To Stretch or Not to Stretch Hip Flexors (Part 2)
I wrote on Tuesday that you may not have to stretch your hip flexors, even if they feel “tight”. I also showed how easy it is to screw up a hip flexor stretch. If you missed it, make sure to read it HERE. But how does someone knows if he needs to stretch his hip flexors if we can’t rely on the fact that they feel “tight”? Those who are familiar with muscle testing a bit will say to use the Thomas test (or one of its variations) to assess hip flexor length. The Thomas test is a commonly used test among strength coaches, physical therapist and other rehab/training professionals. Here is what it looks like:
By letting one leg hang down, you can usually know if the person has short/stiff hip flexors if the knee of the down leg hangs higher than the hip. In the case of a shortness in the rectus femoris the knee will also stay extended over 90 degrees of flexion. A positive Thomas test (knee staying above hip level) usually is good indications that your hip flexors are short or stiff, but as I mentioned before it might mean that the problem is neurological, and stretching your hip flexors won’t solve the problem. To add to the confusion, a negative Thomas test (knee dropping all the way down) doesn’t mean that your hip flexors aren’t short/stiff. It could mean that your anterior capsule and ligaments are overstretched. One way to prevent this is to make sure that you stretch your hip flexors the right way, like I mentioned in my last post. But how do you know if it’s a capsule/ligaments issue or not?
Using the adduction drop test in conjunction to the Thomas test might be a good option. Here’s what it looks like:
The adduction drop test is something I picked up from the Postural Restoration Institute. They commonly use this test to identify what is called a left AIC (Anterior-Interior Chain) pattern, which implicates that most human beings are stuck in external rotation and abduction, and hip flexion in the left hip. The combination of a positive adduction drop test and a positive Thomas test usually points in the direction of a left AIC pattern because of the lack of hip extension and adduction on the left side.
We can also use the combination of these two tests to identify anterior capsule and/or ligament laxity. A positive adduction drop test and a negative Thomas test would be indication of anterior laxity in the hip capsule and/or ligaments.
Assessing before you prescribe a hip flexor stretch and making sure it is performed correctly if you need to prescribe it are the two keys here.
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