The hips are an often over looked and under utilised part of the body, yet I can’t stress just how important they are. When not correctly strengthened they can often be the origin of a lot of knee and lower back pain and if severely functioning incorrectly, can lead to early hip arthritis.
However, when functioning well, can lead to a vast improvement and cessation of many knee, hip and lower back complaints. In an athlete they can lead to a large improvement in performance and injury reduction.
The hip is similar to the neck, lower back and shoulder in that it has its own ‘core’ muscles that are responsible for keeping the hip in the middle of the joint, or ‘centrated’ as it is known. ‘Centration’ is a very important thing to understand, the hip is a ‘ball and socket’ joint as you can see in the picture below, where the head of the femur (upper leg) is the ‘ball’ and the cup in which it sits in the pelvis is the ‘socket’.
There are many structures that keep this joint in position such as ligaments and a capsule called the acetabular labrum. However, to ensure the joint is allowed to move evenly throughout the joint, the joint must be in the correct position within the joint to allow even force distribution to decrease wear and tear and ensure best function. The muscles responsible for this are the ‘deep rotators of the hip’. These form the base level muscles around the hip and are often responsible for buttock, hip, leg, knee and back pain if tight and weak. To ensure they are functioning correctly, they must first be lengthened and then strengthened. To strengthen them, a set of exercises that can be done at home are called ‘clam shells’. The Clam shell routine is designed to strengthen up key musculature around the hip including the most important part, the deep hip rotators. Once these are strengthened you effectively have a solid foundation upon which to work.
The next stage is to strengthen the ‘global muscles’ that overlay the deep rotators, the most important ones being the Gluteus Medius and Gluteus minimus.
These muscles effectively brace over the hip downwards, preventing the hip from collapsing sideways. These muscles are also prone to tightness (a tight muscle is a weak muscle), this can lead to compensations such as TFL and Glut Max tightness that when overused and tight can effectively cause Iliotibial band tightness and common problems such as ‘runner’s knee’ and problems in other areas. Glut Min and Med are strengthened using a piece of light to medium strength Theraband and the X-walk and monster walk, there are many variations of this exercise on Youtube so I combined the best pieces from each into the above word document. These exercises alone will not be any where near as effective as they can be without strengthening your Thoraco-pelvic canister (TPC), the TPC is made up of your Diaphragm, core and pelvic floor muscles all working together to support your pelvis and lower back (a functional body).
There are progressions of these hip exercises to make them more challenging such for the athletic individual, however when in the rehab phase after an injury these exercises are great. I will at some point start doing my own Youtube videos as I find technique lacks in a lot of the videos currently available.
Performing these exercises regularly when the hips are not in pain can help prevent hip osteoarthritis. If however, the hips are already painful it is best to stretch and use lots of ice packs (10-15 mins every 2 hours) to calm the musculature down before attempting any strengthening routines.