Hip extension has been a big theme of the past several posts so I figured I’d keep on riding that train. This week we talk hip extension, iliopsoas and the TFL (tensor fascia latae). These muscles can be a limiter of hip extension but not just in the traditional way you’d think. Check out the video of a thomas test, traditionally used to measure hip extension:
Now, we’re checking motion at the sagittal plane. Does the knee drop below the hip? Obviously if it does not we’re dealing with a mobility restriction (depending on who you ask). However, if you change the view up and look at the transverse and frontal planes (bottom up view) a lot of times you’ll find that the knee drops below the hip, but the hip ends up rotating externally and abducting from the body. This could be due to a tightness of the TFL (tensor fascia latae) and iliopsoas (Even though the knee may drop below the hip). Check the video out below:
Notice what happens to the leg when viewed from the below:
- Hip external rotation – the shin is not vertical (The illiopsoas flexes and externally rotates the hip. When it is tight it will flex and externally rotate as seen in the video above)
- Hip abduction – the knee is not in-line with the hip (The TFL abducts and internally rotates the hip. When tight it will move the knee away from midline and internally rotate in the absence of iliopsoas tightness)
Now when addressing this issue we want to make sure we mobilize in a neutral position. One of my favorite corrective exercises is a regular 1/2 kneeling hip flexor stretch but with 2 tweaks:
- Block the foot to keep the hip in neutral
- Line up the knee, hip and shoulder to eliminate hip abduction (A good cue here is to get tall)
Give this one a shot with the next patient you get with a thomas test that looks like this.
Want to learn more about how to assess the hips and to find other great exercises to mobilize it? Check out my latest product with Dr. Dave Tilley:
Monkey Method – Movement Essentials
The Ultimate Guide to Understanding and Fixing Technical Flaws in the Handstand, Muscle-up and Olympic Lifts
My TFL is Toast,
Dan Pope DPT, OCS, CSCS, CF-L1