If your sciatica pain is paired with tight hips, groin pain, and/or tightness in the front of your thigh; then you may be experiencing tension in your hip flexors. This can also be even more present when you have what is called an “anterior pelvic tilt” where your pelvis is rotated forward, giving you a more pronounced arch in the lower back.
But what are the hip flexors, why do they get tight, and what is their role related to sciatica pain?
The Psoas muscle (I like to call them the “filet mignon” of the body), starts on the front side of your lumbar vertebrae (T12 to L5) and then travels down your abdomen and attaches to a high point of your thigh bone (the lesser trochanter). The role of this muscle is to lift up your leg (when the back is stationary), or arch your back when your hip is stationary. The psoas muscle also is responsible for turning out your thigh (aka “external rotation”).
This muscle consists of two types of muscle fibers. Type I fibers are slower twitch, endurance specific with a focus on maintaining posture and this is often found in the area closer to the spine. Type II fibers are more fast twitch and generate more force, which is important to lift up the leg at the hip.
Muscles can be (and/or feel) tight due to many reasons. One major reason is if the muscle is placed in a shortened position for a long time and the fibers get “sticky”. They are more averse to moving, and hence will create the “tightness to reduce movement”. The second option is that the muscle is overstretched for a long period of time, and the muscle has to contract (eccentrically or isometrically) to prevent further elongation. The psoas hip flexors can get tight due to being perpetually short (like sitting in a chair) or being perpetually lengthened and strained (like standing up for a long period of time).
Technically, we can reduce the incidence of tension by having regular bouts of movement throughout the body and throughout the available range of motion in the hips and low back.
However, if we stand or sit for too long, our hip flexors may get “tight” and be resistant to move. As a result, it can place even more pressure on our spine.
Specifically when the hip flexors are on the tighter side, it will present with pinching in the groin, tightness in the back, tension or pinching in the back, and some pain radiating to the front of the thigh.
Tight hip flexors can be present when dealing with sciatica, due to some cases in which the hip is moving well, but there is an excessive arch in the lower back. With that excessive arch, it can narrow the spaces and pinch the nerves exiting the spine. This can often be seen in people with a more pronounced arch in the lower back (we call it a sway back). With this type of posture and positioning, the low back muscles and hip flexors are working overtime to create stability, and the gluteal and abdominal muscles are not doing their jobs. We need to have balance.
There are 3 simple steps to implement to release a tense muscle to allow for normal function.
1) Relax the tight muscle. This can be through stretching, exercise, movement, or massage. I like to relax the hip flexors with the supported hip bridge (not just for spinal decompression)
2) Strengthen the weaker muscles. You can do this with positioning and true strengthening exercises. I’m a huge fan of squats to strengthen the glutes which allow for a more upright posture, plus, you can do this all day (getting on/off toilet/couch).
3) Focus on positioning. It is important that we maintain a more neutral position. There’s truly no such thing as bad posture, however, if we are stuck in one position over a long period of time (no matter how good it is), we are more likely to develop tension. I’m a huge fan of bracing the core whenever we are lifting, exercising or moving, so that we can properly find neutral and our abs. Even something as slightly moving the hips backwards over the feet can help with finding a neutral position.
Here’s a little sample as to how I help my clients on restoring normal function to tight hip flexors.
If you are still suffering from sciatica pain and are looking for some answers as to how you can recover, we have many ways to help you.
1) You can try out our sciatica protocol. It’s fast, easy, no wait times, and it gets sent directly to your phone. Remove the guess work from trying to figure out what is going to work for you. You can check it out here. You can literally start this program right now.
2) Start our 12 Week sciatica pain course. You get all of the necessary information broken down into a simple step by step program. You don’t need to be overwhelmed by too much information. You can check it out here. You can literally start this program right now.
3) If you are currently under the care of a provider, that’s great news! Our patient advocate program can be helpful by providing you extra support between sessions. Have all your questions and concerns answered by the ifixyoursciatica.com team within 24 hours. We’ll also help you find a provider and help you determine what questions to ask your provider so that you can get the best care. The patient advocate program is only $24.99/week and it’s designed to help you recover. To hear more book a free call with us here.
4) Work with us privately. All you need is a web camera and a space to move around. We’ll work with you 1 on 1 to determine the best strategies to help you return to your life free of pain. It’s convenient and you don’t have to wait long to get started. You can book your free strategy call here to get started.
We are rounding out the year. I hope you have taken action on your recovery. If you need help, we are here for you.