My Hip Flexibility Experiment
While traveling through the Amazon and the Andes last summer I was often obliged to sit on the floor as tables and chairs were infrequent in these rural areas. I wrote a post about this phenomena with some pictures of the various sitting positions I had tried and how long I could stay in them before it was too uncomfortable. In short, positions that were comfortable on my back such as seiza (kneeling with the feet tucked under) resulted in my feet going numb while other sitting positions such as long sit and lotus sitting caused my back to ache because my hip tightness forced me into a slumped spine position. Follow this link to hear more of my woes of chair-less travel.
After kicking the problem around in my head for awhile and going through the different sitting positions and the range of motion required for each one, I have picked a position for my test and stretch for my intervention.
Goal: Sit comfortably on the ground without back support. I call this ability the invisible chair. (While sitting on the ground without any props is not really necessary in the developed world, neither is squatting 400lb. This sitting goal is another way to expand my movement bandwidth and will come in handy when traveling and playing with small children.)
Functional Test: Time to onset of discomfort sitting cross legged.
Result: Feeling of falling backwards began at about 30 sec, a low intensity discomfort/tightness began on the right side at 1min 20sec and worsened at 3min 30sec and at 4min 46sec it was intense enough to make me want to change positions. (I decided not to work on long sit because it with my height it takes up a lot of space and I have already worked extensively on this ROM with improvement but would rather work on something else for awhile. I decided not to do seiza because the problem is that my feet go numb and I really don’t have any idea what to do to prevent that.)
ROM Tests: Hip external and internal rotation at 90 of hip flexion, hip external rotation at full hip flexion and the FABER test. (I picked these assessments because they are standard goniometric measurements which closely mimic the hip flexion and external rotation required to sit cross legged with a straight spine. These measurement are commonly used in physical therapy and shown to have an error range of 5 degrees.
Intervention: Z stretch on soft surface 3 min a day on each side. (I picked three minutes because the position of hip flexion and external rotation is limited in large part by the hip joint capsule. Stretching this viscoelastic connective tissue requires prolonged holds to allow creep to occur unlike muscle stretching in which the goal is to tolerate a greater range of motion with less discomfort. I picked this stretch because it is fairly easy to hold for a long time and it looks less likely to torque my knee than some of the other stretches. I worked on my lotus stretch in undergraduate and ended up stretching out my knees more than my hips)
PlanRe-test sitting and hip range of motion weekly
If no increase in ROM in two weeks, double the dose (stretching twice a day)
If still no increase in 30 days, replace Z stretch with hip ER in full flexion.
I will post an update when I have my ROM re-measured.