Video Transcript: Hip Flexor Exercises for People with Hypermobility Syndrome

Hi, everyone! Dr. Orit Hickman here from Pain Science Physical Therapy. Because my clinic treats a lot of patients with persistent pain, we also often see patients who have a diagnosis of hypermobility or hypermobility syndrome. And so, if you are somebody that has a lot of flexibility in your joints, this exercise is for you.

So, I don’t know about you, but I have tight hip flexors, and there are lots of patients who have tight hip flexors. And, there’s lots of ways to stretch the hip flexors, but if you have hypermobility, it is often really challenging for you to stretch that muscle group properly. So, in order to stretch it properly, it’s important to know where these muscles start and end. Okay. So, the hip flexor muscles actually start deep in the front of the femur bone. So, if we can visualize, they start way down in here. Then, they come up, and they attach to the sides of the lumbar vertebra. So, they’re pretty deep. And oftentimes, the way people like to stretch this muscle group, and you know who you are, is doing a stretch like this, and then you’re way down in this position. And, you’re really, really, really deep trying to get that stretch in that muscle group.

Here’s the problem: if you hypermobility in your joints, when you do a stretch like that, a lot of the times, what’s happening is the femur bone is actually pushing forward into the hip joint capsule. And, what you’re actually doing then is stretching the hip capsule, which means that the hip joint starts to get more flexible, not more stable over time. And, this can cause a variety of problems from groin pain to injury to the tissue around the inside of the joint called the labrum to sciatic nerve symptoms. You name it. So, we really don’t-the hip joint in general is a very stable joint, so we don’t want more flexibility. And, if you are already having more flexibility in your joints, we don’t want to add even more flexibility to your hip flexor muscles.

So, the question is: how do you stretch this muscle? Well, again, knowing where the muscle starts and stops is really important. So, I will put patients in this position. Okay? And, I will say, “Alright. What I want you to do is I want you to just squeeze your butt.” And, that’s the first step. [It] is squeezing your butt muscles, and that may or may not elicit a stretch. But, really for me who is not hypermobile, all I have to do is squeeze my butt, and I already feel a stretch here.

Now, my sister who’s probably watching this video is very, very flexible, and when I showed her this, because I was horrified with how she was stretching her hip flexors, when I showed her this, she said, “I don’t feel a stretch.” And, I said, “Okay. Well, let’s try this. Let’s try tilting the pelvis under.” And, she had to tilt a lot before she could feel a stretch. And, I said, “That’s okay because I at least know that you are not putting that hip [and] that femur bone and pushing it way far forward in the joint to get too much flexibility in the joint.”

So, for those of you who are stretching the hip flexor, start with a butt squeeze, add a little bit of a pelvic tilt, and if you feel like that’s not enough, you can tilt a little bit more. And then, if you’re like, “Okay. I got it. I got a little bit of stretch but not a lot, then you can add in a little bit of a side bend because remember what I said: that hip flexor attaches to the front of the femur, but it also attaches onto the lumbar spine. So, if you then pull that lumbar spine over to the side, you should feel a stretch all the way up into-deep into those hip flexors.

Give it a try. Let me know how it goes. I’d love some feedback and information from you guys. If you say, “Man that sucked. That wasn’t a good stretch. That didn’t help at all.” That’d be helpful. If you felt like it was helpful, I’d love to know that as well. So, feel free to give me a thumbs-up. [Write] any comments again below that would be great. If you want to get more videos in which I address pain and persistent pain, as well as, you know, how we use physical therapy to treat patients in pain, then feel free to subscribe. And, I hope you have a great day!