Author Pam Versfeld physiotherapist    Email sfa.tomt@gmail.com 

Infants and toddlers born preterm, and those with low muscle tone, joint hypermobility and delayed motor milestones, often have tightness in some muscles that affects their posture, balance and coordination.

Tightness in the hip abductor muscles

The hip abductor muscles pass over the side of the hips. The iliotibial band extends from the lower back over the side of the hip and knee joints. 

Tightness of the hip abductor muscles is common in infants who lie and sit with the legs wide apart and the hips twisted outwards.

How hip muscle tightness affects tummy time  

Active infants move through a great many positions when on their tummies. These actions are important for stretching and strengthening the arm, leg and trunk muscles. 

If the hip abductor muscles are tight, the infant finds it more difficult to move about on the tummy. 

How hip muscle tightness affects getting into the crawling position

When the hip abductor muscles are tight the infant has difficulty aligning the knees under the hips in the crawling position.  This affects the ease with which an infant can push up into the crawling position.

How hip muscle tightness affects standing and walking

Toddlers with tightness in the hip muscles tend to stand with their feet wide apart, and sometimes turned outwards. They have difficulty shifting their weight onto one leg in order to take a step. This affects their balance. 

Tightness in the iliotibial band is associated with toe walking. 

An important word of caution

It is important that you check with your child's doctor or physical therapist if you have any concerns about the flexibility of your child's hips. This is particularly important if you think that there may be some muscle tightness. 

How to test for hip abductor muscle tightness 

Sitting test

Let your infant or toddler sit on a low step with the hips and knees bent to 90 degrees.

With your hands over the side of your infant's thighs, very gently push the knees closer to each other. It is very important that you do not force the thighs together

Is this movement easy, or is there some resistance?

Keeping your hands over the side of the thighs, encourage your infant to reach forwards. If the hip abductor muscles are tight, the thighs will move sideways against your hands. 

Tummy lying test

Let your child lie on the tummy. Encourage him/her to reach forwards towards a toy so the he/she lifts the head and shoulders a little.

In this position the hips should extend and and the thighs should move closer to each other. 

Infants with tightness in the hip abductors do not extend the hips and tend to keep them in abduction. If your child tends to move the thighs apart, gently try to move them closer to each other. This movement should be easy. 

What next?

If you think that your child has some tightness in the hip muscles it is very important to as your child's doctor or physical therapist to check the hip joints for any abnormalities. 

If you child is under the care of a physical therapist, ask him/her to about ways you can improve your child's hip flexibility.