As we previously spoke about in the last two parts of this series, Hip Flexor Tightness (HFT) is a common problem and once this has been diagnosed, a stretching programme should be started to promote extensibility of the muscle complex and prevent future injuries from occurring. While static stretching to this muscle group alone tend to promote good results, often the issue can come from the hip capsule.
The hip capsule is formed of a variety of ligaments that surround the hip joint and aid in stability of what is a very free movable joint. Just like the hip flexor complex, the hip capsule can also tighten and thus decrease the available movement of the hip. In order to get the best improvements in range of motion, it is therefore crucial to assess and work on the hip capsule as well as the muscles that surround it.
In order to best improve the hip capsule and free up any tightness from this structure, both deep stretching as well as banded mobilisations should be used. The deep stretches will effectively target the hip capsule tissues, while the banded mobilisations will cause gentle tractioning to the joint, to encourage a stretch to the capsule, as well as promote smooth gliding of the joint surfaces.
Together these stretches and mobilisations promote extensibility of the muscle and capsule tissues, as well as improvements to the joint mechanisms. These mobilisations can be completed on a regular basis, however there is no need for excessive stretching of the capsule and I would therefore suggest a few times per week is sufficient.
If you wish to fully understand the banded mobilisations below, a good knowledge of the concave-convex mobilisation rule is needed. For the nature of this post, this will not be explained, however the short is that both these banded mobilisations below will help to improve hip flexion.
The first mobilisation as seen in Figure A below, creates an inferior glide on the head of the femur in the acetabulum. Start by attaching a band to a strong anchor, in this picture the anchor is the opposing foot, however this technique works much better with a solid anchor. Once the band tied around an anchor, place the other end in to the hip crease while being careful not to catch any skin. Its important the band should sit right in to the inside of the thigh to get the most from this mobilisation. Once this is in position, lay supine and bring the knee of the banded hip in to the chest. From here complete between 30 – 50 occilations per leg at a tempo of 2 occilations per second. The movement should be small and fast and completed towards the end of range.
Figure A – Inferior Hip Mobilisation
The second mobilisation as seen in Figure B below, creates an anterior-to-posterior glide on the femur. Start by attaching a band around an anchor and then in to the hip crease in the same position as mobilisation 1. Once the band is in pace, assume a kneeling hip flexor stretch. Make sure the positioning in this stretch is as outlines in the last blog post, so the pelvis is neutral and core stays strong. This is to be held for 30 seconds just like a normal stretch, the band works by creating a posterior pull on the femur encouraging better hip arthrokinematics and hip flexion improvements. For this mobilisation a stronger band can be used, make sure the resistance isn’t so high that you are struggling to hold yourself in position, but also ensure that it is strong enough to create a slight traction to the joint. To alter the resistance either increase the band, or increase the distance from the anchor.
Figure B – Anterior-to-Posterior Mobilisation
In summary, both these mobilisations can be used as a warm up, or part of your stretching routine. Ideally they should only be done a max of 2-3 times per week, and if you are completing them because you’re having issues with your hips, then complete these before your leg sessions to free up the joint before you lift. Happy lifting!