Ever since I've entered this profession, I have been amazed at the number of MTs who are uncomfortable with working on the hip flexors. In most cases, I've been told "we didn't spend much time on it in school" as the primary reason they avoid treating hip flexors. :?
A number of MTs have further suggested that working the hip flexors is a bad idea for male MTs. "It's kinda close to the groin," and "It'll freak people out," are representative comments.
The hip flexors are sorta important. They play key roles in balance, posture, core strength and stability, contribute to back pain, hip pain, leg pain, may inhibit the glutes, and a few hundred other things. Iliopsoas major and minor, iliacus, and pectineus are too vital to be ignored.
There are many ways to address the hip flexors. Some authorities recommend working from distal to proximal attachments, while others advocate avoiding direct pressure above the inguinal ligament. Other authorities recommend stretching them and/or using compressed air to release them. The key, in my opinion, is to find a way that works for you
, and become comfortable
with doing the work. If you have several different approaches you know how to use, great!
As a male MT, I exercise due caution and educate my clients before working the hip flexors. This process begins during the intake prior to the session, and we communicate more during the session so I know the client and I are on the same page. Whether they are supine, sidelying, or prone, and regardless of the method(s) employed, my clients know what we are working on and why. Though they may experience some physical discomfort, they remain mentally/emotionally comfortable with having me do the work.
The "hip flexor phobia" that afflicts some MTs creates opportunities for me to build my client base. Some MTs, afraid to do the work, have referred clients to me. This is always appreciated, and I do my best to provide excellent treatment for those clients... and they usually decide to stay with me!
Don't fear the hip flexors. Learn to understand and treat them, and to effectively communicate with your clients when they need the work, and reap the rewards!