Prolonged sitting and activities like jogging and cycling can lead to tight hip flexors and muscle imbalances which contribute to low back pain. Tight hip flexors create an anterior pull on the pelvis known as an anterior pelvic tilt. This alters posture and also inhibits, or turns off, the opposing muscle group, the gluteus maximus, leading to muscle imbalances. Microspasms or trigger points often develop in the overused/tight muscles like the hip flexors. Releasing the trigger points before stretching a tight muscle can lead to greater improvements in range of motion.
To restore tight hip flexors to the proper length, begin by eliminating the trigger points (microspasms in the muscle) with a medicine ball. A softer volleyball or a basketball can also be used. To release the right hip flexor, assume a prone position on the toes and forearms. The shoulders should be over the elbows and the feet placed wider than shoulder-width apart. Place the medicine ball under the hip joint and just inside the iliac crest (hip bone) of the pelvis. You can control how much pressure is applied by distributing more or less weight onto the left foot. Maintaining a neutral spine, turn the right toe out and roll the ball slowly downward towards the thigh. When you feel a burning sensation or find a place where the muscle does not conform well to the ball, stop and hold that position for 30 - 90 seconds or until the trigger point releases (muscle relaxes). Continue rolling downward toward the thigh or inward or outward releasing any other trigger points. Repeat on the other side.
After releasing the trigger points, perform a static hip flexor stretch to increase range of motion. A kneeling hip flexor stretch works well for this. To stretch the right hip flexor, assume a kneeling position with a 90 degree bend at the left hip and knee. Statically contract the right gluteus maximus (buttocks) and press the right thigh slightly forward. You should also keep the right big toe pressed into the floor. Bring the right arm overhead while keeping the hips aligned and facing forward. Hold the stretch for 10-30 seconds and repeat for a total of 60 seconds of stretching on each side. For those with knee problems aggravated by pressure on the knee cap, another hip flexor stretch may be advisable. Using extra cushioning under the knee may make it tolerable for some. To achieve this, roll up one end of an exercise mat and place the right knee on the rolled up section of the mat.