ANATOMY REVIEW
Type of joint: Synovial
Degrees of freedom: Three (Tri-Planar)
Joint ROM norms:
Flexion- 120
Extension- 20
Abduction- 40
Adduction- 30
External Rotation- 50
Internal Rotation- 35
While these are the norms for hip range of motion (ROM), a crucial thing to understand is how much variance there is from person to person! Everyones ROM will vary. Another important thing to understand is the angle of the femoral head as it sits into the acetabulum. Retroversion vs anteversion as well as its implications.
Retroversion: Tends to have more of a “toed out” stance. Because of this, we might see folks have more external rotation ROM.
Anteversion: Tend to see a “toed in” stance. Because of this, we tend to see folks have more internal rotation ROM.
HIP MOBILITY: WHY?
Once we understand how much variance there is in the hip, now we can take a look at why hip mobility is so desirable. Simply put, this joint is extremely dynamic and powerful, and the king of motion when it comes to lower extremity movements such as a squat and deadlift. If we lack hip mobility, we consequently get range from other joints, like the lumbar spine.
One of the major concepts we talked about in the first post, is how sometimes lack of stability can actually cause surrounding muscles to be “tight.” Conventional stretching might not be the best tool to address improving hip ROM, we will probably have better luck with a neurological approach to unlocking the hips. Besides for dosing stability training, using a neuro based mobility protocol can help reduce the resting state of tone in the surrounding muscles. See post below for more on tone, as well as the routine to help improve hip flexion and internal rotation!
Here is one of my favorite sequences below….
1/2 kneel hip flexor mobilization-> Shin box -> Deep Squat with prying
1. 1/2 kneel hip flexor mobilization: 1/2 kneel position, without arching back, squeeze your down leg glute as you gently drive your hip to its first end range, oscillate back and forth x10, and then switch
2. ER/IR mobilization (Shin box): begin with your right thigh directly in front of you, and your left thigh out to the side at 90 degrees, with both knees bent roughly at 90 degrees. Spend some time exploring end ranges and oscillating into your right hip, followed by going onto your left forearm, and exploring end ranges of your left hip.
3. Deep Squat with prying: drop it like its hot (but controlled) into a deep squat and explore your hip mobility by prying your thighs in and out, as in the video.
IMPORTANCE OF HIP INTERNAL ROTATION
Let’s discuss some of the implications that hip internal rotation has from an everyday life lens to performance lens.
For walking, running, and squatting, we utilize some degree of closed chain hip internal rotation (aka acetabulum on femur). When we lack internal rotation at the hip, we can sometimes see compensations that occur up and down the chain and contribute to development of pathology.
We have to be careful, though, with the closing pain symptoms that occur with end range internal rotation. Generally this position can be provocative for anyone, so just keep that in mind. That being said, if we can improve our hip mobility into internal rotation in pain free manor, we can give ourselves a good shot at reducing our risk of injury.
Joe (@Joegambinodpt) does a great job taking us through an advanced way to help improve hip internal rotation. He integrates in concepts within the Functional Range Conditioning system. Basically, it utilizes a neuro-centric driven model that improves our strength and control at end ranges of motion. Check out Joe’s video below for further instructions.
The last post of the week was by Teddy (@Strengthcoachtherapy), he composed some really good exercises that he uses to establish good motor control for hip muscles as a warm up.
Remember above how I discussed the importance of stability for improved mobility? Well this triplet of “activation exercises” does a FANTASTIC job of allowing us to recruit the muscles of our hip girdle effectively before a workout.
Essentially, by utilizing the single leg bridge, we are able to get excellent stability through the planted leg, while recruiting our adductors and adductors in the contra lateral (opposite) hip. See video below for further instructions.
CONCLUSION AND KEY TAKEAWAYS
The hip is an extremely critical joint. While we must be able to express mobility into all ranges, understand that STABILITY can play a crucial role in allowing us to express our mobility. Utilize neuro-centric techniques to get improved joint ROM and make sure you OWN that new range, and load it to have better carry over.
Image Links
Hip) http://www.aafp.org/afp/2009/1215/p1429.html
Retro/anteversion) https://www.iadms.org/page/325