Hip Flexion

Abdominal muscles help to maintain our posture and are said to support the back with a muscular “corset.” The abdominals, however, do not cross the hip joint and are therefore not involved in the primary movements of the hip. It is the iliopsoas group, the deepest core muscles, that keep us moving in space, connect the spine with the thigh bone and help to maintain good alignment over two feet. This article is about these primary hip flexors and ways to activate and train them.

The iliopsoas group provides the proximal power for moving the body forward in walking, running, climbing or creeping on hands and knees. Clients with poor use of the iliopsoas group may walk with short steps and have difficulty achieving neutral extension of the hip joint. That is, the joint may remain in slight flexion and the pelvis may be anteverted (tilted forward at the ASIS) even in stable standing. Lacking this deep postural support, the mover will have difficulty in the basic locomotor skills listed as well as in changing levels (sitting/standing, squatting, using stairs). I don’t need to remind trainers that no muscle group works on its own. Crucial partners in good hip flexion/extension include functional quads, hamstrings and a mobile center of gravity.

Irmgard Bartenieff observed a certain inertia in the modern mover’s pelvis/hip unit and called it the “dead seven inches.” It spans the area between the ASIS and the greater trochanter. Hackney takes a positive view and calls it the “Vital Seven Inches.” In a culture that sits too much and has too little variety in whole-body activity, this area of the lower torso becomes disused and misused. Disuse/misuse occurs when the superficial hip flexors (rectus femoris and tensor fasciae latae)--not designed for deep core support--are substituted and overused. It also occurs when the abdominals and the back extensors have to stabilize the whole torso in order for the mover to raise the leg from the hip (supine single leg raise only).

Bartenieff (pronounced bar TEN yeff) developed a movement sequence named “thigh lift” to activate the deep postural muscle group we know as the iliopsoas. One of her “Basic Six” sequences, it is a deceptively simple open chain movement using a short lever in the sagittal plane. I will describe three sequences to activate and mobilize the iliopsoas group: heel slide, marching and thigh lift.

Anatomy of the Iliopsoas Group

The iliopsoas is actually three muscles of the deep posterior abdominal wall. (The four abdominal muscles which typically get all the press as “core” muscles form the lateral and anterior, superficial abdominal wall.) The psoas major and minor (treated here as one) originate on the bodies, discs and transverse processes of T12-L5. They lie to the sides of the vertebrae and travel down the back of the pelvic bowl to join with the ilacus muscle. The iliacus originates as a broad patch in the fossa of the ilium and has many tendinous connections throughout the pelvic interior. The three muscles join in a common tendon that passes over the pubic ramus and takes a sharp turn downward and backward to attach on the lesser trochanter of the femur. Visualizing this muscle’s pathway helps us to appreciate its potential for flexing the thigh/leg or flexing the torso on the thighs as in a full sit-up. [Illustration adapted from Calais-Germain, 1993.]

Activating the Deep Hip Flexors

The sequences that follow are deceptively simple exercises embodying a profound complexity. They represent core functions of the bipedal process. Take your time and practice with a partner. Have one person read and observe while the other moves.

Heel slide

This sequence trains the heel-sitbone connection and teaches the mover to keep the thigh/leg in the sagittal plane throughout the motion.

• Starting position: Lying supine with legs straight and hip width apart. Pelvis is in neutral alignment.
• The motion: Take a breath and dorsiflex the right ankle. Exhale as you draw the right heel up toward the sitbone. Keep the heel on the floor. A slight backward tilt of the pelvis should occur spontaneously. Stop and rest the foot opposite the left knee. Take another breath and dorsiflex the ankle. Exhale as you slide the heel away from the sitbone, returning to the original starting position.
• Remember: The abdomen remains soft throughout the movement, rising on the in breath and hollowing on the out breath. On the exhalation, yield the weight of the body into the floor, anchoring the torso without excess muscular activity. The leg moves in the sagittal plane throughout the movement.
• Repetitions: Do alternating heel slides four or five times and finish with both knees flexed and feet flat.

Marching

Marching trains the mover to use grounding and anchoring with each “step” and to alternate weight-yielding and foot-off for good support and weight transfer.

• Starting position: Lying supine with both knees flexed and feet flat. Arms are away from the body with palms facing downward. Pelvis is neutral.
• The motion: Take one foot off the floor a few inches and return it. Alternate feet a few times and note what is happening in the supporting foot. It should press into the floor when the other lifts. Continue the marching movement slowly, now actively pressing the supporting foot into the floor. Breathe normally throughout.
• Remember: The abdomen remains soft. Yield the weight of the whole torso and supporting leg into the floor to appreciate the stability this provides. Keep leg in the sagittal plane.
• Repetitions: Repeat marches (about 10) alternating sides and finishing with both knees flexed and feet flat.

Thigh lift

Trains the iliopsoas to flex the hip. The rectus femoris and tensor fasciae latae initiate hip flexion, but the iliopsoas is the power train for completing the thigh lift.

• Starting position: Lying supine with both knees flexed and feet flat. Arms are away from the body with palms facing downward. Pelvis is neutral.
• The motion: Take a breath and exhale about half of your air as you anchor the torso and left leg. Flex hip to 90° during second half of exhalation by arcing the knee toward the shoulder. Do this leisurely and do not initiate the movement by kicking the foot. Maintain a 90° angle at the knee as shown in the drawing. Return the whole leg in a piece to the floor, ending in the starting position. The pelvis will rock backwards on the lift and return to neutral on the return (a dynamic pelvic tilt).
• Remember: The abdomen remains soft throughout, hollowing with the exhalation and rising with the inhalation. Feel the stability of the weight of the body yielding into the floor in whole torso and leg. Experience the sensation of weightlessness in the raised leg. Feel the deep soft crease at the hip joint (medial to rectus femoris) that occurs when the movement is done properly. Keep leg in the sagittal plane.
• Repetitions: Repeat the exercise alternating sides about 10 times in all. Take your time and do not neglect the breathing component.

Benefits of Thigh Lift Practice

• Teaches the correct use of the iliopsoas group in hip flexion movements of all types.
• Trains the dynamic pelvic tilt.
• Helps to enliven the “dead seven inches” by mobilizing the hip and sacroiliac joints.
• Teaches grounding and anchoring (i.e., yielding the weight into the surface for stability).
• Cultivates the use of the breath to support and facilitate correct movement.
• Restores pelvic-femoral rhythm (the functional relationship of the thigh bone and pelvis).
• Establishes mobility/stability rhythm (i.e., the alternation of closed and open-chains) in walking.
• Cultivates the coordinated action of superficial and deep hip flexors.

References:

1. Bartenieff, I with D. Lewis (1980). Body movement: coping with the environment. NY: Gordon and Breach.
2. Calais-Germain, B (1993). Anatomy of Movement. Seattle: Eastland Press.
3. Hackney, P (1998). Making connections: total body integration through Bartenieff Fundamentals. NY: Gordon and Breach.
4. Woodruff, D L (2003). Hip extension and back pain. PTontheNet.
5. Woodruff, D L (2001). 3-D WORKOUT, vol.1: the Basics. 48 minutes, VHS format. Oakville, ON: Body-in-Motion.