Weak Hip Flexors and the Problems that Can Result

What Does it Mean to Have Weak Hip Flexors?

Hip flexor weakness or tightness can affect the mechanics of walking, running, and climbing stairs. It can also affect the pain of multiple areas of the body . The tightness of the hip flexors can cause problems with posture, depending on the age group and preexisting conditions. As a physical therapist, we often see tight and weak hip flexors on people with lower back pain. Lower back muscles and hip flexor muscles, mostly the psoas muscle, tighten up to “guard” the lower spine from further injury. This guarding of the lower back can carry on beyond the first week, where protecting the recently injured area is beneficial. So, beyond a week or two, the psoas may start adding to the problem.

Where are Your Hip Flexor Muscles

The hip flexor muscles are in the front or anterior aspect of your hip and pelvis. The image below shows you exactly where the muscles are located. The iliacus, and psoas major are the two main hip flexor muscles.

Hip Flexor Muscles

What Causes Hip Flexor Weakness?

The major cause of weak hip flexors is excessive sitting through the years. Putting the hip flexor in a shortened position causes the muscle adaptively to shorten. Like many other adaptations, the body allows this shortening, as it may make things more mechanically efficient for the “activity”. Specifically, for the “activity” of sitting, this shortening of the hip flexors causes more problems than efficiencies. A muscle that adaptively shortens or lengthens over time, can often become less efficient and problematic. For more examples of this just Google “Upper-Crossed Syndrome” and “Lower-Crossed Syndrome”.

Are Hip Flexors Usually Weak?

Hip flexors are often weak, as the general population do not do much walking and often do not challenge the flexibility of the hip flexors. Additionally, the shortening of the muscles on a microscopic level puts the muscle cells at a mechanical disadvantage.

Hip Flexor Stretches

What are Symptoms of Hip Flexor Problems?

Hip flexors, other than the psoas, are more local to the hip joint. Therefore, the weakness or tightness of them can of course directly turn into problems. Snapping hip syndrome is a condition that can develop over time. If the hip flexor or IT band is too tight. This syndrome can come with and without pain but can often lead to bursitis in the hip. It is worth noting that physical therapists often see people with back problems develop hip problems, given enough years of time. Symptoms of hip flexor weakness, or tightness and pain, can often be hard to decipher. Imaging and having a qualified professional exam you will save you lots of time and resources.

Who is Most at Risk for Hip Flexor Weakness?

Sedentary people are the most at risk due to the sitting posture and the low activity level of the hip flexors. They are also weaker in similar muscle groups of the hips and low back. Athletes are at risk for the opposite reason, as running, especially sprinting sports require powerful and repetitive hip flexion.

Those with previous back or hip injuries also have an increased risk. Preexisting muscle imbalances can throw off the mechanics of the hip flexors and other muscles that cross the hip, pelvis, or low back. A prime example of this is people with previous hip impingement syndrome or people with arthritis of the hips. The main reason for this is that certain hip flexors have some of their attachment at the labrum of the hip.

Like all muscles as we age we begin to lose the strength of the hip flexors. So, this is an easy direct relationship to hip flexor weakness.

Written By: George Dudziec, PT, DPT

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