Wednesday, April 18, 2012

Hip Flexor and Piriformis Stretching and Strengthening

Almost all of my running injuries stem from one problem area: my right hip and hamstring. My most recent injury iteration is a pain in the hip flexor (psoas major and/or illiacus if you want to get technical), so I’ve been dealing by:
  1. taking time off running,
  2. stretching,
  3. foam rolling,
  4. and strengthening. 
Injury treatment is very personal – everyone has different issues – but the following stretches and exercises are pretty standard and might be worth considering even if you’re not injured. (Had I been stretching my piriformis none of this recent business would have happened.)

The following are a few of the stretching/strengthening exercises I've been doing at least once a day. Disclaimer: I’m just a runner, not an athletic trainer or doctor.


Hip Flexor:

As seen in the picture, go into a lunge position.  Keep your front knee at a 90 degree angle, keep your lower back straight, and gently push your hip flexor forwards while you lean back slightly.  You should feel a light stretch in your hip flexor.

Hold the position for 5 seconds, go slightly further into the stretch for 5 seconds more, and go slightly further once more for 5 seconds.  Alternate legs, and repeat twice more for a total of 3 sets for each leg. (source)


Starting Position: Standing at table of hip height, place right leg on table with knee bent and the hip externally rotated so the outer low leg resting on the table. The standing leg is in parallel and the torso is square to the working leg (Figure A). Hinge forward from the hips with the back straight and rest your hands on the mat (Figure B). All motion comes from the hips, so the spine should not be curved or arched.
Then perform the same stretch with the standing foot turned out with the body facing in the direction
the toes are pointing (Figure C). Then hinge forward from the hip with the back straight (Figure D).
Last, perform the same stretch with the standing foot turned in with the body facing in the direction the toes are pointing (Figure E). Then hinge forward from the hip with the back straight (Figure F).
I hold each stretch for about 3 seconds, then hinge back up, then repeat about 5 times. (source PDF)

Foam Rolling

I've been rolling out my quads, piriformis, hamstrings, and IT band. Read my article about foam rolling here, and check out the slideshow to see pictures of how to foam roll.



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Hip Flexor 

Starting Position: Lie on your side on a mat/floor with your legs lengthened straight away from your body. Stack your feet in neutral position. Your lower arm can be bent and placed under your head for support. Your upper arm rests upon your upper hip. Your hips and shoulders should be stacked up and aligned vertically to the floor. Your head should be aligned with your spine. Engage your abdominal muscles to support your spine.

Upward Phase: Exhale. Gently raise the upper leg off the lower leg. Keep the knee straight and the foot in a neutral position. Do not allow the hips to roll forward or back. Both knees should be "looking" straight ahead. Continue raising the leg until the hips begin to tilt, the waist collapses into the floor or until your feel tension develop in your low back or oblique muscles.

Downward Phase: Gently inhale and return the leg to your starting position in a slow, controlled manner. After completing your set, roll over and repeat with the opposite leg. (source)