Weakness is the culprit! Hip flexors test/massage/exercises (NO stretches for low back pain)

Weakness is the culprit! Hip flexors test/massage/exercises (NO stretches for low back pain)


Stop doing this. it’s not going to fix your flexor problem Hi guys. Rehab safely. Mr. Physio here in Australia. Let’s talk about hip flexor today There are a lot to cover in this video and some of them are a bit confusing and controversial I hope I can deliver my message properly. So let’s get started there are many hip flexors, and I will show you all of them and discuss how you can deal with hip flexor tightness, or weakness. Probably I will focus more on hip flexor weakness today. Let’s have a look at the Hip flexors in our body. There are so many. TFL, adductors, rectus femoris and so on Of course we have Psoas and Iliacus as well. this muscle starts from the front of the lumbar spine and attaches on the inside of the thigh bone and it contracts, that lifts your leg up like that, If you look closely Psoas muscle is the only muscle attached on your spine All other muscles attach on your pelvis Since they are attached on pelvis, they are more likely to assist hip flexion up to 90 degree(pelvis level) whereas Psoas muscles are attached on the spine, so it can bring your leg higher than 90 degree Basically Psoas muscles get help from other muscles below 90 degree, but have to work harder above 90 degrees Psoas muscles are more active within that higher range of hip flexion which is important when testing its strength later on but when you sit down you put that muscle into a shortened position (half size) and if you sit for a long time that muscle is likely to get short and tight and then when you stand up the tight/short muscle can pull your spine forward and that will create more arch in your lower back, and that’s the typical scenario You might have heard of until this happens ok once your lumbar spine gets pulled forward like that Because of Tight Psoas muscle your whole body weight gets shifted forward as well like that but of course your body doesn’t want to go forward because it doesn’t want to fall forward. So what our body does is actually compensate through the upper spine these forces can affect your body without your body turning into this poor posture. For example, you can still have your flexor tightness without anterior pelvic tilt that means probably your core is strong enough to support your spine in a neutral position rather than just going forward like that, but that doesn’t necessarily mean you don’t have hip flexor Tightness. so your hip flexor tightness is there pulling your spine down, but your core can fight back against it the same goes for thoracic spine here. The force created by thoracic spine leaning backwards like that still can exist even if you don’t see any excessive thoracic spine extension so even if your hip flexor is tight and shortened. it’s pulling your lumbar spine down that way against that stretching force against the stretching force created by the thoracic spine, so there is always this prolonged stretch on that Psoas muscle. It has to fight against ‘stretch’ And if you put a prolonged stretch on a muscle your muscle is likely to get weak. So the Psoas muscle can’t function properly 100% and the other muscles the other hip flexors start to compensate and it will make that Psoas muscle even weaker. Plus we don’t use Psoas muscle that much, especially within the above 90 degree Range when do we lift our leg above 90-degree almost never. so the Psoas muscle doesn’t get used throughout its full range, which will make it disfunctional and weak. So if you’ve had hip flexor tightness for a long time, there’s a pretty high chance you have hip flexor weakness, and I will show you how to test it try to hold your leg above 90 degree without your hands helping like that. you can hold onto the wall and hold leg above 90degree In muscle strength test, if you’re able to contract your muscle against gravity throughout its full range, Your muscle strength is considered to be grade 3 out of 5 being normal And if you can do that against light resistance for example against your hand pushing down and you’re still able to hold that position It’s grade 4 strength. And if you can do that against even more strength like someone pushing your leg down and you’re still able to hold that position your muscle strength is normal(grade 5) but if you have weakness in your Psoas, You will notice your leg slowly goes down like that. That means you can’t use your hip flexor against gravity throughout its full range. That’s not even grade 3 you may feel comfortable around that 90 degree range because other muscles other hip flexors can help your hip flexion up to 90 degree so they start to support when it comes to 90 degree So what do we do about that first of all we need to loosen up your hip flexor as mentioned earlier even weak muscles can get tight so we will loosen it up and strengthen after that To loosen up your hip flexors. You need to find ASIS and this is my belly button so between these two landmarks you put the tennis ball you put the ball right next to the bone and pres down like that with any object. You can apply pressure with just press down and roll around there So if you press down like that a little bit down and out to the side towards your back pocket area, You can get Iliacus and if your angle is more towards the midline, You can target the Psoas muscle you don’t need to push too hard. Just gentle pressure so when you do this angle(out) You’re massaging Iliacus and when you do this angle(in) you are massaging Psoas muscle belly As mentioned earlier, If you put a prolonged stretch on your Psoas Muscle. It will become weak and dysfunctional It’s especially true for your tendon. Tendons attach your muscles to bonds. it’s normally elastic it’s a spring-like structure. It always wants to go back to its original length, but if your muscle’s tight in the middle, that will pull the tendon away from the bone and your tendon starts to lose its elastic component elastic ability to go back to its original length. so it’s always being pulled and it will become dysfunctional if tendons become dysfunctional, It’ll be harder for you to contract and relax your muscles because that’s what your tendons do, contracting and relaxing your muscles so your muscle, in turn, can go disfunctional. And if you can’t use your muscles properly, they will be weaker and tighter and a vicious cycle starts, so we need to restore the muscles function, to be exact, the tendons function to control that stretching force. And it can be done by eccentric exercises. If you do a biceps curl, if you pull the weight towards you, your muscle gets shortened. If you lower the weight your muscle gets lengthened(but still being used) that’s eccentric control and we need the same thing for your Psoas muscle Because when you do a squat or when you pick up something from the floor. Your muscle is in a shortened position initially and when you stand back up that muscle has to be elongated, but if you don’t have enough eccentric control, your muscle still wants to sit in that shortened position pulling your spine down when you stand back up that will create a lot of stress on your lower back. as always, we’re going to start with simple exercises we’re going to start with your knee above 90 degree in sitting. From here, You start to push your leg down with your hands while pulling your leg up embrace your core. don’t slump down like that. Keep your back straight. and bring your knee up about 90 degree. So that’s Psoas muscle being used and then keep pulling up while you push it back down with your hands slowly in about 3 to 5 seconds. In this exercise, you are activating your Psoas muscles as you keep pulling it up, but the muscle elongates because you’re forcibly pushing it back down. So your muscle is being used but at the same time it gets lengthened you can do it in lying position too. Bring your leg up towards your chest and from there, push it down while you keep pulling it up. You can also increase range of motion using eccentric exercises You lie on your tummy with one leg off the bed (standing on the floor) and embrace your core and suck your tummy and squeeze your glutes I’m working on my left side and try to drive your left leg into the bed like that. Keep pushing down while propping yourself up on your hands so start from here and you are going to raise yourself up while doing this action First, tummy in. squeeze your glutes. drive your knee into the bed. Keep pushing while raise yourself up like that, so that’s it. Most of the hip flexor problems involve some degree of weakness in Psoas muscles That’s why the stretching is not the key instead. You need to use that muscle. You need to restore that muscle’s function or tendon’s function to deal with the stretching force properly. Once your tendon function’s normalised, working as a spring again your muscle function follows. I hope this video gives you a bit of different insight into hip flexor issue. Thank you for watching I will see you next time and rehab safely!

28 Replies to “Weakness is the culprit! Hip flexors test/massage/exercises (NO stretches for low back pain)”

  1. 와 장요근을 풀고 왼쪽 다리 뒷쪽에 전반적으로 있었던 땡기는 느낌? 쥐나는 느낌?이 사라져서 개운해요. 운동법 알려주셔서 감사합니다!

  2. 영상 감사하게 잘 시청하고 있습니다.
    모든 영상에 있는 동작들을 전부 다 따라해봤습니다. 정말 큰 도움이 되었습니다.
    특히 어깨와 목쪽에 만성적인 통증이 상당히 부드러워졌습니다.
    예전에 도수치료 받으면서 들었던 MET였나 그 느낌과 비슷했구요.
    원심성 수축과 구심성 수축의 차이점에 대한 영상과 틀어진 골반등 체형교정을 위한 영상도
    올려주시면 도움이 많이 될 것 같습니다^.^
    좋아요~ 누르고 갑니다.

  3. 호주 물리치료사 님이 주기적으로 체크하는 혹은 좋아하는 논문학회나 사이트가 있다면 소개 부탁드립니다.

  4. 섬샘님 궁금한게있는데요!
    썸네일에 장요근 스트레칭도 두번째운동처럼 뒷발의 고관절 굽힘 동작에 힘을 주고 상체를 위로 세워주면
    같은효과를 볼수 있을까요?

    힘을 뺀 상태에서 근육의 길이를 늘였을때 부정적인 점이 어떤것이 있는지 궁금해요!

  5. 90도로 들어올리는 운동을 할 때 장요근의 수축은 잘 느껴지지 않고 허벅지 힘으로 버티는 느낌인데 장요근 힘이 부족해서 그런가요? 마지막 침대에 다리 두고 하는 운동은 장요근에 자극이 오면서 같은 다리 햄스트링도 자극이 오고 골반 뒤쪽 허리가 뒤로 꺽이면서 약간의 통증이 있는데 잘 하고 있는건가요? 통증은 없어야 할 것 같은데…

  6. 아주아주 공감해요~
    항상 일관되게 말씀하시는 원심성수축운동!!
    근육은 늘리는게 아니고 사용되어야한다!!
    장요근때문에 계속 고민하고 있었는데 선물처럼 나타났네요.
    안전재활을 위한 소중한 영상 너무 감사드여요 즐거운 한가위 되세요~

    볼마사지는 엎드려서 해도 되겠지요?

  7. 해피추석! 초보자는 누워서하는게 더 추천되겠네요. 영상 잘봤습니다
    궁금한게 있는데요 이센테릭 운동일때와 흔히말하는 스트레칭일때 건의 사용 정도가 얼마나 차이날까요?

  8. 근육 위치상 마사지가 잘 안되는 느낌인데, 마사지대신 정적운동(맨몸스퀏, 런지, 앉았다일어나기) 같은 운동으로 장요근 기능을 충분히 올릴 수 있을까요? 저번에 장요근 요청했었는데 이렇게 자세하게 올려주셔서 감사합니다 덕분에 많이 배우고 있어요!

  9. 가끔씩 걸어다닐때 왼쪽 고관절쪽이 결리고 찝히는 느낌이 나면서 아픈데 그럴때 주저 앉으면 뚝하면서 손가락마디 소리나듯이 소리가나는데 그후로는 또 괜찮아지고 그러는데 뭐 때문인가요 인터넷에 찾아보니 장요근 때문이라는 거같던데 맞나요 ㅜ 너무 불편하네요 스트레칭하면 나을까요?

  10. Thank you for another great video. Looks like my backache may be related to my weak hip flexors . ! I’ve had really weak back / back aches for almost 7 years since an emergency c-section . Can pregnancy /epidurals cause weak back/back problems Mr Physio ?
    Thank you .

  11. 정말 많은 도움받고 있습니다 병원에서 도수치료할때 활용하고 있어요 많은 분들이 이영상들로 인해 건강하게 살아갔음 해요 정말 약장수?들이 난무하는게 한국 치료계의 현실입니다 가뭄에 단비같은 영상 강추합니다

  12. 달아주신 댓글 보고 이 영상 확인했습니다. 추석이라 못 봤나봐요. 참고해서 열심히 훈련하겠습니다. 감사합니다.

  13. 한쪽골반통증이 두달정도 꾸준해서 낼 지피예약했습니다(여긴퍼스요) 알려주신 장요근근육 사용하는 운동 하고있는데 이거하고 나면 통증이 사라져요. 특히 아이들 픽업으로 운전을 자주하는날에는 이 운동 필수입니다!!
    좋은영상 감사드립니다

    *오른쪽 골반이 아픈데 요즘 걸을때마다 오른쪽 다리가 왼쪽다리보다 길어진거같은 ㅠㅠ 느낌이 들어요
    그러면서 오른쪽 어깨도 좀 쳐진느낌(?) 골반때문에 그럴수도 있는지요?

  14. 추석지나고 올라오나 싶어서 기다리다 이제야 영상 봅니다~. 영상 기다리다가 장요근 마사지를 이래저래 찾아서 5일정도 해줬는데, 허리통증이 많이 좋아졌어요.  오늘 영상보니 장요근이 기능을 잃은거에 확신이 섭니다. 알려주신 원심성 운동 해봤는데 10개씩 2세트도 굉장히 힘드네요.  쉽게 설명해주셔서 감사드리고, 또 방법까지 제시해주셔서 너무 감사합니다~.

  15. 진짜 영상 너무 좋고 항상 공부하면서 배우고 있습니다 ! 그리고 너무 너무 재밌어요 귀에 쏙쏙들어오고 중간중간에 사투리쓰시면서 경고하시는 거 웃겨서 웃으면서 봤어요 ㅠㅠ 구독자 일만된지 얼마안된 것 같은데 이만이 다 되어가네요 십만가즈아 🤤

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