Kinesiology THURSDAY – Cross your Legs or maybe you shouldn’t

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Sitting with your legs crossed for prolonged periods of time gets a lot of bad press. Maybe you did it as a child playing on the floor or these days sitting at a table. However, you SHOULD be able to sit with your legs crossed, or at the very least cross your leg to don a sock or a tie a shoe.

The inability for a hip to flex and externally rotate in this fashion has been noted in many of our lower back patients. Usually, the limitation is seen on the side of lower back pain and results in a “pinching or jamming” sensation in the affected hip. Is this you or your patients?

Here’s what may cause that and 3 Ways to Fix It:

  • Tightness in the hip external rotators: When you externally rotate your hip (cross your leg like a “figure 4” it is supposed to glide anteriorly. Tightness in the hip external rotators, like the piriformis muscle, may cause the femoral head to be positioned anteriorly at rest and “bottom out” the joint, resulting in a jammed feeling in the hip. 
    • Test it: Roll on a foam roller or use a massage gun in the middle of your gluteal muscle. Is it tender? If so, you might have a piriformis trigger point.
    • The fix: Modified pigeon stretch or supine figure 4 stretch. Test both sides and fix what you find. Sometimes, the cause of your hip jam may be tightness in the opposite hip external rotators.
  • Tightness in the adductor magnus: The muscle on your inner thigh not only pulls your legs together but also helps externally rotate your hip as you push off the ground when you walk. Tightness in this muscle can cause the anterior migration of the femoral head at rest and cause a pinch in the hip. 
    • Test it: Try the revolving forward bend. The adductor gets stretched as you rotate away from the leg you are testing. Also try the runner’s stride stretch.
    • The fix: Perform 30 seconds of the revolving forward bend (1x/day) or the runner’s stride stretch (6 repetitions/day)
  • Hip flexor (psoas major) trigger point: This muscle runs from your lumbar spine to your femur bone and, though it is known as a hip flexor, it is also a hip external rotator. Tightness in this muscle may also cause the hip to jam. 
    • Test it: Lie flat on your back with your legs out straight. Can you come up to sitting without pain? If not, you may have a psoas trigger point. 
    • The fix: Perform the power pelvic tilt (6 repetitions x 6 second hold) and the supine 90/90 rotation (3 sets x 12-15 repetitions). The key is to hyperactivate the abdominal muscles to neurologically inhibit your psoas muscle. Re-test the long sitting test to see if your pain is gone and then re-try crossing your legs.

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