Weak Hip Flexors Could Lead to Mobility Decline as You Age, Study Says

Loss of mobility as you age can have wide-ranging impacts, including higher risk of falls, chronic pain, and less independence. That’s why being able to prevent mobility decline is so important.

A recent study in the Archives of Gerontology and Geriatrics suggests a key factor for predicting these issues is hip flexor strength. Here's why researchers indicate that weak hip flexors may be a sign of future issues as well as what you can do to strengthen them.

About the Study

Researchers looked at 433 older adults and assessed their physical function through handgrip strength, hip flexion, hip extension, hip abduction, knee extension, and toe flexion. Participants also did several standard mobility tests. These tests included:

• Getting up from a chair five times without using their hands, to gauge muscle power
• Standing on one leg for balance function
• Going up the stairs quickly, to determine muscle endurance

A year later, the mobility tests were repeated to determine whether function had decreased compared to the baseline tests, and about 43% of the participants had less mobility. In reviewing the initial assessments, researchers determined that low hip flexor strength was the biggest indicator of reduced functional capacity, which means it served as a predictor of who would have lower mobility during the second set of tests.

Causes of Weak Hip Flexors

Connecting the lower back to the thighs, hips, and groin, hip flexors are muscles that work to stabilize the lower spine. They are crucial for proper posture and alignment, walking, and balance. There are a number of symptoms that indicate that there may be an issue with weak hip flexors. These symptoms include:

• Lower back pain
• Knee pain or instability
• Changes in gait
• Stiffness or tightness in hips after being stationary
• Limited range of motion, especially when kicking or jumping

Although hip flexors can be affected by overuse of the muscles—such as increasing exercise intensity too rapidly—the biggest culprits are usually too much sitting and not enough physical activity, according to Jared Beckstrand, DPT, a physical therapist and trainer.

“This is a common condition, and most people think that pain in the front of the hip is from tightness, which may be true in many instances, but not all of the time,” he says. “Often, it’s from weakness as a result of spending so much time in positions with our hips bent, mainly sitting.”

When hip flexors are in that position too much, they undergo what’s called adaptive shortening, says Beckstrand. The muscles tighten up in this position, potentially restricting the range of motion and limiting function. When that happens, doing hip stretches may actually worsen the issue, he adds. Instead, the recommended treatment would be strengthening.

Get Moving

There are numerous hip flexor exercises that can be done at home or in the gym to target these muscles, such as straight leg raises, floor sliding mountain climbers, pigeon pose, jump lunges, Bulgarian split squats, and banded hip marches.

Another important approach is to simply get moving more, according to strength and conditioning coach Aaron Leventhal, CSCS, owner of Fit Studio in Minneapolis.

“Doing exercises regularly is important, but even if you’re doing them daily, what’s happening the other 23 hours of the day?” he says. “A major reason hips become weakened is environmental, as people sit more than they should. Like any muscles that don’t get used, some atrophy comes into play. Putting frequent movement breaks into your schedule should become a regular habit.”

Even if you aren’t experiencing any hip issues now or feeling tightness, the recent study indicates that paying attention to hip flexor strengthening may pay off in the future by helping you maintain mobility as you age.

“Addressing potential imbalances before they become a problem can be a great way to prevent injury,” says Leventhal. “Finding ways to build strength in the hips can be very valuable for mobility now and into the future.”