Hypermobility is encouraged in yoga, dance, and gymnastics. But if you’re naturally flexible and are someone that has no problem reaching – or reaching past – your toes, you may be just as susceptible to a hip pain as someone who regularly experiences hip flexor tension and/or lives a sedentary lifestyle.
In fact, you can actually be too flexible. And, yes, your stretching may be causing hip pain.
Let me explain.
You have two large muscles that are central to the movements you do every day. Your psoas muscle and iliacus muscle sit side by side and run from your spine to your pelvis to your thigh. Together, they are called the iliopsoas muscles, and they allow you to sit upright in your chair, drive a car, go for a morning jog, balance on a high beam, do a forward fold, learn a new four-count, and more.
The iliopsoas is in a compressed position when you bend forward, sit down or pull your knees up. And, for many people with tight hips or hip flexor pain, it’s a result of keeping these muscles in that shortened position for too long. It causes your iliopsoas to hold that position – sometimes even after you straighten your legs or stand up.
If you’ve ever felt stiff in your hips after a long day at your desk, this is what’s happening. Parts of your iliopsoas have not effectively relaxed after use, and they continue to pull on your pelvic bone and spine.
This whole idea of opening up the hips and creating more space in the hips is an idea that is useful for people who have a lot of tightness. Some of us tend to be really stiff and tight and need more flexibility, and yoga is a great form of exercise for those kinds of bodies.
In contrast, those who are already really mobile and can easily get into a deep lunge or fold forward with their hands to the ground already have a very flexible hip and do not need their hips opened more.
In fact, hips are designed to be stable and when they become too loose, your muscles tighten up to try to keep you from falling apart. It seems counterintuitive, but in this situation, a tight iliopsoas muscle is the result of your body trying to stabilize itself after overuse or too much mobility.
Let’s take a closer look at what’s happening in your hips as a very flexible person.
What causes hip injuries in yoga, dance, and gymnastics?
People who are naturally inclined to be more flexible may find themselves drawn to sports and activities that let them highlight that strength and continue to strive for a deeper stretch. If you’re a dancer, gymnast, or yogi, you probably have those “goal postures” you are working toward, like the splits, a deep pigeon pose, a flatter forward fold, or kicking your legs up to your nose.
And, when that’s the goal, more flexibility is revered.
However, these extreme motions are well past a normal range of motion for your body. They bring the lower back, hips, and pelvis into positions that are outside of what these joints are really designed to do. And, though they may be accessible to you, repetitive motions, swift movements (such as when dancing), stretching unevenly from side to side (if you favor one side over the other for the deeper postures), and continuing to move into these deep stretches day after day can and do strain your joints and the tissue that holds those joints together.
Even when you take out the swift extension and compression of your muscles, such as in gymnastics or a dance routine, you can still stretch too far. People sustain some of the most common yoga injuries because they are pushing past hip tension. What feels like a sense of accomplishment and that oh-so-sweet depth is setting the stage for problems early on.
This is why most people end up with yoga injuries after about 5 years of practice. Too much mobility has been developed.
With too much mobility, long-standing tension in the iliopsoas muscle develops. It is tightening its grip around your pelvic bone, hip joint, and spine in order to stabilize your core during a stretch or movement.
You see, your iliopsoas muscles are designed to protect your tendons and joints in this region, this is their primary job, so when you’ve created an unstable area to protect, they rise to the occasion.
Your iliacus muscle crosses over the hip joint, attaches directly to the pelvis, and affects the SI joint. The psoas crosses over both the hip joint and the pelvis all the way to the spine. Normally, your iliacus and psoas are responsible for moving these bones – I like to think of them as “puppets.”
But when your muscles become fatigued and are faced with the job of keeping this area from falling apart, they choose to contract and develop knots and tension that stays there not just during your yoga practice, but throughout your life.
This constant tension results in this part of the body taking on more stress and friction than it was designed for.
Furthermore, constant tension in the iliacus and psoas pulls on the pelvic bone and spine, changing the alignment of the hip, SI, and spinal joints and that mechanical change works its way down to the feet and up to the head. Because these muscles are at the core of your body, they affect everything else around them, even creating tension in other muscles in the glutes, hips, and spine that end up playing tug of war with them.
Therefore, that hip flexor pain or tension you feel is really a signal from your iliopsoas that you’ve gone too far. If you push past what your joints are meant to do, you may be inviting a dance, gymnastics, or yoga injury.
Three common hip problems due to hypermobility
There are various injuries or disorders that can cause a dancer, gymnast, or yogi to experience hip pain. I chose to focus on the three most prevalent problems I’ve seen happen in stretching sports.
Hip impingement, or femoroacetabular impingement (FAI), occurs when the hip joint movement becomes restricted by the abnormal contact between the ball and socket bones.
A hip socket (acetabulum) is usually quite deep, stabilizing the ball of your femur during movement. This ball and socket joint is reinforced and protected by a lining and ring of fibrocartilage.
When there is a change in shape (such as with a bony growth or genetic malformation), a misalignment from the bones being pulled on by the iliopsoas muscles, or excessive use of the hip joint (such as in ballet) it causes unnatural friction. Movements can become extremely painful and piercing, which eventually restricts movement.
To maintain a high intensity of hip mobility during dance, gymnastics, or yoga, many female participants actually have very shallow hip sockets. This could prevent them from ever experiencing hip impingement, but it could cause hip dysplasia instead.
Whereas a deep hip socket adds structural integrity to your movements, a shallow hip socket can create instability and put added stress on your hip flexor muscles. Athletes with hip dysplasia rely very heavily on the labrum (fibrocartilage) and soft tissues around the hip during movements like flexion. Because of this inherent instability in the joint, the muscles around the hip often present with excess tension to compensate.
Most dancers or gymnasts that have hip dysplasia may indeed be very flexible, but they are also more likely to experience a labral tear, hip flexor tendonitis, and cartilage damage as well as the host of issues that come with a chronically tight hip flexor.
We often associate arthritis with old age, but early-onset osteoarthritis has increasingly become an issue among young gymnasts, dancers, and avid yogis. There is evidence to suggest that young, athletic people develop it due to consistent stress and overuse of their hip joints.
For example, a grand plié in dance or a malasana (garland pose) in yoga are both movements that require an extensive range of motion within the hip region. Other movements similar to this can further increase the severity of hip impingement or another hip injury (i.e., labrum tear), leading to osteoarthritis at an early age.
Hip impingement is such a big player in osteoarthritis development because osteoarthritis occurs due to the wear of cartilage tissue in your joints. As cartilage is damaged, and additional friction is applied, osteoarthritis develops and worsens with time.
If you are experiencing early symptoms of these hip injuries – or have already been diagnosed – it’s time to gain more stability before returning to those deep postures and swift movements.
Seeking stability and balance for your iliopsoas muscles
The idea of balance, both mind and body, is well-touted in yoga, dance, and gymnastics. However, we often forget what that looks like in regards to our iliopsoas muscles.
As a very flexible person, the solution may be the opposite of others experiencing hip pain.
The mainstream thought is that, if you are experiencing hip tension, a nice hip opener or yoga for tight hips may help. And hip flexor stretches are very valuable for someone who isn’t experiencing or using their full range of motion yet.
Ironically though, a very flexible person may only experience more hip tightness as they continue stretching.
That’s because those who are already really mobile and can easily get into a deep lunge or fold forward with their hands to the ground do not need their hips opened more. What you need is stability and strength in and around your psoas and iliacus muscles.
Now, you may have just learned what your psoas and iliacus muscles are. However, if you regularly partake in a sport that requires deep stretching and hypermobility, you can seek balance by slowing down, listening to your body, introducing stability exercises and learning how to release your hip flexor muscles.
Four yoga injury prevention tips to help you avoid hip flexor pain and tension from overstretching
The good news is, most hip-related gymnastic, dance, and yoga injuries are preventable, or at the very least manageable.
But it can be challenging to navigate the sensations you are feeling in your hip flexors – and to know whether you need more or less stretching. Here are some general tips and practices to abide by in order to enjoy your next gymnastic competition, dance practice, or yoga flow pain-free.
1. Perfect your technique, form, and feel
Many dancers and gymnasts start at a very young age. This can be both good and bad for technique. If you had a competent teacher during that time, they would have corrected your technique.
However, that is not always the case.
I have seen clients doing a stretch incorrectly for years, even causing damage, because they didn’t clearly know what they were supposed to feel. Many people who begin stretching or want to become more flexible view tension and slight pain as a sign that their efforts are paying off or they are working new muscle groups.
You know, “no pain, no gain.” But when it comes to your hip flexors, that could not be further from the truth.
If you are feeling pain or tension in your postures and movements, it’s time to re-evaluate your form and become aware of any bad habits you’ve picked up. Understanding what kind of sensation you should be feeling with a certain motion and where will help you evaluate if you are feeling something you shouldn’t.
For example, if you are in a deep hip flexor lunge stretch and you feel a stretch in the muscle in the front of your thigh and front of your hip, that’s an appropriate sensation for that motion. In contrast, if you feel a sensation in the back of the hip or your spine, that’s not good. Similarly, a deep, dull pull in your hip joint could indicate that you are stretching your joint capsule and not a muscle. Joint capsules are not supposed to be stretched.
This may mean enlisting the help of a new coach or teacher. And it may also mean backing off deeper stretches and advanced motions until your body can re-learn what the correct feeling is.
Slowing down to identify and correct improper technique or form will be only a temporary setback that wields long term success and may even prevent an injury.
2. Listen to your body
All of us have a different composition of collagen (the connective ‘stiff’ part of your tendons and muscles) and elastin (the ‘stretchy’ counterpart of collagen) in our bodies, as well as a unique ball and socket shape in our hip.
That means that a leap, hip flexor stretch in yoga, or plié will look a little different from person to person.
Chip up, buttercup, that’s perfectly okay and natural!
When you hold a yoga pose or perform a dance routine, your body will sometimes communicate with you. These messages of slight pain or a sudden loss of strength are not to be ignored.
For example, if you are in pigeon pose or performing a deep hip flexor stretch during yoga, and you begin to feel pain, do not just breathe through it and hope for the best. That is your iliopsoas or joint speaking up and telling you that your body is not ready to be stretched that deeply in that moment.
You may simply need to take it easy that day or invest more time in your warm-up routine. But, if ignored, stretching too intensely can easily cause a muscle strain, tear, or increased hypermobility of the hip muscles.
3. Balance your strength training
Ah, that word balance again.
It’s so important to make sure you are stretching and strengthening your muscles in equal and opposite ways. For example, if you favor one leg when going into a cartwheel, make sure you are also strengthening your other leg. And, when you do a forward fold, balance the movement with a sphinx pose or similar movement that stretches the front of your body.
Your psoas and iliacus muscles are quite capable of holding you and propelling you through poses and dance moves. But, that doesn’t mean they should bear the brunt of the force alone. Stronger glutes, thighs, and abdominals will help stabilize your core even more.
Keeping these muscles evenly conditioned with cross-training will help your body spread out the impact of explosive dance moves and deep stretches.
4. Know when massage isn’t enough
Massaging and tending to sore or tight muscles is important for rest and recovery. It can help break up scar tissue from prior injuries, increase muscle circulation, and relax your mind after a difficult workout.
As an athlete, you’re probably no stranger to professional sports massages as well as self-massage techniques such as foam rollers, balls, and other tools that move or vibrate. However, if a tight iliopsoas has already caused a trigger point or muscle knot, massaging that part of your muscle will likely activate and aggravate it further.
This can actually worsen your hip pain from stretching.
If you’ve reached this point, only a full release will help you get the relief you are looking for.
To do this successfully on your own, you will need a tool like the Hip Hook – or a skilled practitioner – to locate the exact spot where your iliacus muscle connects to your pelvic bone. That’s because your hip flexor muscles are considered inner muscles, and can be very difficult to locate with your own hand. Additionally, a full release requires a precise amount of pressure at a particular angle that you can’t achieve by just lying on a particular tool.
The Hip Hook replicates the motion of a skilled physical therapist, using only your body weight and a lever to apply pressure to and encourage a release of the psoas and iliacus muscle.
This tool and technique is crucial to not only the health of the psoas and iliacus, but for happy hips, SI joints, pelvises and lower backs. Keeping the hip flexor muscles relaxed as you continue with these hypermobile activities, can prevent or help heal injuries in these areas as well as issues up or down the kinetic chain, head to toe.
In addition, happy hip flexors, the Hip Hook actually helps with performance enhancement in dancers, yogis, and gymnasts. When these muscles are not holding tension, it allows for the hip flexors and all the muscles around them to be strong and mobile.
So if you are working on a deeper split, releasing your hip flexors with prolonged pressure using the Hip Hook will stop the tug of war with the hamstring, for example, and allow for a deeper split.
If you are a seasoned gymnast, dancer, or yogi, it may take a bit more time to get to the level of release and pain-free movement you want. However, this is a natural remedy to hip pain that you can practice daily before and after your practice to promote a happy, healthy, and flexible iliopsoas muscle.
Take time to learn more about hip injury prevention
Having a hyperflexible hip can feel like both a blessing and curse. But when your hips start to develop a problem, it is not something to take lightly. Listen to what your body is telling you, and take steps to prevent future hip pain from stretching.
Empowering yourself with accurate information about the anatomy of your hip muscles, tendons, bones and joints, learning more about the correlation between stretching and hip pain, and practicing movements that balance the more flexible postures with strengthening can help ensure your dancing, leaping, and downward dog-ing for years to come.
Want to keep learning? I talk about issues all these issues and more – and provide multiple solutions that I’ve seen work after years of being a physical therapist in my book, Tight Hip Twisted Core: The Key to Unresolved Pain. Interested in the Hip Hook? See why professional dancers all over the globe are excited about it!
Frequently asked questions about hip pain and hypermobility
Can hypermobility cause hip pain?
People who are hypermobile or are very flexible have the ability to move their joints beyond a “normal” range of motion. Their surrounding muscles, tendons, and ligaments may exhibit more laxity where it makes the hip joint less stable. This instability can increase the likelihood of pain or injury when moving within those extended ranges of motion.
How can I prevent injuries if I am hypermobile?
To prevent injuries if you are hypermobile, it is important to work within a range of motion that you can actively control. This idea focuses more on strengthening your muscles at your end ranges of motion instead of stretching. Examples of this could be shortening your stance during yoga poses or reducing the depth on your squats, moving slowly and with control to ensure that your muscles are engaged to support you in those positions.
Should I stretch if I am hypermobile?
If you are hypermobile, the muscles and joints in your body are already very flexible. Continuously stretching can lead to over-stretching, which makes your joints less stable. The surrounding muscles may respond by holding tension in an effort to protect the body and create stability. While some stretching can still remain a part of your routine, you may experience more benefits in how your muscles and joints feel by adding in more strengthening and muscle release.