Tight Hip Flexors

Hamstrings (Pt. 2) – Controlling Knee Flexion

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  acl, frc, hamstrings, hip extension, hips, knees, Physical

In part one of this series, we tried to resolve hamstring tightness by adjusting the pelvis and degree of flexion in the hips.  The goal was to get the leg straight with varying closeness of the thigh to the chest.  This post focuses on the opposite movement, controlling knee flexion or getting the heel to the butt.  Hips extended, can you strengthen and control how your hamstrings make the leg bend?

If you’ve ever injured your ACL or had a reconstruction taken from the hamstring (like I have), the ability to get that hamstring fully functional is critical to avoid re-injury or residual knee pain.  The hamstring is an ACL antagonist.  Tissue mimicry aside, restoring the anterior cruciate ligament at the cost of the muscle that most protects the knee definitely has it’s detriments.  It’s like trimming down the bicep to save the elbow.

To overcome this oversight, practice terminal knee flexion.

Terminal knee flexion is defined by how well the hamstring can flex the knee (near it’s end range of motion) while the hip is extended. 

 

*hip extension means the leg drifts behind you
 

A progression might look like this:
1.  Lying on your stomach
2.  Lying on your back, from glute bridge

Note that the toes are pointed to minimize shin/calf involvement.  
We’re looking to isolate the hamstring in both strength and control.
Lying on your stomach hip extension is neutral, as in standing.  Bridging puts the hips into extension.
My left leg is the one that had ACL reconstruction.
You can easily see the range of motion deficit by comparison.
3.  Half-kneeling, rear-foot elevated
Dean Somerset taking a page from Functional Range Conditioning**
Hip is passively extended – the floor helps hold it here
Knee begins in partial flexion and the task is to control the end range contraction
**Dr Andreo Spina’s marvelous system on joint control and function
4.  Standing Full, Standing Partial
Here you have to work to keep the hip from flexing – active extension.
The left leg attempt is all sorts of wonky.  
You can see the hip and torso flex and the lower leg rotate to get over the bar.
5.  Full Knee Flexion, Hip Extension Off Bench
Less of a hamstring movement and more of a hip flexor stretch, 
this works the hip in the desired end range of motion, heel to butt. 
 Driving the hips forward maximizes hip extension.
Any leverage made in the front of the hip/thigh helps ease the workload for the back of thigh.
Paired with the half-kneel terminal knee flexion, this makes for a powerful one-two punch.
TO REVIEW:
  • Knee flexion is a function of the hamstring
  • Terminal knee flexion dictates how well the hamstring get the heel to the butt while the hip is in extension
  • Practicing terminal knee flexion increases hamstring strength and control
  • Hamstring strength and control is vital to those with a previous ACL injury
  • Hip flexion assists knee flexion, isolation of the hamstring requires hip extension

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