I'm willing to give the benefit of the doubt here and assume the presenter was not only misunderstood but misunderstood by several smart, mature and thoughtful teachers. But just in case, it's good business to remember that just because someone is presenting does not mean they know what they're talking about. Credentials and experience matter. Backgrounds matter. Be discerning and don't let anyone talk you out of using your good old common sense.
That said, this whole hip flexor thing is really quite overlooked in our profession.
I made it through Romana's training with nary a whisper about them. And, the training center I went to was owned by two women, one of whom holds a Masters in Physical Therapy. You'd think she could have taught us a little bit about hip flexors, but no. And that's pretty typical, sadly, even in what I consider to be excellent schools.
I've had several other first-hand experiences witnessing the type of confusion caused by misunderstanding hip flexion, one most notable as follows.
A couple of years ago I took a gross anatomy class at our local naturopathic university and in the class there were several other Pilates teachers, a few massage therapists and a doula. Four Pilates teachers, a doula and 22 cadavers walked into a lab . . . Wait!
As we stood around the open abdomen listening to the anatomy professor give us the 411 on the ilioposas, one of the other Pilates teachers - who happens to have completed one of the Seattle area's most respected teacher training programs - asked, and I quote, "so how do you not use the hip flexors?"
I can honestly say I never in a million years expected to have to restrain myself from picking up a large intestine and slapping someone upside her head, and yet . . . .
Let us pray.
Lord have mercy on us all. As if this brilliantly and elegantly simple work is not made difficult enough by the neurotic overlays of each of us teachers, each of our clients and of our fitness and health industry as a whole, perhaps our greatest struggle is with those who spew nonsense while the masses stare in silence, assuming the weakness is with them. Lord, help us all, but specifically help me, help me know what to believe, help me know what to do, help me know who to trust. Lord, the Pilates repertoire is chock full of hip flexion and it's imperative to my sense of personal peace, my ability to serve others, my professional success and my emotional well being that I understand the truth about hip flexors. In your name I flex my hips, Amen.
Back in Hollywood, I think I satisfactorily cleared this up on the spot but I couldn't wait to get home and write about this so next time someone puts forth the thesis that hip flexors are something not to be used, you'll know exactly what to do.
Hip Flexors: What are they & why we need them
People of the Pilates world, we cannot get out of our hip flexors. We can't. Hip flexors bring the femur forward. If we don't use them, we don't sit, we don't walk, we don't climb stairs, we don't ride a bike, we don't run for the bus, we don't do Teasers. And I ask you, who among us is willing to live like that? Who? Perhaps the presenter who was so terribly misunderstood? I suggest she try it and get back to us.
Hip Flexors and Fight or Flight
Making matters even more confusing, there are well-funded, highly successful presenters who hold psoas workshops all over the globe wherein they teach you to release your psoas muscles from assumed restrictive and debilitating emotional bondage. Forget Tibet, free your psoas!
Well, even though I hate brevity in all forms, I'm going to nip this next part down to the bare essentials because for our purposes, it's only important that you know generally the reasoning behind this theory. For a more detailed description, here's a pretty good website that explains it in much more thorough detail. http://www.thebodysoulconnection.com/EducationCenter/fight.html. It's worth a read, but here's my condensed version just to give you the gist of it.
Generally, the reason some folks think the psoas is a reservoir for negative emotions is the hip flexors are part of the fight or flight response, wherein our bodies respond to traumatic events by prioritizing biological service to various organs and muscles to prepare us to either get the hell out of Dodge or open a barrel of whoop ass. If we actually flee or fight, the response is appropriately used up and we're left exhausted but also cleansed in a metabolic way by the intense physical act the chemistry prepared us for so well.
The problem is when we have the response (road rage, anyone?) but don't fight or flee. All that chemistry is released into our system but never gets appropriately consumed. Please remember that this is a very simplified explanation which in no way is intended to disrespect the trauma experienced by many victims of violence. You may teach for your entire career and never work with anyone who routinely goes through this cycle. If your clients are pretty good at managing stress, this will not be a problem for them or for you. I mention it only so you'll be aware of the reasoning behind the theory and only you can know if it's appropriate for you to do more reading so that you can understand your clients who may have these issues.
One of the most beautiful aspects of Pilates is that it doesn't really matter why something might be tight or malfunctioning, the work - well taught and well practiced - fixes it. God bless Joe & Clara!
Function & Finding
Back to the hip flexors and how they work.
Let's start with the basics, because in Pilates if you start at the beginning and make absolutely certain you're solidly in charge of the basics, you're pretty much golden. In this case, the basics are going to be ultra simplified but if I do my job well, you'll still be able to understand what muscles make up the hip flexors and how they work.
First, you've got to see what we're talking about.
Google anatomy websites and take your pick. Here are a couple of super simple ones: http://innerbody.com/image/musc08.html or http://www.fitstep.com/Advanced/Anatomy/Hip_flexors.htm.
The hip flexor muscles are the psoas, iliacus and rectus femoris and, in layman's terms, I'll talk about each one. For all you anatomists, I know the sartorius and TFL are also hip flexors but as such, they're minor players so I won't be discussing them at length here.
The way I'm going to set this out is similar to the way I talk about hip flexors in my Pilates 101 lecture for clients (http://www.pilates-pro.com/pilates-pro/2007/2/14/pilates-101-for-new-clients.html, but here, I'm going to intersperse comments just for you, my fabulous Nun-reading teachers. I won't have the pictures to show you (permission not requested, permission not granted) so you'll have to get pictures on your own from your favorite anatomy site, then follow along.
Here we go!
Psoas / Iliopsoas
First up, the granddaddy of hip flexors, the psoas.
The psoas is the primary hip flexor, you have two of them, they're completely separate and independent muscles, at the top they connect on either side of your spine from T12 all the way down to L5, then they run unattached through the pelvis, out through the bottom and connect to the lesser trochanter through a common tendon along with the iliacus muscle. Because it joins with the iliacus at the lower attachment, its name morphs to "iliopsoas" when referring to it at the lower attachment.
The psoas is the great unifer of the body, it connects your spine to your legs. Partnering with the multifidi in forming the quad-towers of support for the low back, the psoas muscles should be balanced, strong and long. I think of them as a low back's best friend, the heavy lifter, a great supporter and smart, to boot - it can act on a single vertebrae.
When clients are significantly strength biased on one side, the pull of the stronger psoas on the spine can be painful and cause all sorts of bio mechanical problems including tucking the pelvis under and pulling the leg up. Yikes! When clients are imbalanced, every Pilates exercise should help strengthen the weaker side, all the way down to the psoas, but you're only going to work that effectively IF you're able to teach the client how to engage more intensely on the weaker side than the strong one, just to be even.
Many exercises can be broken into single sided in order to help aggressively fix the imbalance - come see my Balancing the Body Side to Side at Pilates Style in Chicago! - but even on the bilateral exercises, you should lead your client to work harder on the weak side than the strong one. You'd be surprised how many form and sustainability problems can be fixed, completely, when the weaker side is made to come to the party, be the center of attention - get up on that table and dance! - and stay until the bitter end.
Back to the function of the psoas. When you see an athlete lift her leg up along side her head and keep it there, she's doing that from her psoas muscles. Think of the lever, the angle of pull, and you'll understand that you can't get your leg above the hip without using the psoas. In Pilates, knee floats and stirs are usually the easiest way to find the connection to your primary hip flexor. You'll feel the psoas working like a pulley or fishing reel, deep inside and toward the back of your abdominal cavity.
Iliacus, Ilioposas
Next in line, but not literally, is called the iliacus and again, you have two of them, they're glued down all around the inside of your ilium bones, the big hip bones that marry into the sacrum around back. Not so functional in feel because your hips move essentially as one unit, the iliacus muscles run through the base of the pelvis and join with the psoas through a common tendon at the lesser trochanter. Another great unifer of your body, iliacus muscles connect your pelvis to your legs. These muscles undergo the same name change as the psoas muscles do, and are called iliopsoas at the trochanter attachment.
Rectus Femoris
Lastly, this hip flexor is the black sheep of the hip flexor family, it's the top quad, the rectus femoris. The other 3 quads connect at the front of the trochanter well below the hip socket, but this most superficial quad connects at the top at the AIIS, the lowest front notch of your hip bones. That means, it does cross the hip socket and because of that, it can act on the hip joint but it only just barely crosses the joint and that tenuously brief crossing is part of the problem in using it as a primary flexor. At the bottom, it connects along with the other 3 quads below the knee cap.
The job of the rectus femoris is two fold; it combines with its 3 quad brothers to extend the lower leg - that's the primary job of the quads - and when pressed into action because the more appropriate hip flexors are off the job, it will bring the hip into flexion, but only so far. Remember, a muscle cannot pull beyond its attachments and this black sheep rectus femoris attaches at the AIIS, not high enough to be your best friend in helping hold your legs up on your Teasers, throughout the Stomach Series or in any of the zillion other Pilates positions where our legs are up and out in front. It can't.
What's more, quads fire as one and when a client (or you?) feel that deep hip crease fatigue, which is soon followed by failure, it's almost always because you've backed out of your primaries and are trying to use the black sheep to do the heavy lifting. Compounding this problem, in many Pilates exercises the quads are already trying valiantly to do their real job which is extending the lower leg.
Tight hamstrings anyone?
On exercises like Teaser where our legs are straight (they're straight, right?) and lifted, the quads are working to keep the legs long and they're pulling against the tightness of the hamstrings. While that battle is playing out, it's the deeper hip flexors that should be tasked out on delivering the femur to the proper angle and keeping it there. If you lose your connection to your primary hip flexors on any of the straight-and-lifted-leg Pilates exercises, your quads will take over completely and it's a matter of a quick second or two before your form blows up and you're done. It reminds me of the old Steppin' Wolf lyric "fire all of the guns at once and explode into space" . . . that's pretty much what it feels like to torch your quads.
Let us pray: Lord, my hamstrings are so tight that I cannot straighten my legs on Teaser and I have no idea how to use my hip flexors. This bothers me. My teacher has told me that eventually my tight hamstrings may pull my back down and cause me to be in pain. My teacher also told me that every step I take will be easier, lighter and more efficient if only I can learn how to use my hip flexors. I really want to do that, Lord, but I need your help. Specifically, I pray you'll help me find the 5 minutes a day I need in order to properly stretch the hard working muscles in the back of my body and to practice knee floats and stirs. I know the stretching studies show that holding a proper stretch for 30 seconds results in the same muscle fiber length gain as those who held the stretch for 2 minutes, and Lord, I know you know that, too, but my point is, I really only need to carve out a couple of minutes of time in order to get this terrible tightness out of my body and a couple more to practice knee floats and stirs. Sound good? I pray you'll arrange for me to find easier parking, that express and empty elevators will be awaiting my call, Lord, make it so the people in front of me in line at Starbucks only order drip and that my copiers run out of toner and/or paper just after I've finished using them. Any single or combined circumstance as mentioned would certainly provide me with the time savings I need in order to discover my hip flexors and stretch my hamstrings. Lord, I pray you'll show mercy on me and help me help myself. Amen.
Educating Clients
You'll find that even the most body savvy client, unless they've had a hip flexor injury, won't have a clue where these muscles are located and what they do. Almost everyone through the door thinks their hip flexors are in the front of their thigh. It's your job to educate them about where these muscles are, what they're for, how they work and, best of all, get them using the right tool for the job.
Most assuredly, finding your primary hip flexors is key to proper form, endurance and mastery of any Pilates exercise. And now, hopefully, you're beginning to get the idea of how these muscles work and that using them is unavoidable and that the client's lack of connection to them is a barrier to the work and, here comes the caboose on this train of thought, how do we, dear Teachers, lead our clients to this difficult and elusive engagement when so many of us do not understand hip flexion and what, honest to Pete, are we supposed to do when we try to learn about it but we end up listening to people who do not understand hip flexion themselves. I ask you, what are our chances of success under these circumstances?
They're non-existent. And that makes me mad (but well beneath the fight or flight response!), then sad, then motivated.
We're going to try this, but I'm not sure it's going to work. I wish, I wish, I wish I could show you this so you'd be certain you're doing it right . . .it's a foolproof way to lead your clients to find, feel and develop their hip flexors versus their quads.
I call this Separation of Church and State. Bear with me:
Sit balanced on the back plates of your hips just like if you were preparing to Roll Like a Ball, cross and grasp your forearms underneath your lower legs, draping your lower legs over them, pulling your knees and thighs into your chest using your upper body strength. Legs are released over the forearms, lower legs dangling. Got it?
In this position, your quads are essentially off because your lower legs are dangling and, with your forearms crossed under your knees holding your kneecaps up toward the ceiling, your upper body strength is doing the work of your hip flexors. Slowly, and I mean s-l-o-w-l-y (haste lessens sensation!) decrease the support of your upper body but leave your legs in the same position with feet dangling toward the floor but not touching it, and once you're no longer holding your own legs up with your arms, put your awareness deep into the backside of your abdomen, on either side of your spine between your hips and ribs and . . . do you feel it? Amanda, meet your psoas!
Now, use your upper body strength to hold up your legs again, and make sure everything that can be off, muscularly speaking, is off. Keep holding your legs up with your upper body strength and straighten one leg and . . . . do you feel it? Courtney, meet your quads!
Lower that leg and take a quick break. Straighten the other leg and . . . there they are again. The gunk you feel on the front of the thigh of the lengthened leg are your quads.
Now, regroup, reset the original position, slowly withdraw the support of the arms so the hip flexors turn on, then slowly straighten both legs. Once the torso and legs are both lifted, place the arms parallel to the legs. I call this Sneaking Up On A Teaser, and it's a great way to separate out the primary tasks involved in sustaining the sit-up-in-the-air that is my favorite exercise, Teaser.
In Conclusion (I miss you already!)
Have you had enough of hip flexors? Did you get down on the mat and practice knee floats and stirs looking for them? Have you separated Church and State? Does this make sense? Does this help?
M'dears, in the words of my #1 mentor, Ron Fletcher, you can't give what you haven't got.
We absolutely must understand how to bring our legs forward, straighten them, hold them up high and keep them there. There's no success in this work without that skill.
Get busy and figure it out, call or write with questions, keep practicing and it will come. I promise.
Flex your hips for Jesus!