Sitting does not shorten or spasm the hip flexors

Thigh scarecrow

Too often we have to explain to patients that their pain, dysfunction, or poor performance in whatever movement they perform is caused by the great hip bugbear—tight hip flexors. The origin of this idea is unknown, but may have originated with the theory of the lower cross syndrome. She states that when the hip flexors and psoas muscles are tight and the gluteal and abdominal muscles are relaxed, the pelvis tilts forward, which leads to dysfunction. In fact, this theory perceives the body as a puppet, in which the position of the pelvis depends on which strings we pull or which muscles we strain.

Lying options[edit | edit code]

By performing exercises while lying on the floor, you increase the load on your muscles and decrease your range of motion.

• Lie on your stomach and support your body weight on your forearms. Bend your back slightly at the lower back.

• You can also do the Superman variation. Starting position: Lying on your stomach, straighten your arms and legs, then lift them at the same time. This variation also works the lower back muscles and the muscles at the back of the shoulders.

Lying hip extension and Superman

Why are they tense?

Most experts, including those sincerely respected by Lehman, are convinced that the hip flexors are tight due to a sedentary lifestyle - a sign of our age. If we sit at a desk for 8 hours a day, our hips will be constantly flexed, and our hip flexors will be tense, contracted, and then difficult to stretch. Despite the attractiveness of this theory, Lehman refuses to believe in it. He has been dealing with this theory for 15 years and is convinced that its conclusions are not based on anything.

Can prolonged sitting tighten and shorten the hip flexors? No way. And that's why.

1. Even if you sit for 8 hours a day without a break, this is not enough for the muscles to become shorter. Shortening occurs when you are in a cast for a really long time, not hours, but days and weeks, and your muscles are shortened and immobile. A sitting person stands up during the day, interrupting this muscle shortening.
2. Even if those 8 hours are so terrible, you nullify their effect when you sleep for 8 hours with your legs extended or do something standing. On the other hand, why don't we shorten our thigh muscles if we sleep with our legs bent in the fetal position? Has anyone told their patients that it is harmful to sleep on your side with your knees bent? What about embryos that spend 9 months in a curled up state? Maybe they also have difficulty straightening their legs?
3. The way we sit is often contrasted with other cultures that sit differently. In some countries, it is customary to sit in a deep squat, that is, squatting. I wonder how their hip flexors are? Do these people realize the danger of redundancy they are exposed to? Perhaps they should be warned.

Muscular structure of the pelvis and their function

Human anatomy is complex, therefore, for convenience and a better understanding of all areas, the entire body of the body was divided layer by layer, that is, each tissue is considered separately.

The muscular elements of the pelvic area are divided into external and internal blocks, each of the muscle fibers has its own functions.

The external block is divided into three layers, one after the other.

Indoor unit

The internal pelvic muscles primarily serve as a kind of wall for the abdominal cavity, their second function is to carry out upright walking and control the femoral region of the limb.

The internal block consists of the following muscles:

1. Greater lumbar. It originates on the outer sides of the vertebrae, starting from the thoracic region, and serves as a kind of fastener for the lumbar region and pelvis.
2. Ileum. It connects to the lumbar major in the area of ​​the iliac fossa and is further called the iliopsoas.
3. Iliopsoas. A wide element attached to the femoral trochanter. Helps bring the leg towards the stomach.
4. Internal obturator. From the obturator foramen it passes through the pelvic area, in the middle it abruptly changes its orientation and strives for the greater trochanter.
5. Bliznetsovs. The twin muscles help in abduction of the femoral area.
6. Pear-shaped. Divides the greater sciatic foramen into 2 parts vertically, next to the femoral neck it enters the tendon structure to the greater trochanter. It moves the limb in the upper zone outward, but the abduction is extremely small.

In addition to these muscle elements, another one is distinguished - the small lumbar, but in 39% of people it is absent and does not have any significant function.

External unit

The external block of the muscular structure of the pelvis is located on the outside of the pelvic region. The entire block is involved in the motor activity of the hip joints.

The outer block is formed by three layers:

• superficial;
• average;
• deep.

The superficial one contains the gluteus maximus, which performs powerful straightening of the limb, for example, during physically heavy loads for a person, and the tensor fascia lata.

Nuance! The tensor fascia lata is able to direct the thigh towards the abdomen and helps in controlling the knee joint.

The middle layer contains parts of the internal pelvic muscle structures:

• pear-shaped;
• internal obturator;
• twins.

This also includes the gluteus medius muscle, which, together with the small gluteus, helps keep a person in an upright position. Another muscle, the quadratus femoris, helps rotate the limb outward.

The Tight Hip Flexor Theory Has Implications

If you subscribe to the tight hip flexor theory, then your ideas about muscle function and movement must be formed in a certain way.

Incorrect application of the law of mutual inhibition

Many therapists refer to Sherrington's law of reciprocal (conjugate) muscle innervation, or the law of reciprocal suppression. According to him, muscle contraction is accompanied by relaxation of its antagonists. Therefore, tight and shortened hip flexors should suppress gluteus maximus activity. However, we cannot agree with this for two reasons.

A). Reciprocal innervation requires that the signal that contracts a muscle be associated with the relaxation of its antagonist. The assumption that shortening of the hip flexors is caused by prolonged sitting implies that it is a passive process not associated with tonic contraction of the flexor muscles. If there is no nerve impulse that contracts the muscle, there is no associated innervation.

B). Even if a nerve impulse is sent to the muscle, it may not be sufficient to noticeably suppress the antagonist. This mechanism differs from the mechanism of mutual innervation. An overview of the article devoted to this problem and its full text can be read here. Reflex inhibition when walking usually occurs at the reflex level, and not at the volitional level. Greg Lehman isn't even sure if anyone has specifically tested the strength of a "suppressed" muscle, because as soon as we try to do this, the antagonist immediately turns into an agonist. In addition, muscle contraction occurs during many activities. We contract muscles (such as the hamstrings and quadriceps) to provide joint stability and control movement. If mutual inhibition worked with tight or overactive hip flexors, it would be difficult to achieve joint stability during co-contraction. According to Lehman, there is little evidence that reciprocal innervation causes weakness. If someone thinks differently, he is ready to listen to counter-arguments. Lehman cites two articles, one on the effects of stretching on reciprocal inhibition and the other on neuromuscular adaptations to stretching, that support his point.

Tight hip flexors need relaxation

Greg Lehman himself has had his hip flexors pulled several times. This procedure literally penetrated to the intestines: both the intestines and the omentum were compressed, the abdominal muscles contracted, but the lumbar muscles, at least the deep ones, did not relax. And how could 3 minutes of lower back relaxation affect the consequences of many years of sitting for 8 hours a day? Mechanically? Through a neural mechanism? Nobody believes this. One can imagine the consequences of trying to stretch the psoas muscle by considering the limits of stretching as long-term muscle stiffness and, therefore, resting length changes. A short post about stretching and muscles here.

Believing in tight hip muscles can lead to hyperextension

Anyone who believes in the theory of lower cross syndrome will look for and find this syndrome, and having found it, will want to correct it, that is, stretch the hip flexors. However, stretching them can be harmful to both athletes and patients. This is like forcefully twisting your shoulder, abducting and supinating it. What happens in this case to the anterior capsule? Is it an adaptation or a stress that you want to subject everyone to?

Why do you want to extend your hips? How necessary is this?

We only need 10-15 degrees for walking and about the same for running. Consequently, the importance of hip stretching is overrated. You don't even use your glutes to stretch your hip when you walk or run. By the time your foot is behind you touching the ground and begins to move out of neutral, your glutes have already switched off. This is the extensor paradox.

Clinical Implications Warning: Hip extension during running is associated with anterior pelvic tilt.

Some experts believe that limited hip extension when running increases lumbar lordosis and can cause injury. Lehman has something to object to.

1. No one has actually tested whether this situation leads to injury and reduces performance. These are just assumptions.
2. Tests to assess the elasticity of the hip flexors (the Thomas test, for example) do not correlate with quantitative indicators of extension during running. This means that you are not required to fully extend your hip while running. This causes the pelvis to tilt forward, not because the hip flexors are tight. The degree of hip extension does not correlate with the degree of flexion. This is a perfect example of how the results of quasi-static and dynamic tests are not always the same. Hip flexion may be limited by movement rather than physical limitations identified during the Thomas test.
3. The pelvis tilts forward not because tense muscles are pulling it into a new position. Rather, the tilt occurs because the hip must move backward, and this can be done in two ways: by extending the hips or by tilting the pelvis. Some people prefer to tilt their pelvis more, so they don't need to extend their hip.

Back muscles

Mostly the flexor muscles are located here.

Double-headed

Thanks to it, we are able to rotate and maintain balance. Represented by two heads:

The first one comes from the ischial tuberosity, the second one originates from the lateral zone of the linea aspera. They are attached to the head of the fibula and are located closer to the lateral edge.

Semitendinosus

Located in the medial part. It begins in the ischial tuberosity, passes near the knee, and attaches to the tuberosity. The center is often interrupted by an oblique tendon bridge. Performs similar actions to the two-headed one.

Semimembranosus

The longest and flattest in its class. The initial end is connected to the pelvis and goes around the epicondyle.

It is interesting that it is the muscles of the posterior surface that are deprived of the proper load. Modern people have a sedentary lifestyle. This leads to less use of them, which leads to an imbalance of development and an increased risk of various injuries, especially the knee. And they are extremely unpleasant, as they limit movement and take an extremely long time to heal. Re-injury is also possible, which will lead to a longer recovery period.

Final Thoughts

1. According to Lehman, the diagnosis of shortened hip flexors is overused. The Thomas test may give false positive results. Lehman himself often tests patients by simply placing them on a couch and stretching their leg into extension. Loss of movement is extremely rare.
2. Lehman doesn't think sitting for eight hours will shorten the hip flexors.
3. The feeling of hip flexor tightness can be subjective.
4. Stiffness in movement does not necessarily have mechanical causes. We also have a nervous system, and restriction of movement may be associated with a perceived threat or defensive behavior.
5. However, all methods used to treat the nonexistent "lower cross syndrome" may be helpful for pain or dysfunction. You shouldn’t throw out the baby with the dirty water of non-existent diagnoses, i.e. useful exercises.

Greg Lehman self-critically notes that he is not the first to write on this topic. There are other posts, shorter ones.

External part

This is the smallest category. But it plays a very important role and makes up the muscles of the thigh of the lateral group.

Tensor fascia

Relatively small in size, flat and slightly elongated. It originates from the pelvic region, goes vertically down and passes into the iliotibial tract.

Participates in flexion, abduction and rotation (rotation). Actively used when you need to place your foot. Helps in maintaining stabilization of the knee joint. The lesion leads to pain in the deep parts, which are difficult to differentiate.

Conclusion

Our body is designed in a most amazing way. Human anatomy is fascinating, striking in its thoughtfulness in the smallest details. Its understanding is most important for athletes. This allows you to create an effective and safe training plan. Gives an understanding of how to exercise correctly, indicates the importance of warming up and moderate strength loads so that the exercises do not cause harm. For ordinary people, this helps differentiate symptoms and the occurrence of discomfort. It is important to know what the anterior, posterior and inner thigh muscles are called, and everyone needs to take care of their health. You should not allow negative manifestations to occur or delay your visit to the hospital. Early diagnosis can prevent serious complications.