This is 2 out of 3 in our series - see if you can do all 3!
Last time, we learned how the hip flexor muscles affect the alignment of the pelvis, and how tension in these muscles can relate to lower back pain. This week's stretch for the hip flexors is a bit more advanced, and can therefore lead to greater flexibility. Next week's stretch is the most advanced in my opinion; see which is easier for you! Perform these stretches in conjunction with simple low back stretching and you'll begin to notice easier motion walking, and even less pain sitting and laying.
Hip Flexor Stretch #2
(NOTE: This stretch may compress the low back. If you've had any lower back injuries or surgeries, it's probably not a good idea to perform this stretch, as it may aggravate previous issues. Remember to keep your abs tight (by pulling your belly button into your spine) and support your lower back as you stretch. As always, we can discuss which stretches are appropriate for you and which are not after your scheduled session at my office. Please, use good judgment and respect your body when performing any stretches.)
Begin by sitting on your knees on the floor. Reach behind yourself and hold onto your right ankle with your right hand.
Take a deep breath and raise your left hand, pointing your fingertips to the ceiling.
Slowly move your left hand diagonally toward your right foot, reaching backward and trying to touch that right foot (which is almost physically impossible). Maintain space in your low back, NOT compressing the spine at all. Reach back as far as possible, stretching the front of that hip, breathing deeply and focusing on the muscles being stretched. Repeat on the other side.
This is one of my all time favorite stretches after a long day. It almost feels as if you can breathe easier after releasing the body in this way. Relax and enjoy it! Next time, we'll explore the most challenging hip flexor stretch so far – are you up for the challenge? As always, I'm happy to demonstrate these stretches and discuss your personal flexibility more completely during your scheduled massage therapy session. I'll see you in my Westport office!
I'm writing 3 entries to help you open up this often chronically tight area
Many of us spend a large part of the day sitting. This shortens and tightens the muscle group called “Hip Flexors”, which include psoas major, psoas minor, illiacus, and a little of pectineus, predominantly. These muscles work together to flex the leg, that is, move it into the position of sitting, with the upper leg in front of the hip. Often, we're not aware of the actions these muscles take, because they are small, and seemingly insignificant compared to our large posterior hip muscles, like the gluteal group. But these muscles can become very tight and pull down on the pelvis, creating an increased tilt and causing back pain. In fact, I check the tension in this muscle every time a client comes in to work on lower back pain, because it's often implicated.
Stretching the hip flexors will help to alleviate lower back pain, and even help you walk more upright and comfortably. Ideally, the pelvis will be neutral, with no tilt. Such as below:
But tight hip flexor muscles lead to an anterior (front) pelvis tilt, which increases pressure on the lower back:
By keeping the hip flexors loose and functioning properly, the pelvis maintains its proper position. Since the pelvis is like the fulcrum of the entire body, this makes walking, standing, and even laying feel easier. In the next few posts, I'll explore three hip flexor stretches, starting with the easiest and moving to more advanced positions. Accept my challenge and see how many you can do easily!
Hip Flexor Stretch #1
Sitting on the floor with your leg bent at the knee on the side of your body, hold your right ankle with your right hand and move your leg toward your back, letting the movement of your upper leg push your body onto the left side. Rest on your right arm and increase the stretch by pulling your ankle toward your back. Ideally, the foot would be able to touch the low back (although that almost never happens!). Breathe into the stretch and attempt to pull the ankle closer to the back, gently. Repeat on the other side.
Balancing the pelvis is beneficial for almost everyone, but especially those who work at a desk or sit most of the day. To see if you've made a difference in flexibility, perform these stretches on the front of the hip, and stretch the low back by simply trying to touch the toes. Ideally, the stretching will help you to have greater low back range of motion, and definitely decrease in pain and tension. When you come in for your scheduled massage therapy session, I'm happy to help you explore these stretches more and help with any complicated low back issues you may be experiencing. I'll see you in my Westport office!
My analysis of the latest studies
Study: Comparative study of stretching modalities in healthy women: Heating and application time (www.sciencedirect.com/science/article/pii/S1360859213002052)
Authors' Conclusion: “A 10-minute stretch, when performed over four subsequent days, is suggested for faster increase in flexibility. The results could suggest a systemic warming (such as the one provided by a treadmill workout) before stretching for an acute gain of flexibility in the same day.”
Analysis: This study was to test the effect on flexibility of passive stretching combined with heat from warming muscles by running on a treadmill, or warming muscles from microwave heat. The study concluded that stretching with either type of heat application was beneficial and yielded a greater range of motion than no stretching at all. The treadmill warming group was more effective than the microwave group, “related to the number of sarcomeres”. Sarcomeres are the molecular units in muscles that move and increase in number with movement of muscles. They are beneficial for both building muscle mass and increasing muscle function. Therefore, although this study was small in scale (only 50 participants), it proves certain principles which are known to affect massage therapy: Stretching generally and warming muscles by using them in exercise are beneficial for flexibility.
Study: Effectiveness of myofascial release: Systematic review of randomized controlled trials (http://www.sciencedirect.com/science/article/pii/S1360859214000862)
Authors' Conclusion: “The literature regarding the effectiveness of MFR was mixed in both quality and results. Although the quality of the RCT studies varied greatly, the result of the studies was encouraging, particularly with the recently published studies. MFR is emerging as a strategy with a solid evidence base and tremendous potential. The studies in this review may help as a respectable base for the future trials.”
Analysis: This was not a study per-se, but an analysis of previous studies and literature. The conclusion states that effectiveness of MFR could be proven in the future, but more studies are needed. Clinical studies are important for emphasizing the benefits of massage therapy. Until studies are conclusive, we may only take educated guesses at which techniques are useful. I do use MFR techniques in my office, largely because I believe studies will eventually catch up with anecdotal evidence that the techniques are effective.
Study: Transmission of muscle force to fascia during exercise (http://www.sciencedirect.com/science/article/pii/S1360859214001417)
Authors' Conclusion: “Substantial stress is transmitted to fascia during muscular exercise, which has implications for exercise therapies if they are designed for fascial as well as muscular stress. This adds additional perspective to myofascial force transmission research.”
Analysis: This is a great, simple overview of how fasica affects muscle, which I am asked about all the time. Clients often ask if fascia affects muscle and vice versa, and the answer is yes. One cannot function without the other, and this study shows that fascial stress is transmitted to muscles during exercise, which is why MFR (as noted above) is needed in the first place. This is a good reminder that massage therapy is especially important as exercise levels increase.
Study: Comparative analysis of ultrasound changes in the vastus lateralis muscle following myofascial release and thermotherapy: A pilot study (www.sciencedirect.com/science/article/pii/S1360859214002046)
Authors' Conclusion: "HPT may produce only superficial effects. Because MFR improved all measured parameters, continuous stretching and pressure are probably important for improving fascial gliding and flexibility of the vastus lateralis muscle."
Analysis: This study compared heating tissue with ultrasound to Myofasical Release (I technique I perform!). The MFR technique had more lasting and deep effects. This study shows how effective this massage technique is, which I love!
I'm always happy to talk to clients about the latest research! It's exciting to note how science proves and disproves certain methods; I'm always striving to keep up with the latest efficient techniques. I'll see you in my Westport office!