It is now nearly a month after I started regularly stretching my hips in my quest to be able to sit comfortably on the floor. Here is the synopsis
-I was consistent with stretching up until the end
-I can sit cross legged for a longer time before my back hurts than before but my posuture seems about the same (back still curved slightly)
-The stretches seem to have a short term effect on my flexibility
-I have had a hard time finding reliable measurement of my hip range of motion
-The results have been OK but not spectacular
-I have now doubled my duration of stretch to be six minutes
Adherence: Did I Follow Through?
Here is my adherence table. A check mark means I stretched that day. I did not stretch at the same time every day. One morning I woke up at 3am realizing I hadn’t stretched that day so I stretched right then. I dropped the ball and missed a few days right before my last testing. 😦
Functional Test: Time to onset of discomfort sitting cross legged.
Result: 1-9-13 Before Program, Discomfort Within A Minute, Less Than 5min Tolerance
0:30sec Feeling of falling backwards began
1:20 A low intensity discomfort/tightness began on the right side at 1min 20sec
3:30 Same discomfort worsened
4:46 Same discomfort 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.)
Result: 1-22-13 After Two Weeks but Before Stretching, Discomfort At Two Minutes, 10min Tolerance
0:20sec Feeling of tightness in right side lumbar paraspinals around L3-4 starting at 20sec,
2:00 Tightness worsening then dissipating somewhat.
6:00 Tightness not worse at 6min but visible curve in my lumbar spine when looking at it from the side in the mirror.
10:00 Still uncomfortable in the same place but tolerable. Not yet meeting the goal of no discomfort but an improvement from two weeks ago.
Result: 2-5-13 After Nearly A Month But Before Stretching, Discomfort At Six Minutes, 10min Tolerance
4:10 Feeling of stretch in right side paraspinals and sense of being pulled into lumbar flexion began
6:93 Ache on right side of low bck increasing
8:10 Definitely feel my back creeping into more and more lumbar flexion. The ache is spreading across my back but thintensity is still very low.
8:47, ache worsening want to change positions
Result: 2-5-13 Immediately after 6min of stretching into hip flexion and external rotation, Worse Tolerance, Enter the Skepticism
2:54 began tightness/ ache in right lower back
3:57 increased tightness In my back
ROM Tests: Did I Get More Flexible?
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.
I had my friend Skylohr who is a PT student test my hip range of motion before and after stretching my left hip. I went to the other room to do the stretch and Skylohr was blinded to the intervention. He had no idea what I was going to do or what the point of measuring my hip range of motion was, he had not read my blog post. Thanks to Skylohr for being willing to take the time to do this, i had a hard time finding PTs with time to do this.
The result of doing 3 minutes of z-stretch on the left hip was a 15 degree increase in hip external rotation at maximal hip flexion. It also improved my FABER. The measurement error looks fairly wide given the difference in all pre-post values. My right hip rotation increased and I don’t know if this is the result of the measurement error or the fact that the back leg is getting stretched in abduction and internal rotation during the z-stretch.
Overall it seems like the stretch improves the range of motion it intends tout the skeptical side of me is not satisfied.
Background From Previous Post on Invisible Chair
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.
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.)
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)
In this stretch I push down on my front thigh trying to rotate in clockwise while tipping the pelvis forward. The front hip is the one being stretched here.
-Re-test sitting and hip range of motion weekly
-I have doubled the stretch duration but not the frequency because I want to find and effective intervention that is still convenient.
-If still no increase in two more weeks, replace Z stretch with hip ER in full flexion.
-I will post an update when I have my ROM re-measured.