In the previous hip flexor post we talked about how the tight hip flexor inhibits the gluteus maximus and increased lumbar extension and hamstring activity to compensate.  There are also several other compensatory problems that occur from the tight hip flexor.  Remember that most people have tight hip flexors due to sitting, driving, sleeping in the fetal position, inactivity and repetitive patterns.  So, if the hip flexor is tight it could lead to patellar tendon/knee pain, and plantar fasciitis.

Lets look at jumping.  Jumping requires an eccentric load (hip/knee/ankle flexion and internal rotation) followed by a concentric contraction (hip/knee/ankle extension and external rotation).  In the take off phase if the hip flexor is tight it inhibits the gluteus thereby decreasing its ability to generate force.  This leads to poor jumping ability.  It also limits the amount of hip extension that can occur therefore the knees will hyperextend as a compensation for the lack of extension at the hip.  The hyperextension and the increased quad force cause the patella to be compressed and inferiorly tilt more irritating the tendon and fat pad leading to knee pain and tendonitis.  

Upon landing the gluteus cant control the forces and the femur excessively internally rotates and adducts causing increased stress to the med knee. ( The gluteus maximus eccentrically controls femoral internal rotation during loading).  This can be one of the causes of poor jumping mechanics which has been seen especially in females and correlated too increased ACL injury risk.

If the hip flexor is tight it will decrease extension of the hip and therefore decrease stride length.  This can lead to increased extension of the low back which over time can cause low back pain or as a result cause the heel to come off the ground early in the trail leg of gait.  This results in the trail leg diminishing its eccentric loading and therefore decreasing its ability to push off efficiently.  This ultimately creates more stress on the front leg as the muscles have to work harder to re – supinate the foot.  The lead leg in gait relys on the push off and successive swing of the rear leg to re-supinate and unload.   With the trail leg heel coming off the ground early an a-propopulsive gait results.  While this is a mild stress that wont cause problems in one step, the microtrauma and/or fatigue over time (thousands of steps in a day, 7 days a week and 4 weeks in a month etc.) eventually leads to the tissue unable to tolerate the stress and bang, pain occurs in this case plantar fasciitis.  So, a tight hip flexor on one side can lead to plantar fasciitis on the opposite side.  The beauty and challenge on understanding function, it never gets old!

Get Strong! Stay Strong!

Chris

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Comments
  1. KJ says:

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  2. chriskolba says:

    Thanks for visiting the site and hope you check back often. i too was at the Arnold and am always amazed at the number os supplements that are out there. Have not tried diesel but have samples. Ill give it a a shot. I really liked Con-Crete creatine. I thought it worked well.
    Hope to hear from you soon.
    Chris
    PS just curious, do you sell Diesel?

  3. Sean says:

    Hi Chris,

    Very interesting article, especially the link between a tight hip flexor and plantar fasciitis on the opposing foot. My left hip flexor has hurt on and off for years, but only more recently did plantar fasciitis turn up in my right foot. I managed to rid myself of PF by focusing on the lower leg, but I guess all I did was “cure” myself without addressing the cause. Now I can get to work on my hip flexor!

    I’m in the process of taking running more seriously, and I would like to start with a solid foundation. Although just a novice at things biomechanical, I think that I have quite a few of the symptoms of tight hip flexors you describe e.g. arched lower back, rounded shoulders, poor jumping performance. So I’m going to do the exercises described in your article for the gymnasts and see how it goes.

    Might I ask two questions?

    1. Why do I have a tight hip flexor on just one side?
    2. My knees tend to rub each other when I run- is this also caused by tight hip flexors?

    I’m enjoying your site a lot and will read further. Thanks Chris. Sean.

  4. chriskolba says:

    Some times we see the asymmetry. Could be an imbalance or maybe a leg length or pelvic rotation???
    As far as the knees, probably mostly a weak or inhibited “Butt” problem that could be stemming from the tight hip flexors (reciprocal inhibition). In addition the adductors tend to be overactive. Also could be from excessive pronation of feet. Bony (mis)alignment could also be contributing. Not always an easy or one factor issue.
    CK

  5. Tom says:

    Chris,
    I am not sure it is my hip flex(rs) that are tight so here are my symptoms, when I do sit ups both sides hurt. Anytime I do an exercise that requires me to bring my knee up, as in high step walking they hurt. I am 52 years old and play hockey. They cause me pain each time I stride and bring my leg back under my body. I do stretching but it seems to just make the problem worse. I do tend to drink Coca Cola, maybe one or one and a 1/2 a day. Last year I had my left hip fixed. I had the Birmingham Hip technique. Is there a supplement that I can take that will make those muscles less tight? My quads seem to be tight as well

    • chriskolba says:

      Actually it appears you have some significant problems that should be evaluated by a good physical therapist. Stretching is probably not the answer. It could be one of many problems. Why continue to suffer when you can get it taken care of. Find a good PT and let them help you. NO supplement is going to correct muscle imbalances, tightness or joint restriction problems. Also no amount of training or supplements can make up for a poor diet. Good luck
      CK

  6. Cheryl says:

    I play tennis and have been experiencing tremendous PF in my left heel. In the last few days, I have discovered that by stretching my left hip flexor, the pain in my heel has gone down substantially and have wondered if there was a connection between a tight hip flexor, my knee pain and heel pain. What else can I do to stretch this tight flexor?

    • chriskolba says:

      Thanks for the comment. There is a definite connection. Stretch the hip flexor, the rectus and calves. Also foam roller self message to the leg muscles or using a rolling pin to work out the tension and knots in the hip and leg muscles works well.
      Good luck.
      Chris

  7. Mallory says:

    Thanks for your post.! I have been experiencing pain at where the patellar tendon inserts below the knee for a few months now. I am wondering if tight hip flexors could have led to this? I’ve been stretching, but am wondering if focusing on the glutes and hamstrings would be a better strategy…I’ve had a lot of soft tissue work on the quads working out knots, etc. but that pain is still there….

    • chriskolba says:

      It can be a combination of hip flexor,calf and ITB tightness, weak hip muscles and an overpronatory foot. Also need to look at the orientation of the patella. Good luck. Hope it resolves soon.

  8. Darlena says:

    Thanks for this article. I have had PF since Dec. and no one ever took my tight hips into consideration. Actually have been doing IT band stretching and seems to be helping my PF too!

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