Rectus?? It Nearly Killed Us!!! HA HA HA.


I was working with a chiropractor who sent me a couple of clients to train, and pretty much every one of them were listed as having problems with their “hip flexors”, and upon further consult with said chiro, it turns out pretty much 100% of his clients had some form of problem with their illiopsoas. Now, I’m not one to pick a fight (mmph!! Sorry, I couldn’t hold a straight face at that one either), but 100%?? Seriously?? Are there no other muscles in the human body that can’t be causing pain these days??

I think “hip flexor” pain has turned into a bit of a garbage term catch-all for any kind of pain that originates in the anterior hip, abdomen, low back, knee, left ear lobe, or iris of the eye. Sure, the movement and muscle mechanics are important, but there are more than one muscle that can be causing all the problems here.

Imagine you’re playing an important role in doing some sort of important task: head of a wicked-cool personal training company, test driver at the Lamborghini factory, Adriana Lima’s bikini waxer, whatever.

Now let’s say for hypothetical purposes, that you’re doing the best you can, and some other ass-hat who does the same thing gets all the credit and all the publicity, and what’s worse all the girls. That would kinda cheese you right off, wouldn’t it?? This is the kind of life the rectus femoris has.

Seriously, I think the world has (for a lack of a better term) a serious hard-on for the illiopsoas. They get all the credit for everything from anterior pelvic tilt to disc bulges to why Charlie Sheen shot off his nutter a few weeks ago. Boom!! Winning!!

Sure, they may be some powerful muscles, but what about the rectus femoris?? The illiopsoas connects to the transverse processes of all five lumbar vertebrae and connects to the lesser trochanter on the medial superior border of the femur,and causes hip flexion and some external rotation. Therefore it’s role in providing hip flexion is more of a stabilizer to the spine and pelvis to allow for flexion to take place without rotating the hips into a crazy anterior tilt. The rectus femoris attaches to the anterior inferior iliac spine at the bottom front of the pelvis, and to the knee cap through a long-ass tendinous aponeurosis, and causes hip flexion and knee extension. Check it out here.

 

 

 

 

 

 

 

From a positional standpoint, the rectus directly pulls the bottom of the front of the pelvis and would have a greater influence on pelvic tilting than the illiopsoas. If the illiopsoas was tense, the resultant action would place the femur in external rotation, a position that is not commonly found when the pelvis is placed in anterior tilt. The rectus, when short, has the propensity to pull the femur into internal rotation. I do believe that is check and mate, sir.

Since the hip flexors are crazy important in performance aspects like squatting, deadlifting, and flexing your calves for skinny-calved friends to become envious of…

….working on this specific difference is pretty important to making sure you can drop it like it’s hot, back that thang up, dip it low and pick it up slow, or whatever you want to call it.

The classic Thomas test, which is supposed to look at the hip flexor flexibility, has a few major flaws. A good friend of mine, Tony Gentilcore, looked at this crazy little dude a while ago in a couple of posts HERE and HERE. First, when the leg is draped over the side of the table, the knee is allowed to be passively flexed, which will cause the rectus femoris to become tight at the knee joint, restricting the movement capability through hip extension. Additionally, in the classic Thomsa test, there is little attention paid to whether the leg hangs in internal rotation, external rotation, or neutral. As the illiopsoas pulls the femur into external rotation, a leg hanging in this way would indicate a short or tight illiopsoas, but if the leg wasn’t hanging off kilter, we couldn’t necessarily assume this to be the case, right?? Fo Sho.

To test the illiopsoas more directly, testing the movement with the knee in full extension and the toe pointing in both internal and external rotation to try to elicit a pain or stretch sensation will give a better idea versus a false positive affected by the rectus femoris.

Conversely, if we were to see any kind of internal rotation with this test, it may indicate some form of tension through the sartorious, TFL, glute med, or other bags of happy on the butt.

Now I’m sure you’re going to ask: What the hell was the point of this post?? Well, my good-natured readers, the point was that if we continuously chase a muscle imbalance that is commonly believed to exist in a large segment of the population without looking alternative possibilities, we’ll wind up chasing symptoms instead of finding solutions.

Now that we’ve gone through whether a tight hip flexor is the result of a tight illiopsoas or a tight rectus femoris, let’s look at what the hell we should do with those little buggers.

If we’re looking to stretch either one, there’s two slightly different methods to use. For the illiopsoas, stretching into hip flexion with an internal rotation of the femur, and with an ipsilateral lean and reach, meaning bring the same arm up and back, tends to hit the shit out of that muscle.

If we’re looking to train the illiopsoas without getting the rectus involved in the mix, we need to train hip flexion with some form of knee bend to remove the influence if the rectus, and also with some form of external rotation. Commonly you can do this with a bent knee raise while ensuring there is some form of spinal support to limit pelvic tilting. To train the rectus, simply lock out the knee while performing the exercise and rollin up on that thang with an anterior pelvic tilt.

So in conclusion, my dear friends, there is commonly more than one muscle that can cause any movement, so testing should look at all the possibilities, not simply the ones that are the most commonly believed. The chiropractor I work with who has a 100% illiopsoas population will have to forgive me for finding those with rectus femoris issues and working with them differently than those with illiopsoas issues. Plus, it makes me look way to rediculawesome when I can chat with a chiro and tell him what time it is.

About deansomerset

Certified Strength & Conditioning Specialist, Post-Rehab Specialist, personal trainer and probably the coolest guy my mom knows, I try to impart a little knowledge with a sense of humor to keep people reading. I've always thought if it's something that can grab your attention, you're gonna remember it tomorrow!!
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13 Responses to Rectus?? It Nearly Killed Us!!! HA HA HA.

  1. Danny says:

    Dean,

    What would you say to clients who question your judgement even after you explain all of that merely because the “doctor” says otherwise (assuming you’ve even had this experience).

    • deansomerset says:

      Hey Danny. I would still follow the orders, but work in my own components to help them get more out of the training session. Want to focus on the illiopsoas? Sure, but while we’re at it, we’ll also give some attention to the rectus as well as the hamstrings, low back, glutes, and abdomen, as they all play an intrinsic role in illiopsoas function.

  2. Jd says:

    Rectus?? It Nearly Killed Us!!!

    lol this has to be blog post title of the year 😉

    Great article as well ,

    Cheers

  3. Domenic says:

    Dean,
    Since the Psoas plays an important role in maintaining lordosis in the lower back, are you recommending we use something to support that low back lordosis while performing the bent knee raise?

    On a similar note, I’m sure you have noticed some clients have a pop as they straighten their leg out while lying supine. My take is that the psoas as relaxed and the femur, having lost that pull into the acetabulum, shifts. I can usually feel this pop in the lower back as well, indicating the psoas is the culprit, and this is often paired with back discomfort to some degree. Working with clients to recruit psoas while they are straightening their leg into full extension has in many cases, stopped that popping.

    I’ve tried to use this technique based on an article written by Dr. Evan Osar, http://www.completetrackandfield.com/EvanOsar.pdf

    what do you think of this, specifically the maintenance of a low back lordosis? I’ve played with it a bit and it seems to be a great activation technique for the psoas.

    I hear you about the psoas though, after I learned about it I started thinking everyone had a psoas issue for awhile.

    • deansomerset says:

      Hey Domenic. The spine should stay static during a leg raise so that pelvic tilting doesn’t shift which muscles are pulling and how they are effecting the movement. If tilting happens, it means the abs are no longer providing adequate support and stability. The popping is simply due to the shifting of the illiopsoas within the muscular groove beneath the anterior inferior illiac spine, and when it’s tight it doesn’t slide easily, but kind of snaps across this groove. The fact that actively making the psoas stretchin and contract reduces this sensation simply means the muscle is becoming more pliable and maleable as it begins to warm up. Good eye!!

  4. Michael Gray says:

    Hey Dean, I have chronic, explosive diarrhea. Could that be caused by my illiopsoas? : ) Nice work!

  5. R Smith says:

    Dean,

    I keep waiting for a single post that I DON’T find immediately applicable.
    Dayum!

    RS

  6. Domenic says:

    Interesting…
    After finding some research on snapping hip syndrome and reading your reply it definitely seems like that is the case, not the femur shifting but the psoas sliding thanks for clearing that up. With regard to the psoas sliding because it is tight and does not slide easily but then becomes more pliable and doesn’t pop, it seems that this is fixed too quickly (after one rep) by queing the client to engage the psoas, I wouldn’t think enough time for the tissue to loosen up… does that change your thoughts as far as that goes? I could be wrong just trying to figure out whether that is a sign of the psoas disengaging… thanks for the responses very insightful.

    • deansomerset says:

      Funny thing about that little bugger, when you perform a proper rep with psoas engagement, the sliding is almost like a form of active release against the bone, so it helps to break up any adhesions that might be there. It’s kind of a unique situation in the body due to how the muscle moves over bone directly. I’ve had some clients that take one rep to have it settle down, and some take 20-30 reps with varied pelvic positions to get it to “release” properly. Good observation!!

  7. Domenic says:

    Cool thanks for the information Dean, very detailed and precise much appreciated. Its good to know thats not necessarily a bad thing.

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