Many of us sit a lot. This idle position can shorten our hip flexor muscles over time, causing tightness in these soft tissues. Some people feel tight or stiff in the front of their hip and thigh, while others notice discomfort in their lower back. This makes sense as the primary hip flexor, the psoas, attaches from the front of the lower back to the front of the upper thigh bone.
The remedy for tight muscles is often stretching or passive treatments such as massage and foam rolling. Although this is a very appropriate approach for tight muscles, sometimes that feeling of “tightness” is related to something else. Sitting for long periods can also lead to hip flexor weakness. In this case, the remedy would be to strengthen instead of stretch. And, sometimes, these muscles need both.
Confusing, right?
Psoas=highlighted muscle. Screenshot from Essential Anatomy 5 app
How do we know what our body needs? Enter the physical therapist. Physical therapists know how to test your body to determine if a muscle is tight (or adaptively shortened) or weak. Concerning the length of the hip flexors, they utilize a specific test called the Thomas Test. The following video illustrates how to perform this.
The Thomas Test for Hip Flexor Tightness
Tips for the Thomas Test
Your hip flexor length is considered “normal” if your thigh rests parallel to the floor. It is considered tight or shortened if it is elevated above the table. Hip flexor tightness may also be indicated if you feel a deep or strong pull within your groin or the front of your hip, even if your thigh rests on the table. Keep in mind that your pelvis needs to be positioned in neutral. In other words, your lower back should not be pressed firmly into the table.
What to Do with the Results of Your Test
If your Thomas test is positive
It is a good indication that hip flexor stretching would benefit you. The following video illustrates how to stretch your hip flexor effectively. It also explains how to advance the stretch to include your quadriceps muscle.
If your Thomas test is negative
This may signify that the “tightness” you feel at your hip and/or lower back may be related to hip flexor weakness or something else. This would be an excellent time to consider getting a physical therapy evaluation to determine where your symptoms are coming from.
If you are local to Manitowoc, our physical therapists at Juniper Physical Therapy & Fitenss would be happy to help you. Call us at (920)320-9838 or click HERE to schedule your free phone consult today.
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