The anatomy of tightness in hip flexion has two main aspects;
1. Psoas tightness
2. Rectus Femoris tightness
This exercise addresses tightness of the rectus femoris (RF) which attaches at the anterior inferior iliac spine. The RF is the only quadricep muscle which crosses the hip joint and when it is tight it can inhibit the action of the other quadricep muscles and cause low back and/or knee pain.
The reason RF tightness can cause low back pain is because its proximal attachment to the pelvis, causes an anterior pelvic tilt and therefore an increase in lumbar lordosis. Quality lengthening of the RF has the capacity to bring the feeling of space and ease to both the knee and low back.
Figure 1. shows that when hip flexors are tight and facilitated, it concurrently creates tightness in lumbar extensors, while inhibiting the action of the lower abdominals and hip extensors. Professor Janda termed this pathology of the locomotor system; ‘Lower Crossed Syndrome.’
Exercise No. 17. Rectus Femoris Lunge
- Place your right instep and shin against the wall, or hook it over the top of the mattress, place your knee underneath this in line with the right hip, if your quads are very tight place the knee further out from the wall.
- Have the left leg in front in a lunge position with the front knee lined up with the hip.
- Square the pelvis, front/back and left/right and keep a push pattern through the weight-bearing knee, as though it was your foot.
- Lengthen the spine and bring the chest position down, ensure that the head is reaching forward and up. It is important to maintain intra-abdominal pressure within the cylinder of the abdominal cavity so that the shoulder and pelvic girdles are communicating from inside via this positive pressure.
- Kick the instep into the support surface on an in-breath and feel that you go back and up with the spine and pelvis on an exhalation.
- This position is an important re-programming in the way that the quads talk to the pelvis. It is important to move from tensing the quads to stabilize the pelvis to be being able to feel pelvic floor activation working with the thoracic diaphragm, so that hips are free to move the body.
- Repeat Contract/Relax 5 times.
- Repeat the exercise to the other side.