The Couch Stretch: How to Do One of the Best Exercises for Knee Pain, Hip Pain & Back Pain

As a Physiotherapist, I'm often asked to reveal the "best" stretches for people to do. And with such an extensive catalog to choose from it can be a daunting question.

However, there is one exercise that stands out. And that exercise is the Couch Stretch.

At its core, the Couch Stretch is a stretch for tight hip flexors. But it's also so much more. We'll get into the specifics of the stretch in a second, but I'd like to first provide some context to really highlight it's awesomeness.

From how easy it is to do, its ability to scale to suit your current needs, it's capacity to make an immediate change, to the importance of the areas it mobilizes, the Couch Stretch is a powerful ally to anyone wanting to prevent injury, recover from injury, and/or optimize physical function and athletic performance.

So pull up a chair (or couch) and let's discuss one of the best and most useful stretches you'll ever do.

 

Origins of the Couch Stretch

As far as I know, the Couch Stretch was the brainchild of the brilliant Kelly Starrett (ex-MobilityWOD, now The Ready State). I wanted to find the video (below) that first exposed me to one of the most important exercises I've seen in my professional career. Clearly I'm a nerd here, but I certainly feel nostalgic watching this again after almost 10 years.

Kelly and his Couch Stretch came to me at a time when I was seriously questioning traditional Physical Therapy ideas and exercises. Mainly because I felt many lacked perspective and missed the mark. I was on my current journey of trying to figure out this broader perspective and Kelly's Couch Stretch confirmed what I was beginning to understand. That common issues are usually a consequence of something else and the Couch Stretch gave me a powerful tool to help rectify a crucial piece of it.

So let's get into the stretch and discuss how to do it, when to do it, and how to scale it up once you start seeing some real progress.

 

How to do the Couch Stretch:

So, before we go deep into the benefits of the Couch Stretch, let's go through how to do it.

The basics of the Couch Stretch are pretty simple. All you need is a chair, seat, bench, or couch and you're good to go. If you struggle with putting pressure on your knees, feel free to add a cushion or pillow to make it easier.

As per the instructions below, the key to a good Couch Stretch is as follows:

Take a look at the video below for some real-time instructions.

Related: What is the best way to stretch? Find out here!

How to do the Couch Stretch (Advanced):

One of the best things about the Couch Stretch is that it can easily be scaled up for those who find it a little too easy. Interestingly, I encourage everyone to start with a chair as it can be quite challenging if you've never done it before. After all, we are attempting to undo decades of accrued hidden hip stiffness here.

If you're ready for a more challenging position try the Couch Stretch down on the ground up against a wall. This asks more of both hips and increases the demands of the stretch.

Similarly, try adding a power band to bias the deeper anterior hip joint capsule. I highly recommend pairing the Couch Stretch with a power band as its hard to get to the deeper tissue handbrakes without one.

If you've progressed well through each of these added layers, then consider putting your front foot up onto a step or stool. This further winds up the hips and surrounding soft-tissue, turning an already challenging hip stretch into a monster.

As per the beginner steps from above, make sure to focus on taking those slow, deep breaths to cue your body and those tissues into staying relaxed and malleable.

If you don't have access to a chair or wall, you can still perform the Couch Stretch. All you need to do is reach behind and grab your back foot to hold it against your bottom. This requires a little balance so make sure you have something else to hold on to if required.

 

Things to Be Aware Of:

The Couch Stretch is inherently safe but it's important to be aware of a few things.

• It can be quite challenging to do early on. This isn't because it's a brutal stretch, but because it can expose years/decades of hidden hip tightness and stiffness.
• Start within your comfortable limits. This may mean not pressing your hip as far to the ground, or extending up as vertically early on. If you can't breathe or talk comfortably then you're too deep into the stretch. You'll make faster mobility progress if you stay within your comfortable tolerance. You can't force flexibility.
• Don't let your hips shunt off to the side. If you're super tight at the front your body may try to find a way around this as you strive for extra depth. Ideally, your back shin and thigh should be vertical, with your hip directly in line with your knee.

 

Benefits of the Couch Stretch:

Now that you know how to do it, let's talk about why its a keeper.

As mentioned above, the Couch Stretch is a fantastic hip flexor stretch. When applied correctly, it should make immediate changes to the mobility of your hip flexor muscles. But its benefits extend far beyond basic hip muscle stretching. Here are some of those benefits.

 

1. Decrease Hip Flexor Muscle Tightness

This one's a no-brainer. The Couch Stretch's ability to loosen up the hip flexors is its flagship benefit. And this is hugely important thanks to the amount of sitting we tend to do each day.

Sitting is perhaps the most common cause of hip stiffness in the modern world, so it's important to have a simple exercise to combat it.

Now, the Couch Stretch is clearly not the only exercise out there for tight hip flexors, but its versatility makes it the clear front-runner.

 

2. Decrease Anterior Hip Capsule Tightness

Anterior hip capsule tightness doesn't get the credit it deserves for creating dysfunction. As yet another by-product of sitting each day, anterior hip capsule stiffness is often neglected as its usually asymptomatic. Capsular restrictions don't feel overtly stiff or tight like the more superficial muscles will. It just impedes the normal expression of movement, creating the potential for dysfunction around it.

Now the Couch Stretch doesn't have a monopoly on freeing up the anterior hip capsule either, but it's just so easy to add a power band (as shown in the second video above) and immediately see change.

 

3. Decrease Thigh Tightness

The beauty of the Couch Stretch is that it basically combines a standard hip flexor stretch with the stereotypical quadriceps stretch.

By doing so, we can also quickly decrease enormous amounts of built-up thigh tightness.

Why waste time doing two separate stretches when you can just combine them into one super stretch?

 

4. Decrease Tensor Fasciae Latae (TFL) Tightness

By letting your back leg fall out to the side (from 12:00 to 10:00'ish on the right leg and 12:00 to 2:00'ish on the left) and twisting your hips towards that side, you can also bias some very common, and sometimes hard to reach hip tightness.

Hip internal rotation is another aspect of hip mobility lost through constant sitting. And it's clearly important if wanting to express normal hip function. Rotating that back leg while doing the Couch Stretch can really help open up some of those other tight peripheral muscles ultimately adding another layer to the Couch Stretch.

 

5. Decrease Ankle Tightness

This one's a little obscure, but your back leg position also allows you to stretch the front of your ankle if your foot is also outstretched.

Once again, being stuck in a chair all day not only keeps the hips stuck at ninety degrees, but the ankles as well. And unless you love to kneel and sit back on your heels, we usually don't spend a lot of time pointing our feet and opening up the front of those ankles.

Obviously this depends on the height and angle of your chair's backrest. However, this is a nice little side-benefit for anyone who's also progressed down to the floor and are up against the wall.

 

6. Decrease Low Back Pain

Beyond the ability to mobilize tight hip and thigh muscles, the Couch Stretch really comes into its own when we start talking body mechanics.

Many don't realize the hip flexor muscles anchor on to the front of the spine. As a result, any restriction in these muscles can change the way you load the back, setting it up for dysfunction.

So the Couch Stretch becomes a powerful exercise for anyone with any form of low back pain. From acute back pain to chronic back pain, from a disc bulges to stenosis, or sciatica, it will help feed slack to these areas, helping your body recover.

 

7. Decrease Knee Pain

Another easily overlooked aspect of body mechanics is the hip's role in knee pain. Many recognize the importance of gluteal muscle strength, yet are equally unaware of how important hip and thigh tightness is to the equation.

If the front of the hip is tight, the body is forced to find a path around this restriction when needed. And you can often see this with walking or running. As the back leg trails behind, any hip tightness at the front forces the hip to externally rotate as it runs out of room. This is characterized by walking and running with your feet turned out. And as a consequence, we see more oblique forces added to the knee - setting it up for dysfunction.

Similarly, the Couch Stretch's ability to mobilize the front of the thigh allows us to directly feed slack back into the knee from above. After all, the muscles at the front of the thigh directly connect to the knee.

The Couch Stretch is particularly useful for those with Patella Tendonitis, Fat Pad Impingement, Patello-Femoral Joint Syndrome, Iliotibial Band (ITB) Syndrome, Meniscal issues, knee Arthritis, etc. So if you're trying to recover from these types of injuries or hoping to avoid them entirely, make the Couch Stretch an integral part of your life.

Related: Why Knee Pain is Often a Consequence of Something Else

 

8. Improve Pelvic Positioning

An important feature of normal back, hip, and pelvic function is good pelvic positioning. More specifically, I'm talking about a neutral pelvis versus an anterior tilted pelvis.

An anterior pelvic tilt can increase the load through the lower back, short-circuit pelvic floor function, and lead a decrease in functional capacity.

And one contributing cause of anterior pelvic tilt is tightness in the hip flexors - particularly the Rectus Femoris. This muscle anchors onto the tip of the pelvis as the front and, if tight, can tilt the pelvis down towards the thigh.

Stretching this area is hugely helpful if trying to re-establish a better pelvic position.

 

9. Perfect Pre-Exercise Performance Enhancer

Another useful benefit of the Couch Stretch is that it will make anyone a better athlete. Coupled with its ability to be done literally anywhere means its the perfect pre-cursor to athletic performance.

Whether you're about to go for a run, a ride, a swim, or even just a walk, the Couch Stretch will help improve your performance.

As mentioned above, it can help release some of those hidden handbrakes in essential areas for optimal human function. And if you're about to express that human function in the form of exercise or competition, then you'll be closer to the best version of yourself.

 

Conclusion

So whether you're keen to avoid injury, improve daily function and performance, or just doing what you've been told, invest your time into the Couch Stretch. It's a versatile, scalable ally to anyone who cares about the function of their body.

It can certainly be a challenge initially, but its ability to make change and address the root cause of so much dysfunction means that you'll be thanking yourself in no time at all.

What's your experience with the Couch Stretch? Do you have any variations we haven't discussed? Let us know in the comments below!

 

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