Bennett Richardson, DPT, PT, CSCSThe iliopsoas is a group of muscles found on the front of the thigh. These muscles work as a team to bring the thigh up and forward (biomechanically speaking, this is known as “hip flexion”).
Due to our largely sedentary lifestyles, many of us maintain extremely tight, problematic iliopsoas muscles. For this reason, it’s critical that everyone implements a PSOAS mobility and flexibility program into their lives.
In this post, I’ll provide some background on the iliopsoas muscle group and outline 10 great starting exercises to loosen up these chronically tight structures.
Iliopsoas 101
As was mentioned in the introduction, the iliopsoas is a group of muscles that flex the hip. Specifically, this muscle group consists of the iliacus and psoas major muscles.
When muscles are in a shortened position for long periods of time, they tend to “tighten up”. This makes it hard to move the hip joint through a full range of motion. Additionally, this tightness can contribute to pain and dysfunction in other, seemingly unrelated joints of the body.
Psoas tightness, for example, will often lead to back pain and problems with the knee, hip, and ankle joint. Loosening up this muscle group will often lead to a reduction (or sometimes even a complete resolution) of these issues.
How to Diagnose Psoas Tightness
As always, you should rely on the professionals to diagnose a medical issue. A physical therapist or physician will often diagnose psoas tightness through a number of clinical tests. One such test is called the Thomas Test.
During the Thomas Test, the patient lies on his or her back, with one leg pulled up to the chest and the other leg hanging off the end of the treatment table.
If the hanging leg is unable to fall to a point where the thigh is level with the table, the patient is said to have tight hip flexors. From there, the clinician can bend the knee to determine exactly which muscles are tight, such as the iliopsoas or rectus femoris.
10 Key Hip Flexor Stretches
The following list includes some of my favorite hip flexor stretches. However, not all of these are appropriate for everyone. You should always be sure to take your time and listen to your body before beginning any exercise regimen. Further, be sure to touch base with a rehab professional, such as a doctor or physical therapist, if you have any specific questions or concerns.
1. Thomas Stretch
Sometimes, a test can be used as a treatment. By simply assuming the position of the Thomas Test, you can get a great stretch for your hip flexors.
How to Perform
- Lie on your back with your right knee pulled up to your chest.
- Keep your left leg straight, with your toes pointed to the ceiling.
- At this point, you may already feel a deep stretch in the front of your left thigh. If not, allow your left leg to hang off of the side of the table, or bed to deepen the stretch.
- Hold this position for 30 seconds and repeat 4 times on each side, once per day.
2. Lunge Stretch
The lunge is a key movement for overall health and mobility. Lunges can be performed for both increased flexibility and strength, which makes them a versatile exercise for many different populations.
How to Perform
- Assume a staggered stance, with the right foot in front of the left (the further forward the lead leg is, the better).
- Bend your right knee and lean forward, keeping your chest high.
- Once you feel a pull in your left hip flexors, hold this position for 30 seconds and repeat 4 times per side, once per day.
3. Bridge Stretch
Much like lunges, bridges can be used as both a stretching and a strengthening exercise. This movement actively pushes the body into an extended position, counteracting the tightness of the iliopsoas muscles.
How to Perform
- Lie on your back with your knees bent and your feet flat on the floor.
- Push your heels into the ground and lift your buttocks in the air.
- Hold this position for 30 seconds and repeat 4 times per session, one session per day.
4. Self-Psoas Release
When you visit a rehab professional, such as a physical therapist, they will often use massage techniques to loosen up your tight muscles. But you can also perform some of these muscle releases yourself at home!
How to Perform
- Place a solid, but not pointy, object on the ground in front of you. A tennis ball works great.
- Carefully, lie down on on the ball with your psoas muscle centered on the ball.
- Using your arms and legs, carefully roll yourself forward and backwar on the ball, or just remain with steady pressure in one spot.
- Repeat this sequence 4 times, 30 seconds each time, once per day on both sides.
5. Frog Stretch
Yoga poses are often helpful for building both mobility and flexibility. The frog stretch is a great way to loosen up both the inner thighs and the hip flexors.
How to Perform
- Lie on your stomach, with your knees out to the sides and your feet spaced apart as far as your hips are. You should look like a frog!
- Hold this position and attempt to “sit” backward by pushing your hips toward your heels.
- Once you’ve found your deepest point of stretch, hold for 30 seconds and repeat 4 times per session, once per day.
6. Half-Pigeon Pose
This stretch doesn’t directly target the hip flexors, but rather the external rotators of the hip. By stretching these muscles, you can make more room for your hip to move backward, thereby allowing for increased ability to stretch your iliopsoas.
How to Perform
- Start on your hands and toes in a pushup position.
- Tuck your right knee to your chest and turn your hip out so that your knee is facing the right and your foot is facing the left.
- Place your right leg on the ground in this position and try to relax your body down as much as you can.
- Hold the stretch for 30 seconds and repeat 4 times per side per session, once per day.
7. Boat Pose
Strengthening the abs is critical for all orthopedic ailments. This isometric exercise helps to increase both balance and strength throughout the body.
How to Perform
- Sit with your feet flat on the ground.
- Lean back and straighten out your trunk, with your arms straight overhead and your legs straight out in front of you.
- Hold this position for 30 seconds and repeat 4 times per session, once per day.
8. Angled Straight Leg Raise
Stretching the iliopsoas is key, but strengthening it is also critical. This move helps to increase the strength of the hip flexors and surrounding hip/core musculature.
How to Perform
- Lie on a table or bed with your right leg hanging off the side.
- Raise your leg up and across, keeping your thigh as straight as possible.
- Repeat for 3 sets of 12 reps, once per day on each side.
9. Standing Knee Tucks
Standing balance and strengthening exercises are excellent for overall physical function. This move accomplishes many different goals all at once!
How to Perform
- Stand on your left leg and tuck your right knee to your chest.
- Hold this position for 30 seconds and repeat 4 times per side.
- Complete this movement once per day.
10. Straight Leg Raise
Straight leg raises are a mainstay of many different physical therapy programs. This move strengthens the abs, hip flexors, and various other muscles in the area.
How to Perform
- Lie on your back with your right knee bent and foot flat on the floor.
- At the same time, straighten out your left leg.
- Lift your left leg up in the air, then slowly return it to the ground to complete the rep.
- Perform 10-12 reps for 3 sets per session, 1 session per day.
Conclusion
The iliopsoas muscle is problematic for many people. If this muscle becomes tight, the person can experience back pain and movement-related problems. But with some dedicated stretching and strengthening exercise, anyone can overcome these issues and lead a healthier, pain-free life.
However, if you find that your pain or other issues related to your hip flexors is not getting better with stretching and strengthening on your own, be sure to visit your healthcare provider ASAP.
Works Cited
- Lakkadsha TM, Qureshi MI, Kovela RK, Saifee SS, Lalwani SS. Efficacy of Single Stretching Session of Iliopsoas Using Proprioceptive Neuromuscular Facilitation Versus Muscle Energy Technique on Low Back Pain in Patients With Lumbar Hyper-Lordosis. Cureus. 2022 Aug 12;14(8):e27916. doi: 10.7759/cureus.27916. PMID: 36110466; PMCID: PMC9464355.
- Vigotsky AD, Lehman GJ, Beardsley C, Contreras B, Chung B, Feser EH. The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled. PeerJ. 2016 Aug 11;4:e2325. doi: 10.7717/peerj.2325. PMID: 27602291; PMCID: PMC4991856.
