Did you know there are 27 muscles that cross the ball and socket hip joint?! Some muscles act as primary movers while others act as dynamic stabilizers for the hip. When the hip capsule is hypomobile (or tight), your body is likely to compensate either up or down the kinetic chain to still achieve movement. This can lead to various pathologies in the lumbar spine as well as the lower extremity (1-5). The good news is there are many ways that someone can improve their hip mobility. In this article, you will learn why hip mobility is important for overall movement capacity and longevity, and we will show you 4 exercises to improve your hip mobility!

 

The Importance of Hip Mobility

As discussed in the introduction, a decrease in the amount of hip mobility available may lead to compensation as well as potential injuries in other areas of the body. More specifically, hip mobility deficits have been found in people with hip osteoarthritis, sports-related groin pain, and femoroaceteabular impingement aka FAI (6-8). When FAI and labral tears are present, one typically exhibits reduced hip mobility into flexion, internal rotation, and adduction (9. Regardless of the pathology, you want to at a minimum to maintain the hip mobility that you have and mitigate the loss of hip mobility. In an ideal world, you even gain some mobility back!

 

The Ultimate Hip Mobility Program At Your Fingertips!

The Hip Mobility Overhaul [P]rehab Program is the ultimate resource for those looking to improve their hip mobility. The natural design of the hip allows it to serve as the key to foundational movement. If we begin to lose access to that mobility we are missing out on significant movement potential and increase the risk of injury at the hip along with areas above and below such as the low back, knee, and feet. With this program, you’ll regain access to your hip mobility and enjoy life with limitless movement! Learn more HERE.

Why Hip Tightness Is Bad

When hip mobility is adequate, there are better arthrokinematics, which leaves you with a happy hip. Limited hip mobility is one of the most common causes for low back pain. To learn more about the low back and how to maintain a healthy spine, listen to our [P]Rehab Audio Experience!

LISTEN: IMPROVING YOUR LOW BACK HEALTH

 

Exercises To Improve Hip Mobility

Now that you have an understanding of the importance of hip mobility in addition to the different motions that occur at the hip, we will now transition into visual demonstrations of various exercises to improve hip mobility. Follow along with visual and written descriptions that will detail exactly how you can replicate these exercises on your own to optimize the mobility of your hip!

Supine Hip Flexion mobilization

Sample Hip Mobility [P]rehab Program Exercise

There are various ways in which one can self-mobilize their hip joint. Achieving optimal client outcomes can be achieved with self hip-mobilizations (10). The goal here is to improve the hip capsule and connective tissue mobility.

 

• Tie a band around a stable surface on one end and bring it as close as you can to your hip joint on the opposite end (feel free to pad the band with a towel if the band alone irritates you). Scoot yourself back until you feel a strong pull from the band. Using a band here will help clear some space in the hip joint -> improve the hip joint’s ability to glide properly. Bring your hip into as much pain-free flexion as your hip will allow. You can hang out at the end or oscillate back and forth. Play around with moving your hip into Internal or External rotation as well. Find whichever restriction works best for you. Follow up your mobilization with active exercises (continue reading to learn some!)

 

Note: It is important to seek a skilled clinician to consider if mobilizations are warranted. When hip mobility deficit is due to bony morphologic changes, mobilization may be INAPPROPRIATE.

 

More Content For Tight Hips!

 

Hip External/Internal Rotation With Forward Trunk lean

Limitations in hip flexion and internal rotation range of motion have been implicated as characteristics of hip pathology. Any activities that require squatting, pivoting, planting and cutting, and/or rotating your body will likely be hindered by limited hip flexion and internal rotation range. Here is a drill that helps to improve both hip internal and external rotation simultaneously.

Keep both feet and knees touching the floor throughout this exercise. If you don’t have adequate hip mobility in this position, you can sit on a yoga block to decrease the amount of hip mobility required to perform this exercise. Stretch the leg to your side into an abducted and internally rotated position and the leg in front of you into a flexed and externally rotated position.

To further the stretch you have two options:

1. Increase the load by leaning forward toward your front leg.
2. Rotate away from the leg on your side.

Note: This is an advanced drill that requires a lot of hip mobility!! Make sure you are not reproducing any hip symptoms with this exercise.

I particularly like this exercise because it focuses on flexion and external rotation AND abduction and internal rotation, two motions that are typically overlooked. A Systematic Review by Dallinga et al in 2012 showed that limited hip abduction ROM has been suggested as a predictor of future lower extremity injuries whereas limited hip internal rotation ROM is a strong predictor for the presence of hip OA (11, 12)

READ: EXERCISES FOR FAI SYNDROME

 

Quadruped Inferior and Lateral Hip Mobilization

Sample Hip Mobility [P]rehab Program Exercises

Research has demonstrated that clients with femoral-acetabular impingement (FAI) have limited squatting motion compared to patients in a control group due to limited pelvic sagittal plane motion (13). Squat depth has been improved post-surgically in clients with FAI as a result of reduced acetabular coverage and an improved pelvic posterior inclination angle (14). Theoretically, improving capsular mobility (in cases of limitations) may be beneficial as it also improved sagittal plane motion. Therefore, this technique is likely most beneficial for the client with limited hip flexion motion in a loaded position (13).

Here are 2 additional ways you can improve hip mobility by moving your pelvis over your femur:

• Begin on your hands and knees in a quadruped position. Put the mobility band as close as you can to the hip joint. Allow the band to pull either laterally (as shown on the right) or inferiorly (as shown on the left).

 

• Sit back until the desired stretch is felt. You also have the option to rotate the hip into external rotation (pigeon stretch) or internal rotation. To progress this exercise go into a loaded position of a squat and attempt to go into as much hip flexion as possible. You can use a band to provide lateral traction in the hip if required. This will help you learn and maintain your new hip flexion range of motion.

 

Note:  This position is great because your own bodyweight is providing the posterior glide of the femur on the acetabulum that will help with your hip mobility!

 

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 Self hip mobilization into flexion and External rotation

Sample Hip Mobility [P]rehab Program Exercise

Here is the last self hip mobilization!

• Find an elevated surface where you can perform a lunge to mobilize the hip. Anchor the mobility band by stepping on it at one end and allowing the other end to wrap around your hip joint. Make sure to keep your foot on the band, you don’t want it to slip out from under you!

 

• Lunge into pure hip flexion. If you need, you can use your arms to assist by pulling your hip closer to your chest! In this position you have the option to either internally or externally rotate your hip. On the right, I demonstrate a variation with hip external rotation.

 

Closing Thoughts

Following the self-joint mobilizations, it is critical that you perform several repetitions of isometric end range exercises and isotonic exercises through the end ranges of hip mobility to re-educate the musculature and maintain the newly gained ROM! Shown Here, Here, and Here are a couple of great ways to strengthen the hip in its new range of motion.  Finally, perform several dynamic drills to achieve neuromuscular control in the new hip ranges. The aforementioned self-hip mobilizations are meant to be integrated into a multimodal therapeutic home exercise program for a client by a clinician. Little evidence exists to describe the efficacy of these self-hip mobilizations in isolation or to demonstrate one technique’s value over another’s.

Note: It is suggested that you seek a skilled physical therapist or a rehab specialist to perform this skilled joint mobilization!

 

Take Control of Your Hip Mobility

The powerhouse of the movement system: the hip. With all of the force it can generate and without purposeful attention, this joint can start to feel pretty stiff. It’s a ball and socket joint by design meaning it was made to move in all planes of motion. If you want to optimize your movement system hip mobility,  this program is a great choice!

 

REFERENCES

1. Reiman MP, Weisbach PC, Glynn PE. The hips influence on low back pain: a distal link to a proximal problem. J Sport Rehabil.  2009;18(1):24-32.
2. Devin CJ, McCullough KA, Morris BJ, Yates AJ, Kang JD. Hip-spine syndrome. J Am Acad Orthop Surg. 2012;20(7):434-442.
3. Burns SA, Mintken PE, Austin GP. Clinical decision making in a patient with secondary hip-spine syndrome. Physiother Theory Pract.  2011;27(5):384-397.
4. Cliborne AV, Wainner RS, Rhon DI, et al. Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test fi ndings, and short-term response to hip mobilization. J Orthop Sports Phys. Ther. 2004;34(11):676-685.
5. Currier LL, Froehlich PJ, Carow SD, et al. Development of a clinical prediction rule to identify patients with knee pain and clinical evidence of knee osteoarthritis who demonstrate a favorable short-term response to hip mobilization. Phys Ther. 2007;87(9):1106 1119.
6. Birrell F, Croft P, Cooper C, et al. Predicting radiographic hip osteoarthritis from range of movement. Rheumatology (Oxford). 2001;40(5):506-512.
7. Nevin F, Delahunt E. Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain. J Sci Med Sport.
8. Kubiak-Langer M, Tannast M, Murphy SB, Siebenrock KA, Langlotz F. Range of motion in anterior femoroacetabular impingement. Clin Orthop Relat Res. 2007;458:117-124.
9. Burnett RS, Della Rocca GJ, Prather H, Curry M, Maloney WJ, Clohisy JC. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88(7):1448-1457.
10. Wright AA, Hegedus EJ. Augmented home exercise program for a 37-year-old female with a clinical presentation of femoroacetabular impingement. Man Ther. 2012;17(4):358-363.
11. ltman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34(5):505-514.
12. Birrell F, Croft P, Cooper C, et al. Predicting radiographic hip osteoarthritis from range of movement. Rheumatology (Oxford). 2001;40(5):506-512.
13. Lamontagne M, Kennedy MJ, Beaule PE. The effect of cam FAI on hip and pelvic motion during maximum squat. Clin Orthop. 2009;467(3):645-650.
14. Lamontagne M, Brisson N, Kennedy MJ, Beaule PE. Preoperative and postoperative lower-extremity joint and pelvic kinematics during maximal squatting of patients with cam femoro-acetabular impingement. J Bone Joint Surg Am. 2011;93 Suppl 2:40-45.

 

About The Author

Arash Maghsoodi, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Marketing Officer

Arash Maghsoodi received his Doctorate in Physical Therapy from the University of Southern California. For his undergraduate studies, he attended San Diego State University and studied Kinesiology. After sustaining a career-ending ankle sprain while playing collegiate soccer, he realized how disabling and life-altering injuries can be. Arash currently resides in beautiful Santa Monica, California. His clinical experience is primarily in the orthopedic and sports setting. He has treated a wide variety of conditions ranging from the post-operative individual to the professional athlete. Arash is keeping the family legacy of becoming a physical therapist, as his mother is a practicing clinician of 30 years in the Orange County area.

 

 

 

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.