Does prolonged sitting cause tight hip flexors?

Oct 05, 2024

Sitting for hours is a hallmark of modern life. It brings discomfort, stiffness, and pain, especially in the lower back, neck, and hips. This happens because sitting too long puts strain on the spine and cuts off blood to the muscles. The muscles tighten and grow tired. Researchers and educators often say that sitting too long adds more trouble over time. Posture suffers, muscles grow unbalanced, and joints stiffen. Of the potential consequences for prolonged sitting, hip flexor tightness is often singled out. It is said to come from too much sitting. The hip flexors – muscles at the front of the hip that lift the leg – stay in a shortened position. Over time, they adapt, tighten up, and stay that way.

But does the link between sitting too long and tight hip flexors hold up when weighed against the latest research? If it does, does tightness in the hip flexors make things worse by causing chronic back pain or throw off balance in posture? Understanding this connection is key to keeping the body healthy and moving freely. In this article, I’ll break down what causes tight hip flexors, the signs to watch for, and what can be done about them after sitting too long.

The hip flexors

The hip flexor muscles sit close to the front of the pelvis and upper thigh. Their main job is to flex the hip joint. When you draw the thigh to the abdomen, or bring the trunk to the thighs, these muscles are at work. They play a vital role when walking, running, sitting, and standing. They also keep you upright by holding your posture steady. Every movement you make in the lower body depends on them.

The following list outlines the major muscles of the hip flexor group:

  • The iliopsoas is the strongest and most crucial muscle for flexing the hip. It’s made of two muscles: the iliacus and the psoas major. The iliacus takes root at the iliac crest, that bony ridge along the pelvis. The psoas major, on the other hand, begins its journey from the lumbar vertebrae in the lower back. These two muscles come together at the lesser trochanter of the femur. The iliopsoas, in unison, lifts the thigh toward the body. It’s essential for this movement and plays its part in keeping the spine steady, helping maintain posture and core strength.
  • The rectus femoris is different to the rest of the quadriceps. It crosses both the hip and knee, making it unique. It begins at the front of the pelvis, just below the iliac spine, and runs down to join the patella, then the tibial tuberosity through the quadriceps tendon. Its job is to straighten the knee, but it does more than that. When a person walks or runs, the rectus femoris helps lift the leg forward, aiding in the flexing of the hip. Although it works hard, most never notice it.
  • The sartorius, the longest muscle in the body, cuts across the front of the thigh like a strap. It stretches from the pelvis, at the anterior superior iliac spine, down to the inner side of the tibia. It pulls the leg upward at the hip, swings it out wide, and twists the thigh outward. Crossing over more than one joint, the sartorius also bends the knee, making it a muscle that works in many ways, ready for any movement the leg might make.
  • The tensor fasciae latae starts at the iliac crest and finds its way into the iliotibial band, that long, tough strip of tissue running down the outside of the thigh. Though it isn’t the main muscle for flexing the hip, it plays its part, helping to lift the leg. More than that, it's crucial for keeping balance and holding your body steady while you walk or run. It also lends a hand in turning the thigh inward and moving it out to the side. Simple, but essential work.
  • The pectineus is a small muscle located in the inner thigh, originating from the pubic bone and inserting into the femur. It aids in hip flexion, adduction (bringing the leg toward the body's midline), and medial rotation. The pectineus plays a supportive role in maintaining hip stability

Hip flexors during movement

The hip flexors work in both sitting and standing, but they serve different purposes. When you sit, the hip flexors shorten as the thighs pull toward the abdomen. Muscles like the iliopsoas contract to hold the hips in flexion, keeping the upper body balanced on the pelvis. Sit too long, though, and the hip flexors, especially the iliopsoas, grow tight. They stay shortened, and that can lead to discomfort or a feeling of stiffness when you stand.

In contrast, when you stand, the hip flexors stretch as the hip joint opens. The iliopsoas, rectus femoris, and other muscles relax to let the hip extend fully. Though their main job is to bend the hip, these muscles also activate to help steady you when you’re on your feet, especially during movements like getting up, walking, or running. They team up with the hip extensors to keep your balance and control the pelvis.

How does sitting cause tightness?

When muscles stay in a shortened range for a long time, stretching becomes difficult, even painful. The muscles adapt – and not in a good way. Over time, they lose their extensibility, becoming stiff and tight. (In the context of this article, “stiffness” refers to mechanical stiffness, the intrinsic resistance to elongation that doesn’t involve the nervous system. “Tightness” refers to a reflexive contraction in response to stretching, which is governed by the nervous system. I like to describe them as two sides of the inflexibility coin.) The body resists stretching more than normal. This happens because the muscles and nerves settle into that shortened state. The more they stay that way, the worse it gets. Flexibility fades and restricted movement takes its place. When you try to stretch, the body pushes back, and discomfort follows in response.

Connective tissue elements like fascia and tendons are composed largely of collagen fibres. These fibres are extraordinarily adaptable to mechanical stresses, e.g., pushes and pulls. Ordinarily, they lie in soft waves, crimped and ready to stretch, absorbing the forces they’re subjected to. But when muscles stay shortened, the tension across the tissue fades. With less exposure to pulling forces, the fibres adjust. They tighten, draw close, and lose their give. The waves smoothen out and the fibres harden, becoming rigid and less able to stretch when you try to lengthen them. The changes come slowly but surely, and in time, the collagen becomes unyielding. Moreover, when connective tissues stay shortened for a long time, more collagen cross-links form. 'Cross-linking' means chemical bonds form between collagen molecules. This makes the tissue stronger but less elastic. The longer the fibres stay in a shortened state, the more cross-links they make, essentially locking them in place and making them stiffer. This stiffness can lead to less movement and a greater chance of strain-related injury when stretched or made to work suddenly.

As the body adjusts to the shortened state, collagen synthesis – the production of new collagen – is disrupted. When muscles and the tissues surrounding them aren’t stretched or moved through their full range, the cycle of replacing collagen fibres slows. Old collagen builds up, stiffening the tissue. It grows less elastic and more rigid. The fibres that once kept everything healthy now add to the stiffness, locking the body in place, piece by piece. Furthermore, when muscles stay shortened too long, the fascia begins to bind. The different layers of it stick together and lose their ability to glide past each other. This binding worsens the body's freedom to move, tightens the tissues, and brings discomfort. As time passes, the adhesions deepen. They steal range of motion and make simple movements hard. Pain follows, creeping into joints and muscles. However, it’s worth noting that much of the research on fascial adhesions is based on prolonged immobilisation of a joint rather than directly attributed to too much sitting. That being said, the hypothesis that prolonged sitting causes fascial adhesions remains biologically plausible.

To understand how prolonged sitting causes tightness, we can look to how the body responds when muscles are stretched. After all, the same structures and pathways are involved — and sitting is the inverse of stretching). Stretching raises your tolerance, working through the nerves that control muscle length, tension, and the feeling of pain. It changes how your body handles tensile strain, a process that involves muscle spindles, Golgi tendon organs, and the central pathways that read the body's position and pain. Muscle spindles sit deep in the muscle, sensing its length and how fast it stretches. When the muscle is stretched, the spindles fire, sending messages back to the spine. These messages travel along nerve fibres. The spine, upon receiving this information, answers by instructing the muscle to contract in response. This reflexive action is essentially the muscle pulling in to guard itself from tearing. Stretch the muscle long enough, over and over, and the spindles change by becoming less quick to act. The spindles don’t send signals like before when the muscle stretches. This gives the muscle more room to stretch before it reflexively fires. You feel this as less tightness.

Higher structures in the central nervous system are also involved. The brain, through parts like the motor cortex, prefrontal cortex, and brainstem, influences the stretch reflex. The central nervous system, by way of descending pathways from the brainstem’s reticulospinal tract, adjusts muscle spindle activity. These pathways dampen the motor neurons in the spinal cord, easing the reflex that makes muscles contract when stretched. With consistent stretching, this inhibition grows stronger, allowing the body to tolerate more. Over time, the reflex weakens, and the muscles learn to yield.

Additionally, stretch tolerance comes down to how the brain handles pain when you stretch. The feeling of discomfort is a job for several parts of the brain, including the somatosensory cortex. This part of the brain reads signals from the body. It handles what we feel, including where the parts of our body are in space and the pain we sense. Stretch often enough, and the brain starts seeing those signals differently, raising your pain threshold as you stretch. Furthermore, the anterior cingulate cortex and insula are areas of the brain that deal with the emotional and cognitive aspects of pain. Over time, consistent stretching can lead to desensitisation of these brain regions associated with the action of stretching. Additionally, a spot in the midbrain called the periaqueductal gray is involved in descending pain modulation. It controls pain by sending signals by releasing endogenous opioids – natural painkillers – that help quiet the pain during stretching, making it easier to push your limits.

Sitting too long keeps the muscles shortened, which is essentially the opposite of stretching. The pain associated with stretching increases because the same neural structures and pathways mentioned above – which help us feel less pain and tightness with consistent stretching – now work against us. When a muscle stays in a shortened position, it gets used to it. The muscle spindles become more sensitive and alert to any increase in length. So, when you stretch again, the spindles fire off stronger signals because they interpret the stretch as being more abrupt or intense than usual. The brain’s insular cortex, which process the subjective experience of pain, integrates the unpleasantness of the stretching sensation with emotional information, making the stretch even more painful. Over time, you may even start to fear the stretch itself. Long-duration sitting can increase hip flexor tightness because the muscles become conditioned to it; shortened length becomes the 'new normal.' In other words, you are training yourself to become less flexible via the same mechanisms you would use to become more flexible.

What does the research say?

We know how muscles can grow tight and shorten, how they can adapt poorly, especially when a person sits for too long. But does it always happen? Probably not as often as the loud voices on social media would have you believe. Research shows that sitting for hours leads to reduced hip extension, a sign of tightening in the flexors [1]. Studies show clear differences between those who move often and sit little, and those who sit long and move little. Children who spend their days sitting in school often develop tight hip flexors [2]. These patterns take root in childhood, and shaping good habits early should be part of how we raise minors to be strong and healthy. Among desk workers, muscle tightness is widespread — up to 83% in the iliopsoas amd 96% in the hamstrings [3]. Sitting too long brings discomfort to the back and hips, tightening the hip flexors, and pushing toward lower back pain through changed movement and posture [4]. There’s evidence to show a link between prolonged sitting and tight hips, though proving it outright as a cause is still something we don’t yet know for sure.

There is some evidence that tight hip flexors are tied to musculoskeletal problems. The cause is not simple, and the data are often weak. Still, many say there’s a strong link between hip flexor tightness and lumbar instability in adults with low back pain. Yet, a study shows the connection is there, but it’s not nearly as strong as some believe [5]. There’s clearer proof that tight hip flexors affect how the lower body moves. They change the way muscles work, especially the glutes, which might lead to injury. Soccer players with tight hip flexors have altered muscle patterns while squatting, which could leave them open to harm [6]. Tight hip flexors also affect knee position and balance. Stretching them improves both balance and movement, suggesting that easing tightness might reduce some of these problems [7]. Tight hip flexors can throw off the body’s balance, changing the way we move, especially in demanding activities like running and squatting [8].

Keeping a muscle held held in a shortened position tends to make it stiff and unyielding. This underlies the long-held belief that says long hours sitting in a chair cause the hip flexors to tighten, but the truth is less simple. Office workers often have tight hip flexors, as well as tight muscles throughout the lower body. But is it the sitting that’s to blame, or is it the lack of movement — particularly the absence of stretching — that does it? It’s hard to tell, since sitting still and staying inactive go together. From my observations, a few minutes of stretching each day can correct the tightness in a matter of months. If sitting alone were the real culprit, wouldn’t it take more effort than that to undo?

Flexibility training doesn’t need much time or effort, not if you do it right. People talk about the couch stretch like it’s the best thing for your hips, but it mainly works the rectus femoris. If you really want to stretch the real hip flexors — the iliacus and psoas — there are better ways. I like the long lunge, holding it steady and stretching slow. If you’re just starting out, aim to hold a long lunge without using your hands, feet spread apart at least three times the width of your shoulders. (Measure your shoulder width, multiply by three, and that’s how far apart your feet should be). Hold it for two minutes. When it comes to relaxed stretches, the front split is hard to beat. It shows how much hip flexion you really have. Go as far as you can without too much pain, hold for a couple minutes, and repeat on both sides. Do this daily. Over time, the tightness in your muscles should ease within a few weeks or months, regardless of how long you sit.

 References

[1] Boukabache, A. et al. (2020) 'Prolonged sitting and physical inactivity are associated with limited hip extension: A cross-sectional study.' Musculoskeletal Science & Practice, volume 51, article 102282.

[2] Kale, S. & Gijare, S. (2019) 'Prevalence of lower crossed syndrome in school going children of age 11 to 15 years.' Indian Journal of Physiotherapy & Occupational Therapy, volume 13, number 2, pages 176-179.

[3] Pradip, B. et al. (2018) 'Prevalence of tightness in hip muscles in middle aged Indian men engaging in prolonged desk jobs: A descriptive study.' International Journal of Physical Education and Sports Health, volume 5, number 2, pages 15-21.

[4] Kastelic, K. et al. (2018) 'Sitting and low back disorders: An overview of the most commonly suggested harmful mechanisms.' Collegium Antropologicum, volume 42, pages 73-79.

[5] Khan, A. & Malik, A. (2023) 'Association between hip flexor tightness and lumbar instability in adults.' The Journal of the Pakistan Medical Association, volume 73, pages 2239-2245.

[6] Mills, M. et al. (2015)' Effect of restricted hip flexor muscle length on hip extensor muscle activity and lower extremity biomechanics in college-aged female soccer players.' International Journal of Sports Physical Therapy, volume 10, number 7, pages 946-954.

[7] Aslan, H. et al. (2018) 'Acute effects of two hip flexor stretching techniques on knee joint position sense and balance.' International Journal of Sports Physical Therapy, volume 13, article 846.

[8] Anloague, P., et al. (2014)' The relationship between femoral nerve tension and hip flexor muscle length.' Journal of Novel Physiotherapies, 5, article 244.