Improve Your Hip Stability With Prehab

Hereโ€™s an amazing hip stability prehab series we put together! We dive into motor control, prehab techniques and strength and conditioning exercises. Get working on those glutes for hip stability prehab!

Progressive Eccentric Single Limb Squat Strength

The single limb squat comes in a lot of variations regarding body position, but in this episode we are going to focus on depth. Building dynamic muscle function must incorporate training EVERY type of muscle action, including eccentrics. The lowering phase towards the ground in all squatting motions requires eccentric muscle strength. The body is essentially a system of cranes (muscles) with multiple integrated pulleys (joints/tendons/ligaments) that can slowly lower the weight of the body. Whatโ€™s more important is you need eccentric strength prior to dynamic concentric strength, you must learn to absorb before you can produce. If your performance of the task decreases as you increase depth, youโ€™re not ready to progress! Remember to always promote quality over quantity, optimal active performance of a task using muscles rather than tension from passive structures is key to the longevity of your movement system! Stay tuned for a full week of posts focused on the hip, knee, and lower extremity!

Step Down Testing

A step down is a large component in most peopleโ€™s everyday life. This movement can be used as a quick & functional screen for hip stability in the frontal plane (left to right).ย For optimal mechanics you want the hip, knee, & ankle to be in the alignment shown with the first repetition.ย In the second & third repetition, the right hip falls into adduction forcing the knee to go into a VALGUS or COLLAPSED position, resulting in the knee to be MEDIAL of the ankle joint.ย This is often due to either weak hip abductors or poor neuromuscular control at the hip.ย This deviation from the optimal movement pattern can lead to an increase of reliance on passive structures. Stay tuned for tips on how to strengthen or improve neuromuscular control at your hip to keep ideal mechanics!

READ: Strength Training For Runners – The Step Up

 

Hip Stability Neuromuscular Control



While weakness of the hip abductors is often times the culprit for medial knee collapse, a lack of motor control can also be the source. This is especially prevalent among higher end athletes who demonstrate medial knee collapse with functional activities.


In this case, the athlete more times than not has more than adequate strength, yet they fail to utilize and demonstrate the neuromuscular control necessary to engage the hip abductors during tasks. To see if this is the case, give the athlete visual, verbal, or manual cues to facilitate hip abductor activation.ย Here, we demonstrate a resistance cue with a theraband. The theraband provides tension to drive the knee inward, into hip adduction. This slight resistance is enough to facilitate the hip abductors to fire during the single leg squat. *NOTE: This can also be used as a strengthening exercise once the athlete demonstrates good neuromuscular control…it’s quite hard as you can tell!

 

Clams for Hip Stability Prehab


If neuromuscular control was NOT the culprit of oneโ€™s hip instability, I would bet my lunch money that it is due to hip WEAKNESS. Clamโ€™s are a great way to isolate strengthening of the hip stabilizing muscles, especially the Gluteus Medius.


Gluteus Medius is more than just a hip abductor and external rotator; it is used as a dynamic stabilizer during single limb stance activities such as walking/jogging/step-downs. Despite Clams being such a commonly used exercise, it is very easy to compensate with other muscles during this exercise.


Repitition 1- Performed with optimal mechanics. Similar amounts of Glut. Medius will be activated from 30-60 degrees of hip flexion. There is also an added muscle action cue, noticed with touching the muscle that is to be activated, this may help you recruit this muscle.
Repitition 2- Demonstrates compensation with Sidebending using the QL/core muscles.
Repitition 3- Demonstrates compensation by using the momentum of my upper body to provide movement at the hip.
Repitition 4- Performed with optimal mechanics again. With pure movement at the hip joint, and you will feel the burn!

Progression of Strengtheningย 


Most people exercising their Gluteโ€™s at the gym focus ONLY on the sagittal plane (moving forward and backward). Many are unaware that the Glute muscles are triplanar! Meaning they move in all three planes (frontal, sagittal, and transverse) We are a Sagittal plane society!ย An emphasis on exercising only one plane may lead imbalances through the body.ย The clam is a great way to isolate the hip abductors & external rotators, however this video demonstrates great progressions to strengthen these muscles in a functional manner.

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Episode 33 โ€œHIP SERIES (5/6)- Progression of Strengtheningโ€ Most people exercising their Gluteโ€™s at the gym focus ONLY on the sagittal plane (moving forward and backward). Many are unaware that the Glute muscles are triplanar! Meaning they move in all three planes (frontal, sagittal, and transverse) We are a Sagittal plane society! An emphasis on exercising only one plane may lead imbalances through the body. The clam is a great way to isolate the hip abductors & external rotators, however this video demonstrates great progressions to strengthen these muscles in a functional manner. #glutes #stabilize #valgus #butt #bootyblaster #lateralsteps #resistanceband ______________________________________________ The Prehab Guys: Optimizing human movement and functional capacity, promoting longevity, and keeping your body in tune one post at a time. Instilling new meaning into #physicaltherapy. Follow us on IG and Twitter, like our Fb page, and make sure to visit http://www.humanperformancetherapy.com #prehab #fitness #healthandwellness #exercise #PT #DPT #DPTstudent #mobility #athlete #workout #recovery #rehab #prevention #rehabilitation #fitness #strengthandconditioning #correctiveexercise #stretching #crossfit #gainz #aesthetics #longevity #movement @uclamikey90 @arashxrex @craiglindell

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Performing Alternating Dynamic Lunges


A very popular and common exercise performed during training sessions is the dynamic lunge. It is a very functional movement due to the end position (half-kneeling) is used very often when performing daily activities. It requires hip and trunk strength and stability in all planes of movement, thus a very functional movement! It also requires neuromuscular control and hip and pelvis dissociation due to having to let your hips flex while minimizing pelvis and spine motion.


Depicted are two correct repetitions performed followed by two common mistakes we typically see; a rep lacking hip stability -> knee valgus and another rep lacking trunk stability -> excessive trunk flexion. It is easy to fix these common neuromuscular control errors by utilizing a mirror in front of you and/or a mirror to the side of you for a visual cue to achieve optimal performance of the exercise. Hope you all enjoyed our hip series! Please comment other series you would be interested in and we just might answer your calling!ย 

 

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11 thoughts on “Improve Your Hip Stability With Prehab

  • I’m happy to see you guys addressing the hip abductors!
    In school and during my internships I’ve never heard anyone talk about this or addressing the weakness of hip abductors directly. Not my teachers nor my colleague’s at my internship. Kneeing-in is a common problem and in my opinion as a physiotherapy student, the emphasis should be on the abductors more. Not just using metaphors like ‘push your knees out’ while squatting, because that way you only correct the patient/person’s technique, not his understanding of why he has to do it.

    • Addressing the hip abductors are huge! And the glutes in general, they are a triplanar muscle that affects every motion of the femur involved in non-contact knee injuries or knee overuse injuries.

    • It’s a shame people are forgetting about external rotators and their role in eccentrically stabilising the femur during gait cycle. I’d make an argument that external rotators are more important for hip stability that abductors, purely from an anatomical standpoint as it is excessive internal hip rotation and not lack of abduction that causes knee valgus (apart from feet issues).

  • Agree hip abductors are crucial for preventing knee-in but itโ€™s also down to overall neuromuscular synchronisation / control too hence isolation-integration approach. Loving the posts by the way, come to London sometime, would love to work with you ๐Ÿ™‚

  • I have a question for you. I have done the clamshell excercises – correctly – for a half year, without much if any improvement the last couple of months. Would it be good to substite with the monster walks /side walks or Would it be better to find af thicker band?

    • what are you looking for improvement in? the clamshell exercises isn’t a very challenging exercise, if going for strength gains you’d be much better off doing weighted squats!

  • I have a question for you. I have done the clamshell excercises – correctly – for a half year, without much if any improvement the last couple of months. Would it be good to substite with the monster walks /side walks or Would it be better to find af thicker band?

  • Do any of this exercises work/challenge the deep six external rotators ? form what I understand clams are more of gmed than external rotators

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