Did you just have a baby and think the tension you felt in your lower back and hips would suddenly vanish, yet now your hips feel tighter? If so, you are not alone! Hip tension after delivery is one of the most common comments I hear from my patients during their postnatal appointments.
In order to move our hips, we need to engage structures at the front of our hip (including deep hip flexors and abdominal muscles), structures at the back of our hip (including your hamstrings and glut muscles), as well as the muscles that line our spine. In addition to this, our pelvic floor muscles, which get a workout during labour and delivery, influence how well our hips move.
So why do these muscles matter?
During pregnancy, our body accommodates for the growing baby by rotating our pelvis forward to make space for the larger uterus. If you need a visual, think of your pelvis as a bowl of water and imagine you are pouring water out the front. When this happens, the muscles in the front of your hip (like your quadriceps) and the muscles in your lower back get shorter. In addition to that, the muscles in your abdomen, hamstrings and gluts get longer. After the baby is delivered, your body has to try and find its way back to a neutral position. Sometimes, our pelvis stays in that rotated forward position, and sometimes it tries to overcorrect and we end up clenching our bum muscles for support (for this visual, imagine pouring water out the back of the pelvis). In either situation, the muscles around the hips and pelvis may be gripping or pulling too much, creating the sensation of tension in your hips!
How do I help my tight hips?
In order to know which stretches would be most effective for you, it is best to have an in person assessment with a health care practitioner. However, stretches such as a half kneeling hip flexor stretch, figure 4 glute stretch and standing side opener stretch are great places to start.
How does my pelvic floor play into this?
In addition to the muscles at the front and back of our pelvis, we have our pelvic floor! Following labour and delivery, we can either have too much or too little tension in our muscles, both of which can contribute to the feeling of tight hips.
Our pelvic floors are imperative to our hip health for two reasons. The first is for mobility – the muscles in our pelvic floor help to rotate our hip inwards and outwards. The second is for stability – our pelvic floor is an integral part of our deep core support system. If the center of our bodies is not as strong as we need it to be, it becomes harder for us to move our limbs and transfer forces from one side of our body to the other effectively!
Following caesarean deliveries, the pelvic floor muscles tend to tighten in order to compensate for our healing abdomen. This acts to pull the inside of the hip towards the pelvis, which can make it feel hard to rotate our hips freely. In this case, pelvic floor opening breaths and poses such as happy baby, cat/cow and child’s pose are important for releasing tension in these muscles.
If the muscles stay in a lengthened position post vaginal delivery (since they had to stretch and lengthen during the delivery itself!), they are not in a great position to activate. It does not automatically mean they are weak, but all muscles have an optimal length tension for activation. This means if a muscle is too long or too short, it does not activate as well as if it is in the middle, just like Goldilocks! In this case, working on seated or lying pelvic tilts, pelvic floor activations, glute bridges and butterfly bridges can be very helpful for improving the length of the muscles.
Your nerves may need some love.
Our nerves that run down the back of our legs will also influence how well our hips can move. Our sciatic nerve is formed from a few nerves in our lower spine. As the nerve branches come together to form the sciatic nerve, it then travels through the pelvis, through the deep muscles at the back of the hip and down along the back of the leg. When it comes to nerves, people always assume nerve dysfunctions show up as numbness or tingling. While these symptoms are definitely possible, nerve issues can also present as tension! Insider tip, if you have been trying muscle stretches and you still feel very tight, your nerves being tight may be the answer! Not only can the body position changes and pelvic floor tension mentioned above affect how tight our nerves are, but going through an intense event like childbirth is a lot for your nervous system to deal with. As a result, your nerves may need a little love. For this, try deep breathing, segmental spinal body roll or a sciatic nerve floss in a standing or lying position!
And finally, the importance of strengthening!
There is one more thing that often gets overlooked, the strength of your hip muscles! When we feel tight we automatically assume the muscles need to be lengthened but sometimes, they are weak. A weak muscle can grip, and that gripping on your bones feels like tension! While an in person assessment is best to identify which muscles need strengthening, generally we want to target the deep core, gluts, back and hip flexors. Low impact, progressive exercise routines like Pilates or Jenni’s postpartum workout program is a great way to target all of these areas!