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You’ve probably heard about muscle imbalances before. The condition occurs when one group of muscles is stronger than its opposing group and can lead to strength imbalances, asymmetry, pain, and poor mobility. Typically, we think about things like rounded shoulders, protruding head, and anterior pelvic tilt, but a lot of people also experience poor hip mobility due to overly tight hip muscles.
If you have a desk job, sit for long periods in a car, or tend to veg on the couch at night, chances are the bells are going off for tight hips. But you’re in good company along with millions of other people.
Poor hip mobility and strength are major factors in issues like lower back pain and knee pain but it can also extend further down to affect the ankles and feet, affecting most of your movement patterns to some extent. Your hips are the centre of your body’s movement, so when your hips are healthy and can move freely and unrestricted, it increases the potential for your body to develop greater strength, power, speed, and overall athleticism.
With all of that said, we want to draw attention to something that most people don’t talk about–flat feet. While they may look a little unconventional, flat feet may actually be connected to weak hips, so we’re breaking it down for you and giving you some simple and super effective ways to strengthen your hips and reduce the risk of collapsed arches.
For the majority of people, the feet have three characteristic arches:
Photo source: www.mdpi.com/2571-5577/2/1/3
The arches are shaped by the metatarsal and tarsal bones and stabilized by the various tendons and ligaments of the foot. Of the two longitudinal arches, the medial arch is the highest and the one most people are familiar with. The bones, ligaments, and plantar fascia of the arch create an elastic and adaptive base that can support the weight of the entire body and absorb shock during high-force movements.
The primary function of the medial longitudinal arch is not only for support, but to help with proper function of the lower extremity during gait. This arch heavily relies on its muscle, innervation, and blood supply to carry out its function, and any disruption to these factors can result in major consequences.
Flat feet, also known as pes planus or fallen arches, is a condition commonly seen in young children due to a lack of tightening of the ligaments and tendons in the foot and leg. Typically, the condition will disappear by the age of 3-6 years but for some people can remain through adulthood. While flat feet can be caused by several factors, it tends to create problems with walking, running, and standing for prolonged periods of time.
Flat feet occur when there is a loss of the medial longitudinal arch and most often appear in women over the age of 40 presenting with diabetes and obesity. However, other factors that can contribute to flat feet include laxity of the plantar fascia, spring ligament, or other plantar ligaments. Trauma or injury to the foot can also cause collapsing of the arch. Although flat feet are usually asymptomatic, some people may experience pain in the back, hip, knee, lower leg, heel, and midfoot, as well as a history of frequent ankle sprains due to overpronation.
There’s no denying that the muscles of the hip are a hefty group of muscles. The femur, the largest bone in the body and the major bone of the thigh, is connected at one end to the pelvis to form the hip joint and at the other end at the knee to form the knee joint. Like the shoulder, the hips are a ball-and-socket joint that has a large range of motion and can move in nearly any direction. In order to control these movements, several large muscles attach to the hip, the largest being the gluteus maximus; its role is as one of the primary movers of the hip joint. Along with the glutes, other smaller muscles support the hip with its various movements–front-back, side-to-side, and full rotation of the leg.
That all seems well and good, but how does this have anything to do with having flat feet?
The hip muscles are responsible for controlling the leg's alignment, which subsequently affects how weight is distributed between the hip and foot. If you lack control due to weak hip muscles, it can place extra pressure on the foot and ankle, causing them to roll inwards, especially during walking, running, or balancing on one leg. When the foot is constantly rolling inwards, it can increase the risk of collapsed arches and eventually we could get, you guessed it, flat feet. See the connection?
Here’s a quick test for you to try.
Stand in front of a mirror and place your hands on your pelvic bones. Space out your feet so that the middle of your ankles are in line with the front of your pelvic bones, and line your feet so the outer edges of your feet are pointing straight ahead. Take note of the position of your legs. Are you pigeon-toed? Do your knee caps turn in? How does your arch look?
If you find that your knee caps are turning in, roll your hip bones outward so your knee caps face forward. Take a look at your arches and note their position. Are they higher? If your arches are raised compared to what they previously were before shifting your hips, chances are you struggle with weakened hip muscles.
This is a really simple yet effective way to show people that simply by activating the muscles in the hips, you can change the support of your foot. You may not realize it, but your entire body is connected.
So, what muscles are we actually talking about here?
Photo source: https://pubmed.ncbi.nlm.nih.gov/23445909/
The hip muscles encompass several muscles that function to act on the thigh at the hip joint to stabilize the pelvis and support movement. They’re divided into three groups: The iliopsoas group, gluteal muscles, and the hip adductors.
Iliopsoas groupAt first thought, you’re probably not thinking that weak hip muscles have much impact on the rest of your body, but they do–especially your feet. Internal rotation of the leg due to weak hip muscles promotes the inward collapse of the ankle and foot. If muscles of the feet are relatively strong, they are able to counteract this movement. However, because they are small muscles, there’s only so much fighting they can do before they’re forced to tap out.
This is called pronation. But here’s the thing–pronation isn’t the bad guy. It’s an essential part of movement to allow the body to absorb shock when doing activities involving running or jumping forces. However, like most things, too much of it can be bad.
The solution that most experts will give you is “strengthen the feet.” But what if your foot strength is good because you’ve been regularly using your Toe Spacer products (Toe Spacers + Mobility Band + Rock Mat)? Regardless of the way you run, the ideal landing is on the outside border of the foot. So for some people, maybe it’s not the result of your feet. While pronation is controlled by some of the extrinsic foot muscles, it’s also controlled by your knee and hip. If you can’t control the knee and hip when you’re foot goes into pronation, it drags the foot with it.
You can be working on all the foot strengthening activities you want, but if you’re looking for better foot control and fewer injuries, the feet are only a small part of the picture. The glutes, quads, and extrinsic foot muscles all fire together, which means you have to work on strengthening them all. If your glutes can’t control their portion of the load, it results in your upper leg spinning inwards, which will drag the foot and make it look like there’s major foot weakness. If you’re a chronic runner, chances are you probably have weak glutes because you’re spending a lot of time in quad dominated activities or sitting on your butt in an office job, forgetting about strengthening what’s behind us.
The gluteus medius is one of the most important muscles for preventing the overpronation of the foot. When glute medius is weak, or weaker than it should be, it is unable to provide stability to the hip and knee during movements like walking, running, jumping, and squatting. The glutes are a big muscle group (maybe why everyone wants bigger ones…) and they can make or break your performance. If they’re weak, the little guys get overworked and hinder performance. If there is weakness in the chain of muscles that control pronation, the body hits the ground and can’t move, thus dampening your forces for push-off while simultaneously increasing stress on the body.
Simply put, hip strength is needed to support the weight of the entire body and maintain proper alignment. Since the body is like a series of interconnected parts that all work in sync, strengthening the hips can create better function of the foot and may prevent pronation that can contribute to flat feet. At the same time, developing better control at the foot can allow the hip muscles to function more optimally. It’s not really a one caused the other scenario, so focusing on both aspects is important.
Aside from supporting your feet, weak hip flexors can also predict the likelihood of other health issues that tend to develop with age, such as chronic pain, increased risk of falls, and even increased dependence; essentially, hip flexor strength is a major predictor in and a primary determinant in the progression of functional capacity decline.
When it comes to healthy feet, it’s not always about just strengthening the muscles of the foot. If you want proper movement patterns across the entire lower body and to prevent the foot from rolling in, it’s also important to strengthen the hip. But how do you know if you have tight hips or weak hips? You may be under the impression they’re the same thing, but they’re not.
The hip flexors–the muscles are the front of the hip–are made up of three muscles: two that join together to form the iliopsoas, and one of your quad muscles, the rectus femoris. They work together to flex or bend the hip. The hips flexors are in a shortened position when seated and lengthen when you extend your hip. Here’s the thing. Most people think stretching is the way to deal with tight or weak hip flexors, but it’s often not very effective. Muscles often feel tight when they’re overworked. The muscle isn’t strong enough to meet the demands of what you’re doing, which leads to things like soreness, stiffness, and aches. So rather than trying to stretch the muscle, strengthen it.
Strengthening muscles through their full range of motion is one of the most effective ways to improve mobility and prevent injuries. The hip flexors are composed of several muscles that all need to be strengthened and stretched in different ways. The main goal of hip flexor strengthening is to allow you to hinge at your hips while your knee is either bent or straight.
Here are some great exercises to help strengthen the hips!
This is a minimal equipment needed exercise that’s great for strengthening the hips and activating glute medius. To do banded walks, loop a resistance band (med-heavy resistance) around each ankle. Position your feet about shoulder-width apart so the band is taut but not stretched. Bend slightly at the knees and hinge into a half-squat to activate the glutes. Keeping your feet in line with your shoulders, take a step sideways with one leg, followed by the other. Keep your hips level during the entire movement, back straight, and glutes engaged.
A simple exercise that’s really effective for strengthening the hips. Lie down on your right side with your elbow under your shoulder to prop your upper body up. While resting your right leg on the ground, lift the top leg as high as you can without bending your body or leg. Alternatively, you can keep your side flat on the floor without propping up onto your elbow. Hold the position for 5 seconds and lower your leg. Repeat 5-10 times on each left and switch.
Lying on your back, bend your legs and bring the heels close to the glutes. Keep hips level and engage the abdominals with a neutral pelvis. Slowly raise and lower the hips with control, focusing on stabilizing the legs through the glutes instead of the hamstrings Do 8-10 repetitions.
Deadlifts may seem simple, but they’re one of the best exercises for strengthening the hips and entire posterior chain. Step up to and under a barbell with your feet angled slightly outward, about hip-width apart. Hinge at the hips and bend the knees as you bend to grip the barbell with both hands at shoulder-width until the bar almost touches your shins. With a neutral spine, engage your glutes and your core. Push through your heels while keeping a straight back as you lift the bar up, keeping it as close to your body as possible. Press down with your legs until the barbell passes your knees and squeeze your glutes as you thrust your hips forward until you are standing. Reverse the movement as you lower the bar to the ground.
This may not sound like much of a strengthening exercise, but hip circles are great for improving stability and flexibility in the hips by strengthening and stabilizing the muscles around the joint.
Stand on your left leg with your right leg fully extended. If you need more stability, hold onto a wall or chair. Move your right leg in small circles both clockwise and counterclockwise. Aim to do at least 10 in each direction before switching legs. As you gain strength, increase the size of the circles.
References
Babu D, Bordoni B. Anatomy, Bony Pelvis and Lower Limb, Medial Longitudinal Arch of the Foot. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562289/
Ikezoe T, Tsuboyama T, Tabara Y, Matsuda F, Ichihashi N; Nagahama Study group. Weak hip flexor strength predicts progression of functional capacity decline due to locomotor system dysfunction in community-dwelling older adults: A longitudinal cohort study. Arch Gerontol Geriatr. 2021;97:104499. doi:10.1016/j.archger.2021.104499
Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med. 2005;15(1):14-21. doi:10.1097/00042752-200501000-00004
Reiman MP, Matheson JW. Restricted hip mobility: clinical suggestions for self-mobilization and muscle re-education. Int J Sports Phys Ther. 2013;8(5):729-740.
National Foot Health Assessment 2012
Pelvic Stabilization, Lateral Hip and Gluteal Strengthening Program