Therapeutic exercise
Thomas Stretch (Hip Flexors)
Passive stretch of the hip flexors (psoas, iliacus, rectus femoris) in the Thomas position — supine on a table or bed with one leg hanging off the edge. Allows pelvic relaxation and isolated stretching of the shortened flexor.
How to perform
- Starting position. Lie face up at the edge of a treatment table, bed, or firm bench, with the hips close to the edge.
- Step 2. Bring both knees toward the chest, holding them with the hands — this protects the low back.
- Step 3. Slowly release one leg and let it drop off the edge, hanging by the weight of gravity.
- Step 4. Keep the other leg flexed against the chest — this is the key to the Thomas, as it blocks lumbar compensation.
- Return. Feel the stretch in the anterior thigh and inguinal region of the hanging leg. Hold for 30 seconds and repeat on the other side.
When not to perform
- Recent post-operative hip or lumbar spine surgery
- Symptomatic lumbar disc herniation
- High-grade spondylolisthesis
- Total hip arthroplasty before medical clearance
- Recent femoral neck fracture
- Active inguinal hernia with visible protrusion
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Hip-Flexor Lunge Stretch
Stretches the iliopsoas and rectus femoris, frequently shortened in sedentary patients with sciatic pain, and reduces traction on the lumbar spine.
Pelvic Tilt
Gently activates the deep abdominal muscles through a pelvic tilt. Relieves low-back tension and retrains motor control of the deep stabilizers — one of the foundations of chronic mechanical low-back-pain rehabilitation.
Clamshell
Strengthens the gluteus medius and the external hip rotators. Essential in hip osteoarthritis to reduce the compensatory Trendelenburg pattern during gait.