With nearly every facility having their athletes looking like Flamingos activating their hip flexors, are we actually treating the root problem? I was reading my notes from the Montreal sports medicine seminar and some of the findings of Dr. Marchese and Dr. Morgan with a few summer and winter olympic athletes and it confirmed my suspicions. We are isolating the wrong positions in the wrong way, and treating symptoms. Parroting that the psoas is the only hip flexor that raises the knee above 90 degrees is meaningless in real running action. The real actions involve neural circuits often not talked about because the foot function is very complicated in acceleration vs maximal sprint mechanics. Those stuck in accelerate only for sport are often finding their hip flexors not developing the eccentric adaptations developed in max sprinting. Since the death of the GPP years ago ordered by some strength coaches, we are eliminating running in favor of some alternate means that don’t have the same running adaptations.
What about bands and knee lifts? What about isometric wall holds? Do those methods work? Perhaps. It’s best to see what programs develop healthy hip flexors naturally. Sometimes artificial interventions are important, but they are temporary fixes or scaffolding options when the solution is not available. Program design in paramount and often trumps sports medicine interventions since you can’t treat every joint and muscle in isolation daily. Athletes may get finely tuned like sports cars but they don’t like being in the shop for extended periods of time all the time. Here are some things Dr.Jurgensen have noted in the presentation:
When running athletes have a hypertonic psoas check forefoot joint mechancis and T12 mobility (rotation). The lumbar architecture has limited motion due to the joint structure and connective tissues supporting the spinal column. This (false belief) often creates a misconception that lumbar mobility is bad. In fact is vital since it has precious little range, an absent value will create havoc on the body when the QL is locked.
Thermo therapy is vital in dealing with myofascial and general tightness. Often athletes that are systemically tight need massive doses of dry heat and hot baths during regeneration blocks. Aggressive treatment is about the impact acutely and the duration of application.
John Marchese’s point about gait circuits and foot mechanics point out that it’s important to look at how the metatarsals work in setting up the triggering of the psoas. The research doesn’t support the pretension in max velocity because every spike plate in elite sprinting is fiber based and the windlass mechanism is not exploited actively.
Long gentle static stretches done to the psoas are underrated but work if you work. The problem is high dose therapy is often not compliant with lazy athletes.
A complete review of the psoas, medial/lateral knee health will be available in January for Elitetrack contributors with the Physiotherapy in Elite Sport download