body, as a runner, benefits from a strength challenge that looks like running.
What do I mean?
These exercises below.
I want to challenge you:
Can you see how they look like running?
How they take on the position, posture, and stride of running?
Don't worry, we'll get into the evidence in a second…
Try These Hip Strengthening Exercises Instead…
2-3 rounds // x12 (or 6 on each side)
1/2 kneeling halos
(R: 3 CW, 3 CCW)
Runner's Lunge with single or bilateral OH press
For both of these, can you see the end ranges of hip motion here? Flexion and extension.
Can you feel the leg strength and endurance required in these position?
Step up with lift
Can you see how these are more dynamic?
How they require full hip range of motion + strength + power + single leg balance?
Things that are ALL necessary for running.
That's why these are so specific to runners!
Ready for the evidence part of this?
"the findings of the present study suggest the assessment of hip extensors strength and lower limb movement in runners at high risk of injuries.
Click to read the entire quote
…Smaller hip flexion and greater knee flexion are associated with anterior reach distance of the mSEBT in runners at high risk of injury…These findings provide useful information to clinicians about the contribution of the support limb movement and hip strength to the performance of the mSEBT." The swing limb movement during the performance in the anterior reach displaces the body center of mass anteriorly. Therefore, the runner may increase knee flexion and reduce hip flexion of the support limb to posteriorly displace the body center of mass and consequently maintain balance in single limb support. This may explain the fact that increased knee flexion and reduced hip flexion were associated with the runners’ performance in the anterior reach. In clinical settings, these results suggest that poor performance in the anterior reach of the mSEBT requires further evaluation and intervention on factors that may limit knee flexion (e.g. quadriceps weakness) and control of hip flexion (e.g. hip extensor weakness) in closed kinetic chain, which may help to improve the runner’s performance on the mSEBT
For example, hip extensor weakness may limit hip flexion and quadriceps weakness may limit knee flexion, respectively. In fact, previous studies have demonstrated that quadriceps and hip extensor weakness compromise the performance on the mSEBT. These findings are corroborated by the association between hip extensor strength and performance in the posteromedial direction demonstrated by the present study."
What the heckin' heck was all that about?
That particular paper was calling attention to how runners can "cheat" movement and fake stability by changing different angles within their body to still get the task of running done, but not quite the most "correctly".
Remember how we can keep talking about our bodies are smart and will the job done? (This paper is talking about that also but during a very specific test called the mSEBT.)
Ok, onto something a little more immediately actionable and WHY the exercises above are the bomb-diggity:
"Limiting possible deficits in hamstring and soleus range of motion, improving stability after landing, developing hamstring and quadriceps strength in elongated muscle range, and maintaining a balanced ratio of hamstring/quadriceps strength could help to reduce the injury risk in running."
This recent paper is giving us another tool and another reason to Dare to Train Differently. It's suggesting strength training in elongated muscles length positions.
What does this look like? You actually know.
Think about Usain Bolt's top speed running form.
Can you see the elongated muscle position with that strong, long, back leg?
And that long backwards, sweeping arm?
It doesn't stop there.
Because then he takes another stride and the same thing happens on the opposite side now.
That's what this strength circuit does.
It starts out strengthening you in a more stable position and progresses towards more difficult, elongated positions, making you strong here, too, in these elongated muscle ranges.
All while, looking while running.
Pretty cool, huh?
Putting Everything Together...
Your hip flexors may feel chronically tight and achy.
But it's not necessarily their fault.
They're most likely trying to protect something.
So instead of beating them up with constant stretching, try this instead:
Use my hip mobility circuit from THIS blog
Follow it up with strength circuit above
(Extra credit: top it off with your favorite core circuit )
Remember, your body is smart and it's trying to talk to you!
Talk back to it by Daring to Train Differently.
Ready to take it to the next level? Grab my FREE RUNNING GUIDE here to dive into even more hip flexor goodness!
Until next time,
Marie Whitt, PT, DPT //@dr.whitt.fit
References
Encarnación-Martínez, A., Sanchis-Sanchis, R., Pérez-Soriano, P., & García-Gallart, A. (2020). Relationship between muscular extensibility, strength and stability and the transmission of impacts during fatigued running. Sports Biomechanics, 1-17. doi: 10.1080/14763141.2020.1797863
Pinheiro, L., Ocarino, J., Bittencourt, N., Souza, T., Souza Martins, S., Bomtempo, R., & Resende, R. (2020). Lower limb kinematics and hip extensors strengths are associated with performance of runners at high risk of injury during the modified Star Excursion Balance Test. Brazilian Journal Of Physical Therapy, 24(6), 488-495. doi: 10.1016/j.bjpt.2019.07.011
Trowell, D., Vicenzino, B., Saunders, N., Fox, A., & Bonacci, J. (2019). Effect of Strength Training on Biomechanical and Neuromuscular Variables in Distance Runners: A Systematic Review and Meta-Analysis. Sports Medicine, 50(1), 133-150. doi: 10.1007/s40279-019-01184-9