how to improve hip stability the prehab guys

How To Improve Your Hip Stability With Prehab Exercises

Hip strengthening should be a stable of any rehabilitation or strength and conditioning program. The hip musculature is capable of generating large amounts of torque used for explosive athletic movements. Additionally, the hips are the key to trunk and core stability, and therefore balance. To be simplistic, our trunk sits on top of our hips. Thus, if our hips are weak, it doesn’t matter how much core strengthening we do, because the foundation on which our core sits upon is weak. Moreover, we need to ensure that our hips are not only strong but stable! In this article, we are going to show you the essentials of how to improve hip stability with prehab exercises!

 

The Importance of Hip Stability

A great analogy in regards to hip stability is that of a house on the cliffs. You could build the biggest and most glorious house (i.e 6-pack) on the cliffs overlooking the ocean, but if the stilts and foundation (i.e hips) upon which this mansion sits upon is weak, the house will undoubtedly collapse. This is why our hips need to be strong and stable, so we have a solid foundation to move from! The hip joint is not only very stable innately, but also very mobile, as it is a ball and socket joint that moves in all 3 planes of motion. Therefore, when we work on hip stability, we need to stabilize in each of those different planes of motion.

Bosu Airplanes

Via EarthPorm

 

Maximize Your Hip Stability With [P]Rehab

hip program the prehab guys how to improve hip stability

Our [P]Rehab Program has been specifically designed to not only optimize hip stability, but all other components that are essentail for optimal hip health. The Hip [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your hip health. This 3-phase program will expose you to various hip and lower body strengthening and stabilization exercises supported by science. This program will bulletproof your hips for anything life throws at you! Learn more HERE! 

 

How To Test Hip Stability

There are a variety of ways to test hip stability. Firstly, you want to ensure that the hip is being tested in all 3 planes of motion: sagittal, frontal, and transverse, as the hip moves in all of these planes! If the hip is lacking stability in one or more of these planes, that needs to be addressed!

 

Single Leg Squat For Time – Saggital Plane Hip Stability

Sample Hip [P]Rehab Program Educational Video

Test Description: The Single Leg Squat For Time Test is a reliable tool developed and used to evaluate lower body performance, muscle power, and muscle endurance. Please watch the video to get a visual demonstration of how to perform the test. Below you will find a description of how to do so.

Test Instructions: Get set-up sitting on the edge of a stable surface that ideally makes your thighs parallel to the ground. Lift one leg off the ground and keep it in the air in front of you the entire time, you will perform the test on both sides. Using a stopwatch or something to keep track of time, the test begins as soon as you lift up from the surface to perform your first single-leg squat. Your final score is the total number of quality single leg squats in 1 minute. Perform on the other side, write down your scores below.

Some rules to remember with this assessment. One quality repetition counts as fully standing up and squatting back down until your bottom touches the surface with good form.

 

Side Plank Endurance Test – Frontal Plane Hip Stability

Test Description: The Side Plank Endurance Test is a reliable tool developed and used to evaluate core, trunk, and hip muscle strength and endurance while minimizing load on the lumbar spine. Please watch the video to get a visual demonstration of how to perform the test. Below you will find a description of how to do so.

Test Instructions: Get set-up laying on your side with your elbow positioned under your shoulder and your forearm flat supported on the ground perpendicular to your body. Have your feet stacked, then lift your hips up and off the ground and push them forward. There should be a straight line from your feet to your shoulders. Hold this position as long as you can with good form. Perform on the other side.

 

Copenhagen Endurance Test – Frontal & Transverse Plane Hip Stability

The adductors are a powerful group of muscles that are heavily involved in rotational athletics. It is the second behind hamstring strains in regards to the most common muscle injuries at the hip in athletes. These muscles also help stabilize our pelvis in upright, standing positions. To learn more about advanced groin training, read the article below!

READ: ADVANCED GROIN TRAINING AND [P]REHAB

advanced groin training the prehab guys

Now that you have an idea of some ways to test hip stability, we will transition to optimal exercises to improve your hip stability!

Progressive Eccentric Single Limb Squat Strength

The single limb squat comes in a lot of variations regarding body position. 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.

What’s more important is you need eccentric strength prior to dynamic concentric strength, you must learn to absorb force before you can produce it. If your performance of the task decreases as you increase depth, you’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!

Here are some progressions if you are working on improving your single leg squat depth!

Single Leg Squat – Supported

Sample Hip [P]Rehab Program Exercise Video

  • HOW: Start in a standing position balancing on one leg with your hands holding onto a sturdy surface/object to help with balance. Perform a skater squat by bending at your hip and knee, also let your upper body lean forward by hinging at your hip. Return to starting position, repeat.

 

  • FEEL: You should feel all the muscles in your leg working, especially your glutes and your quadriceps. You may feel your core working as well to maintain torso position.

 

  • COMPENSATION: Do not lose balance, try to keep your knee tracking over your foot, do not let your knee cave in/out. Do not let your pelvis sag on the other side. Do not over-rely on upper body support.

 

Single Leg Squat – TRX

 

Single Leg Eccentric Box Squat

 

Single Leg Pistol Squat

Looking to master your first pistol squat? Read this article!

 

Lateral Step Down To Improve Hip Stability

A step down is a large component in most people’s everyday life. This movement can be used as a quick & functional screen for hip stability in the frontal plane (left to right). For optimal mechanics you want the hip, knee, & ankle to be in the alignment shown with the first repetition. Compensations that are common are that one hip falls into adduction forcing the knee to go into a valgus or collapsed position, resulting in the knee being medial to the ankle joint.

This is often due to either weak hip abductors or poor neuromuscular control at the hip. This deviation from the optimal movement pattern can lead to an increase in reliance on passive structures. Stay tuned for tips on how to strengthen or improve neuromuscular control at your hip to keep ideal mechanics!

Lateral Step Down

Sample Hip [P]Rehab Program Exercise Video

 

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.  

Anterior Step Down – RNT

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.

 This can also be used as a strengthening exercise once the athlete demonstrates good neuromuscular control…it’s quite hard as you can tell!

Beginning strength training can be a difficult task without direction or instruction. To learn more about how to begin strength training the right way, listen to our [P]Rehab Audio Experience Podcast Episode below!

 

LISTEN: HOW TO BEGIN STRENGTH TRAINING

how to begin strength training the best landmine exercises prehab guys

Clams To Improve Hip Stability

If neuromuscular control was not the culprit of one’s hip instability, I would bet my lunch money that it is due to hip weakness. Clam’s are a great way to isolate strengthening of the hip stabilizing muscles, especially the Gluteus Medius. The 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, or descending stairs. Despite clams being such a commonly used exercise, it is very easy to compensate with other muscles during this exercise. To learn the best exercises for the glute med, read this article!

Isometric Side Lying Clam – Band

Sample Hip [P]Rehab Program Exercise Video

 

Standing Clam – Band

 

Standing Clam – 3 Way, Band

 

How To Improve Hip Stability: The Side Plank Exercise

The side plank is another great exercise to include with hip stability programming. There are many variations of progressions and regressions of this movement. It is a great way to target hip stability in the frontal plane.

Modified Side Plank

 

Side Plank

 

Side Plank with Abduction

 

Progression of Strengthening 

Most people exercising their glutes at the gym focus only on the sagittal plane (moving forward and backward). Many are unaware that the glute muscles are triplanar! This means 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 to imbalances in the body and poor control of three-dimensional movement. The clam is a great way to isolate the hip abductors & external rotators, however, we also must perform progressions to strengthen these muscles in a functional manner.

Captain Morgan – Swissball

Sample Hip [P]Rehab Program Exercise Video

 

Bridge Twist and Reach

 

Single Leg Airplane

 

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), which is used very often when performing daily activities. It requires hip and trunk strength as well as stability in all planes of movement, thus it is 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.

Split Stance Lunge

 

Anterior Lunge Walking

 

Posterior Lunge Walking

 

Want To Learn More Lunge Variations?

 

Try Bosu Airplanes To Improve Your Hip Stability!

Bosu airplanes are the perfect exercise for challenging hip stability without any ankle contribution. Bosu airplanes can be used as an assessment test to determine if an athlete is properly recruiting from the hips during single leg movements. Or they can be used as a rehabilitation exercise for foot/ankle patients who are currently non-weight bearing. Additionally, bosu airplanes can be used as a strength and conditioning exercise to dynamically challenge a patient’s ability to control perturbations of balance using only the hip for stability. Bottom line – bosu airplanes are the ultimate exercise for targeting hip stability without ankle contribution!

Bosu Airplanes the prehab guys how to improve hip stability

It’s an extremely challenging exercise, trust me!

 

Closing Thoughts

Hip stability plays a very important role in how we move. If we do not build a proper foundation from our hips, it can lead to issues not only at the hips but above and below the joint as well. When deciphering how to improve hip stability, be sure to work in all 3 planes, and make a progression towards functional movements!

 

Bulletproof Your Hips With [P]Rehab!

hip program the prehab guys

The Hip [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your hip health. This 3-phase program will expose you to various hip and lower body strengthening and stabilization exercises supported by science. This program will bulletproof your hips for anything life throws at you! Learn more HERE! 

 

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

11 Comments
  • Rodrigo H
    Posted at 22:30h, 21 April Reply

    Great and valius job for physical therapy practice, thank for your professionalism. i follow them!

  • Robert
    Posted at 01:34h, 24 April Reply

    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.

    • Michael Lau
      Posted at 18:32h, 24 April Reply

      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.

    • Ignas
      Posted at 04:06h, 08 July Reply

      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).

  • Chris Pii
    Posted at 03:37h, 07 December Reply

    Agree hip abductors are crucial for preventing knee-in but it’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 🙂

    • Michael Lau
      Posted at 21:03h, 06 January Reply

      Agree, strength is first, but strength is nothing but control! Love to work together too!

  • Jackie ismail
    Posted at 04:18h, 03 February Reply

    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?

    • Michael Lau
      Posted at 23:32h, 24 February Reply

      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!

  • Jackie ismail
    Posted at 04:18h, 03 February Reply

    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?

  • Alec
    Posted at 06:53h, 08 September Reply

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

    • Michael Lau
      Posted at 16:05h, 12 September Reply

      They should all challenge the deep external rotators!

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