Follow along in the video as Mike walks you through a groin flow. There is no required sets, reps, or amount of time to spend on each portion of the groin flow. Rather, listen to your body and spend as much time as you feel you need on each portion of the groin flow. Some days, you may need more or less time than others on each portion.
FEEL: You should feel a stretch in the front and on the side of your hip. You also may feel a stretch on the side of your stomach, that is ok. Follow the video for other cues and tips.
If you have been following us for a little bit, hopefully now you understand how important it is to prevent the hip flexor from tightening due to its ability to create back pain as well as contralateral hamstring strain. Here is a great way to stretch your hip flexors without putting your lumbar spine into extension, also a great stretching approach for low back pain with extension sensitivity. You clinicians may recognize this as the “Thomas Test”.
-First I bring my knee to my chest, normal range of motion of hip flexion is approx. 120 degrees, so anything past this range typically will begin to posterior tilt your pelvis/flex the lumbar spine, which will LOCK out the pelvis. As I continue to pull my right hip into flexion it will posteriorly tilt my pelvis which is the opposite of hip flexor action (anterior tilt of the pelvis), therefore more pull of knee to chest=more stretch. If you are still not getting enough stretch, you can have someone push your leg dangling off the side into more hip extension until you reach your desired stretch.
-Here is something to appreciate, when you see me flex my right hip even further, you can see that the contralateral left hip flexes secondary to my hip flexor being at its end range of motion.
-I will then allow my leg to be stretched hanging off the table for 30-60 seconds X 2 sets. You can translate this same idea to the standing hip flexor stretch in which you will elevate one foot to put you in max hip flexion (to lock out your pelvis). Then you can slowly lunge forward to A. Add more hip flexion on the elevated leg and B. Bring the stretched leg into more hip extension.
Ideally here the table surface will be a bit more elevated to put me into end range of hip flexion
-As always you can side bend away and rotate toward the hip that is being flexed. For example, during the standing hip flexor stretch I can additionally side bend left and rotate right.
TAG someone with tight hip flexors that needs this stretch!
FEEL: You will feel a stretch on the front of your thigh of the back leg.
COMPENSATION: Avoid arching the back with this exercise.
FEEL: You should feel a stretch in the front of both of your thighs. You’ll also feel your glutes working hard to perform this motion.
COMPENSATION: If the ground is uncomfortable to use a pad under your knees.
FEEL: You will feel a stretch on the inside of your thigh and your groin on the leg that is kicked out.
COMPENSATION: Take your time with this exercise and try to keep a relatively flat back. Do not excessively arch or bend your back. Do not move your leg
FEEL: You will feel a stretch in the groin/adductor region.
COMPENSATION: Make sure to keep your back flat, avoid rounding the back as you rock back.
FEEL: You will feel a deep stretch in the back hip on the elevated leg.
COMPENSATION: Try to only hinge at the hip and not round your entire back, this should be a hip stretch
FEEL: You will feel a deep stretch in the back hip on the elevated leg. You have the option of rotating your body towards the leg that is being stretched.
The piriformis is a deep hip muscle under all the glute’s. Piriformis syndrome is a non-discogenic cause of “sciatica” from compression of the sciatic nerve through around the piriformis muscle. (1)
Sciatic nerve passes under the piriformis- 84%
Portion of the Sciatic nerve passes through the Piriformis-15% of the time
Entire Nerve passes through the piriformis-1% of the time (2)
There are many ways to stretch this muscle as shown here- laying down, sitting, and standing.
In hip flexion this muscle actually becomes an internal rotator- therefore in hip flexion you want to externally rotate the hip to maximize a stretch of the Piriformis.
The � to maximize this stretch include:
✅Flex your hip
✅Externally rotate your hip
✅Adduct your hip
Note: Some may add a bit of a posterior glide of the femur to FURTHER stretch the piriformis muscle.
But does the piriformis always need stretching?? �A study in 2010 by Tonley et al suggested that the pathomechanics of piriformis syndrome is actually an OVERSTRETCHING as opposed to an OVERSHORTENING of the piriformis. Therefore Movement analysis of a single leg step down will be beneficial in determining if stretching or strengthening of this area is better warranted. (3)
Thanks @barbellapparel for the comfortable � !!!
1.By: Cass SP. “Piriformis Syndrome.” 2015.
2.Variation of the piriformis and Sciativ nerve w/ clinical consequence. 2010.
3.By: Tonley et al. “Treatment of an indicidual with priformis syndrome focusing on hip muscle strengthening and movement reeducation” 2010.
Start position: Start by holding onto a strong resistance band or towel wrapped around your feet.
The movement: Key here is to attempt to make you low back as straight as you can. If you curl your entire spine- the restriction may be due to neurodynamic mobility deficits than hamstring length.Use the Quad muscles to straighten your knee until you feel a hamstring stretch- this will also help with reciprocally inhibiting the hamstrings.
There are 4 hamstring muscles (2 medial and 2 lateral). To isolate the lateral hamstrings bicep femoris long and short head you can do this by internally rotating your legs so that your toes are pointing together. If your goal is to stretch the medial hamstrings- semimembranosus and semitendinosus then you can externally rotate your legs so that your toes are point out.
FEEL: You will feel a pulling and stretching sensation behind your thigh, knee, and even into your calf and foot. If you feel pins and needles or other nerve-like symptoms, back off from the stretch.
COMPENSATION: Limit motion to your knee and leg.
Here is another great way to improve flexibility of your hamstring by using a contract-relax stretching technique.
1️⃣Lay facing up (supine) and bring one leg up onto a wall. Make sure your back doesn’t round- if so you can place a towel to keep your lordosis in order to maximize the hamstring stretch.
2️⃣Contract your hamstrings by pushing into the wall with your heel for 5-7 seconds, follow this by pushing your knee into more extension until a desired hamstring stretch is felt.
�To isolate the lateral hamstrings Bicep Femoris long and short head you can do this by internally rotating your legs so that your toes medially.
�If your goal is to stretch the medial hamstrings- Semimembranosus and semitendinosus then you can externally rotate your legs so that your toes are point out.
�If you are feeling a stretch below your knee, you may actually be stretching nerves! This is fine if your goal is to tension your neural tissue, however this will limit a hamstring stretch. You can minimize this by pointing your toes away from you (Plantarflexing your ankle).
Limitations in hip flexion and internal rotation range of motion have been implicated as characteristics of hip pathology (Burnett 2014, Clohisy 2009, Sutlive 2008). Any activities that require squatting, pivoting, planting and cutting, and/or rotating your body will likely be hindered by limited hip flexion and internal rotation range.
Hip internal rotation is a commonly overlooked impairment. Shown here are 2 different ways in which you can improve your hip mobility which may allow you to improve your squat and deadlift depth.
For these exercises:
✅Cross your opposite leg on top of the leg to be stretched. Use the elevated leg to help drop your knee in towards the floor.
✅Reach towards with your arm towards the side that is getting stretched to maximize this stretch and avoid any compensation.
✅Further this hip stretch, place your legs up against a wall which will put your hips into more flexion as your medially rotate your leg.
You may also feel a stretch in your low back (particularly with the first exercise). No worries, this is likely a stretch of the commonly tight Quadratus Lumborum muscle being stretched.
Normal hip internal rotation is about 40 degrees. Don’t push much through any irritation of the hip. We would recommend you reach out to a medical provider if you are in pain.
FEEL: Feel the muscles on the outer portion of the hip pull with this exercise.
COMPENSATION: Avoid allowing your foot to roll out as your drive your knee to the side.
Mobility Flow [Stay Moving!]
Here is a very easy exercise to mimic mobility flow that we have found to be efficient at keeping a majority of your body parts mobile.
To perform this:
Walk your arms to a downward facing dog, where you will rotate your body pushing your heel down towards the floor one leg at a time, this will mobilize the posterior aspect of each leg.
Lunge one leg into a Runner’s Lunge position and attempt to bring both elbows toward the floor, stretching your hip into flexion.
Straighten the elbow of the side being stretched and rotate your torso towards the opposite side. Make sure to keep the loaded arm against your leg. This will emphasize a groin stretch in addition to mobilizing your thoracic spine.
Rotate your torso towards the leg in front.
Push back into a hamstring stretch. Try to keep a relatively neutral spine, you can see Arash’s low back round a bit here!
Lunge into a hip flexor stretch keeping your arms raised. This will allow you to maintain your trunk upright.
Move back into a downward dog and repeat on the opposite side!
Attempt to combine these movements in the most fluid way possible, allowing a smooth transition from one movement to the next. Hence the word FLOW. Typically each position should be held for a full inhale and a slow exhale, around 5-10 seconds.
Note: Feel free to add a pad under the knee to avoid any irritation.