Common Orthopedic Inflexibilities

Hamstrings Inflexibility

Increased risk of lower back injury during hip extension activities when knees are straight. If hip flexion (eccentric phase of hip extension), is inhibited by hamstrings inflexibility, the lumbar spine may compensate by flexing more than usual. The risk of injury is increased if the lumbar spine is not accustom to this movement or workload.

• Examples of affected exercises:
  • Straight Leg Deadlift
  • Good Morning
• Example preventative / corrective exercise:
  • Hamstrings stretch

Gluteus Maximus or Adductor Magnus Inflexibility

Increased risk of lower back injury during hip extension activities when knees are bent. After complete flexion of the hip (eccentric phase of hip extension), the lumbar spine will flex if movement is continued. The risk of injury is increased if the lumbar spine is not accustom to this movement or workload.

• Examples of affected exercises:
  • Leg Press
  • Squat
  • Single Leg Squat
• Example preventative / corrective exercise:
  • Glute Stretch
  • Adductor Magnus Stretch

Hip Flexor Inflexibility

Increased risk of lower back injury during hip flexion and extension and overhead standing activities. During extension activies, the lower back can hyperextend more than usual if the hip can not fully extend. During hip flexion activities, the Iliopsoas can hyperextend spine during hip flexor activities. Risk is compounded when hip flexor inflexibility is combined with abdominal weakness.

• Examples of affected exercises:
  • Military press (standing)
  • Decline Situp
  • Lunge (rear leg)
  • Lever Back Extention (fulcrum near hip)
• Example preventative / corrective exercises:
  • Kneeling Hip Flexor Stretch
  • Quadriceps Stretch

Transverse Adductor / Flexor Inflexibility

Decreased range of motion during chest exercises. High risk for behind the neck exercises particulary when combined with external shoulder rotation inflexibility. Exasperated and often accompanied by protracted shoulders girdle.

• Example of affected exercises:
  • Bench Press
  • Chest Press
  • Chest Flies
  • Behind Neck Shoulder Press
  • Rear Pulldown
• Example of preventative / corrective exercises:
  • Straight Arm Chest Stretch

External Shoulder Rotation Inflexibility

Increased risk of shoulder injury during activities involving external rotation of the shoulder. Risk is compounded with a winged scapula condition or kyphosis.

• Examples of affected exercises:
  • Behind Neck Shoulder Press
  • Rear Pulldown
  • Lever Fly (on pec deck)
• Example preventative / corrective exercises:
  • Subscapularis Broom Stick Stretch

Internal Shoulder Rotation Inflexibility

Increased risk of shoulder injury during activities involving internal rotation of the shoulder. When the shoulder is flexed and internally rotated, pressure can be created between the insertion of the supraspinatus and acromion or coracoacromial ligament. Incidentally, pain in this position can be indicative of impingement or rotator cuff tendinitis (Hutton & Julin 1997). Tight internal rotators can contribute to protracted shoulders.

• Examples of affected exercises:
  • Upright Row (narrow grip)
• Example preventative / corrective exercises:
  • Infraspinatus Broom Stick Stretch

Iliotibial Band Tightness

Increased risk of lateral knee injury during knee extension activities. Iliotibial band friction syndrome (ITBFS) is a cause of diffuse tenderness over the lateral knee. While weight bearing during knee flexion, the Tensor Fascia Latea contracts to assist the other hip abductors stabilize the pelvis from lateral movement and the Gluteus Maximus extends the hip for forward locomotion. Both the Tensor Fascia Latea and the Gluteus Maxiums can place tension on the Iliotibial tract which produces repetitive friction on the lateral epicondyle. Furthermore, a hip abductors weakness can exasperate this pull on the Iliotibial tract by allowing the hip to sag slightly when standing on a single leg, or during locomotion (Fredericson, et. al. 2000)

• Examples of affected exercises:
  • Lunges
  • Step Ups
• Example preventative / corrective exercises:
  • Tensor Fasciae Latea Stretch
  • Gluteus Maximus Stretch
  • Lever Seated Hip Abduction

Dorsiflexion Inflexibility

Increase risk of Plantar Fasciitis and difficulty in performing squat and leg press exercises in full range of motion. Plantar fasciitis is a common overuse syndrome occuring in runners and walkers. This sydrome is associated with microtears in the pantar fascia at its insertion into the cacaneus and bone spur formations. High incidences of plantar flexion strength deficits and dorsiflexion range of motion limitations are associated with this condition. Dorsiflexion flexibility is required during the lower phases of the squat and leg press. If the range of motion of the ankle is limited, hip flexion may be exagerated and knee flexion is often inhibited. To maintain normal range of motion in both the hip and knee, the heel may have a tendancy to leave the floor or platform.

• Examples of affected exercises with suggestions for affected individuals until range of motion is restored
  • Leg Press: place feet higher on the platform
  • Squats: wider stance or elevate heels slightly on board or weight plates
  • Range of motion may need to be limited so heels do not raise at lower portion of exercise
• Example preventative / corrective exercises:
  • Gastrocnemius Stretch
  • Soleus Stretch
  • Calf Raise
  • Calf Press