Hip Flexors and

Hip Extensors

Hip Flexors• Muscles that flex the

femur at the acetabulofemoral joint

– Psoas Major

– Iliacus

– Rectus Femoris

– Sartorius

– Pectineus

– Tensor Fascia Latae

Iliopsoas Muscle Group• They are the

strongest hip flexors and consists of psoas major and iliacus.

• They act on the lumbar spine and femur.

• FYI: psoas major is the filet mignon of a cow

Psoas Major• Psoas means low back

and major means large• Origin:

– Vertebral bodies of T12-L5 and transverse process of L1-L5

• Insertion: – Lesser Trochanter of

Femur• Action:

– Hip Flexion– Trunk Flexion– Anterior Tilt of Pelvis– Lateral Rotation of Hip

(very weak)

Psoas Major• Integrated Function:

–Assists in eccentric deceleration of hip extension

–Assists in eccentric deceleration of femoral medial rotation at heel strike (gait)

–Assists in dynamic stabilization of the lumbo-pelvic-hip complex during functional movements

Psoas Major Tightness• Can cause increased lumbar extension and hip

flexion, causing the pelvis to tip anteriorly• Avoid straight leg sit-ups-flex the hip and knee

joints and perform a crunch to 30 degrees of spinal flexion so psoas will not be engaged

• Perform the following exercises to correct the imbalance:– Supine Posterior Pelvic Tilt– Supine Bridge – Stretch Hip Flexors– Stretch Trunk Extensors– Strengthen Gluteus Maximus and Hamstrings

(hip extensors)

Iliacus• Iliacus refers to the

ilium of the pelvis• Origin:

– Iliac Fossa of Pelvis• Insertion:

– Lesser Trochanter of Femur

• Action: – Hip Flexion– Anterior Tilt of Pelvis– Lateral Rotation of

Hip

Iliacus• Integrated Function:

–Assists in eccentric deceleration of hip extension

–Assists in eccentric deceleration of femoral medial rotation at heel strike (gait)

–Assists in dynamic stabilization of the lumbo-pelvic-hip complex during functional movements

Rectus Femoris of the Quadriceps• Rectus means straight and

femoris refers to the thigh.• Origin:

– Anterior Inferior Iliac Spine of Pelvis

• Insertion: – Tibial Tuberosity of

Tibia by patellar tendon• Action:

– Knee Extension– Flexion of the Thigh– Anterior Tilt of Pelvis

Rectus Femoris

• Integrated Function:–Assists in eccentric deceleration of hip extension and knee flexion during functional movement

Sartorius• Sartorius means tailor • Origin:

– Anterior Superior Iliac Spine of Pelvis

• Insertion: – Proximal Tibia (medial

to tibial tuberosity)• Action:

– Hip Flexion– Hip Abduction– Lateral Rotation of Hip– Anterior Tilt of Pelvis– Knee Flexion

Sartorius• Integrated Function:

–Assists in eccentric deceleration of hip extension, adduction, medial rotation

–Assists in eccentric deceleration of knee extension

–Assists in dynamic stabilization of the acetabulofemoral and tibiofemoral joint

Pectineus• Pectineus means comb

because this muscle has a comb like appearance

• Origin: – Pubis

• Insertion: – Posterior Surface of

Femur (inferior to the lesser trochanter of femur)

• Action: – Hip Flexion– Hip Adduction– Anterior Tilt of Pelvis

Pectineus

• Integrated Function:–Assists in eccentric deceleration of abduction of the femur

–Assists in dynamic stabilization of the lumbo-pelvic-hip complex

Tensor Fascia LataeThe name tells us that this

muscle “tenses” the fascia that lies over the muscles of the thigh

• Origin:– Anterior Superior Iliac Spine

and Anterior Part of Iliac Crest

• Insertion:– Iliotibial Band which attaches to

the Lateral Condyle of Tibia

Tensor Fascia LataeAction:• Flexion of Femur• Abduction of Femur• Medial Rotation of Femur• Anterior Tilt of Pelvis

Integrated Function:• Assists in eccentric deceleration of hip extension• Assists in eccentric deceleration of hip adduction• Assists in eccentric deceleration of lateral rotation of

the hip• Assists in dynamic stabilization of the lumbo-pelvic-

hip complex and tibiofemoral joint

Hip Flexor Mnemonic

• P I R T S:–Pectineus

–Iliopsoas • Psoas Major and Iliacus

–Rectus Femoris

–Tensor Fascia Latae

–Sartorius

Hip Flexor Exercises• Many people excessively train the hip flexors

thinking that they're training the abdominals• Sit-ups, leg raises, "flutter kicks," and

hanging leg raises are all primarily hip flexor exercises

• Most people tend to have tight hip flexors, which can compromise the structural dynamics of the lumbar spine

• Short hip flexors are also associated with low back pain.

Straight-Leg Raise and Hanging Leg Raise• Hanging Leg Raise:

– When hanging in that position, your latissimus dorsi isometrically contracts, so when the rectus abdominis contracts and the legs move anteriorly, there is a pulling by the lats on the lumbar spine.

– This causes stress on the lumbar spine

• Straight-Leg Raise:– Trunk hyperextension may injure the lumbar spine

The Sit-Up • The sit-up imposes

a large compression load on the spine, regardless of the leg being bent or straight

• Sit-ups should not be performed at all by most people

Ouch!

Hip Flexor Exercises• Standing Hip Flexion

Machine

• Standing Hip Flexion with Tubing

• SB or TRX Jackknife

(hip flexion)

• Walking

• Running

• Biking

• Elliptical Machine

Hip Flexor Standing Stretch

Kneeling Hip Flexor Stretch

Hip Flexor Stretch Using A Bench or Stretching Table

To perform this stretch lie on the edge of a table, flex the knee and hip towards the chest, allowing the opposite leg to hang down

Hip Extensors

• Muscles that extend the femur at the acetabulofemoral joint

–Gluteus Maximus

–Hamstrings

Gluteus Maximus• Largest muscle

in the human body

• Superficial muscle responsible for the roundness of the buttock region

Gluteus MaximusOrigin: • Posterior Sacrum,

Posterior Iliac Crest, and Superior Gluteal Line of Ilium

Insertion

• Gluteal Tuberosity of Femur and Iliotibial Band

Gluteus Maximus• Action

– Hip Extension– Lateral Rotation of Hip– Posterior Tilt of Pelvis– Largest extensor and lateral rotator of the hip– Primarily contracts during forceful extension or

lateral rotation • Running, jumping or climbing stairs

• Integrated Function:– Eccentric deceleration of hip flexion and medial hip

rotation– Assists in dynamic stabilization of the sacroiliac

joint and lateral knee via the iliotibial band

Hamstrings• Semimembranosus

• Semitendinosus

• Biceps Femoris

(Long Head)

• Biceps Femoris

(Short Head)

SemimembranosusOrigin

• Ischial tuberosity

Insertion

• Posterior surface of medial condyle of the tibia

Action

• Extension of hip

• Flexion of knee

• Posterior tilt of Pelvis

SemitendinosusOrigin• Ischial Tuberosity of

Pelvis

Insertion• Anterior and medial

surface of the shaft of the tibia just below the condoyle

Action• Extension of hip• Flexion of knee• Posterior tilt of Pelvis

Biceps Femoris (Long Head)Origin• Ischial Tuberosity of

PelvisInsertion• Head of the Fibula

(lateral)Action• Extension of Hip• Flexion of knee• Posterior tilt of

Pelvis

Biceps Femoris (Short Head)Origin• Linea Aspera of

Femur (on the central shaft of femur)

Insertion• Head of the Fibula

(lateral)Action• Flexion of Knee

Hamstrings

• Integrated Function:–Assists in eccentric deceleration of hip

flexion and knee extension

–Assists in dynamic stabilization of the lumbo-pelvic hip complex during functional movements

–Assists in dynamic stabilization of the tibio-femoral joint

Hip Extensor Exercises• Deadlift

– Single-leg, DB, BB• Squat

– BW, SB, DB, BB Back Squat, BB Front Squat, BOSU, Disk, Single-leg, MB, Free Motion

• Lunge– BW forward/reverse,

DB, BB, SB, BOSU, Disk, MB, Free Motion

• Step-Up– BW, DB, BB, MB

• Hamstring Curls• Prone leg curl, SB,

Standing Free Motion

• Stair Climbing • Running

DB Deadlift• Joint Actions:

– Hip Extension– Knee Extension– Plantarflexion– Trunk Extension

• Primary Muscles Strengthened:– Gluteus Maximus– Hamstrings– Quadriceps– Gastrocnemius and Soleus (Calves)– Erector Spinae

Performing the DB Deadlift• Stand tall, retract scapulas and draw in

navel towards spine while squeezing the glutes

• Important that the hip, knee and toes are tracking in line

• Activate the core-watch for compensation in your client

• Keep arms staight at all times

Performing the DB Deadlift• Lower the weights down as deep as

neutral spine angles can be maintained.

• Ensure no compensations of the knee ankle or hip 

• Return to the starting position, pushing through the glutes (to keep pressure off the lower back) and keeping the head & chest up, this will ensure that pressure is not placed solely on the lower back. 

BB Deadlift

BB Back Squat and BB Front Squat• Joint Actions:

– Hip Extension– Knee Extension– Plantarflexion– Trunk Extension

• Primary Muscles Strengthened: – Gluteus Maximus– Hamstrings– Quadriceps– Gastrocnemius and Soleus (calves)– Erector Spinae

BB Back Squat and BB Front Squat

BB Back Squat• Common Mistakes:

– Heels rise up off the ground causing excessive knee flexion (knees over toes)

– Hyperextending/Hyperflexing the spine

– Allowing the knees to abduct or adduct during the movement

– Forward Lean

• BB Front Squats decrease spinal load (torque, compression, and flexion) and improve back posture

• BB Front Squats are safer than the BB Back Squat

Leg Press Machine• Common Mistakes:

– The potential danger in this exercise is seen when you bring the knees in close to the chest on the eccentric phase. This rounds the lumbar spine and increases the pressure on the spinal discs. The high compressive forces can cause the discs to herniate (rupture)

– Knees over toes

– Shifting of hips or allowing glutes to rise

– Heels off platform

– Knees adduct or abduct

Lunge• Joint Actions:

– Hip Extension, Knee Extension, Plantarflexion• Primary Muscles Strengthened:

– Gluteus Maximus, Hamstrings, Quadriceps, Gastrocnemius and Soleus

• Common Mistakes:– Leaning forward– Knees contacting floor– Pushing off of toes– Rear leg rotates– Increase in lumbar curve

Step-Up• The step should be

high enough to create a 90 degree angle at the knee joint when the foot is on the step

• Keep the spine neutral• Variations include

DB’s, BB and MB• Make sure leg on step

is doing most of the work

Additional Exercises• SB Leg Curl

• Single-Leg SB Leg Curl

Additional Exercises• Seated Chair Scoot

• Knee Flexion with Tubing–Prone

–Standing

• Manual Knee Flexion–Using your hands as resistance

Hip Extensor Stretches