Mobility for Runners and Fitness Enthusiasts: Hips
By Veronica Dilzer
This is the second installment in the Mobility for Runners & Fitness Enthusiasts Series. Click here to read the first installment.
The importance of hip mobility cannot be overstated. It plays a major role in all forms of locomotion, and in the long run (of life), can have a significant impact on the quality and expectancy of our existence. In the more immediate future, or maybe even the present for some of us, poor hip range of motion or lack of motor control can lead to dysfunctional movement patterns that we call compensation patterns.
Everyone has compensation patterns, but it’s only when a compensation pattern reaches its limit that it causes pain. Pain is a request from your body to change; not a punishment or a badge of honor. Compensation patterns can go on for years before you feel pain.
Pain from hip dysfunction most often presents in other areas of the body; it can be a contributor to lower back pain, knee pain, IT band issues, shin splints, core dysfunction, pelvic floor issues, and even contralateral shoulder pain. Much like the number of ways pain can manifest, the compensatory patterns available to the hip are extensive because of the complexity of the joint and the large interplay it has with the rest of the kinetic chain.
The compensatory patterns our hips take on are directly correlated to our lifestyle habits and will shift in order to sustain the most functional capacity while absorbing the least amount of damage, and so the more repetitious a movement pattern the more apparent the compensation pattern (accompanied by pain) will become. Following that logic, it is easy to see why at the beginning of a marathon training program, everyone is relatively pain free, and why by race day, these compensation patterns have caused pain.
Luckily, there are exercises based on our shared lifestyle habits (our society’s propensity for sitting) and our chosen fitness activity (running) that we can incorporate into a hip mobility program.
The Exercise: Soft Tissue Work on Quadriceps and Gluteus Medius/Piriformis
In general, we spend a majority of our days in a seated position which over time may shorten the muscles of the anterior hip. In turn, the shortening of the muscles in the front of the hip will cause an excessive curve in the lower back and shift our hips from a neutral position to an anterior pelvic tilt. An anterior pelvic tilt leaves us susceptible to lower back issues, hamstring pulls, glute inhibition, and core dysfunction. While soft tissue work alone cannot lengthen tissue fibers it does temporarily change the tone of chronically tight muscles and affords us the opportunity to work on reprogramming the muscles through similar techniques that we discussed for the ankle joint.
The Set Up: The Gluteus Medius and Piriformis attach at the greater trochanter (the bony notch on the outside, proximal part of the femur) which is convenient for soft tissue work. For this portion of soft tissue work place the ball right behind this notch.
The quadriceps muscle group is located in the front portion of the upper leg. Place the ball underneath the hip joint in the belly of the large muscle group. There are 4 muscles that make up this group so the position of the ball may be slightly different for everyone. The objective is to get the ball over the most sore trigger point in the muscle groups.
The Execution: to perform this exercise on the Glute Medius/Piriformis cross the leg with the ball over top of the other bent knee. Try to maintain a tall position with your torso by placing your hands behind you for support. Take a few seconds to get used to this initial position after which, push the leg towards the ground. This technique is called a pin and stretch. You are taking the tightest part of the muscles, pinning them underneath the ball, and then exciting the stretch reflex which will elicit a change in tone.
The same execution should be followed for the quadricep muscles. Lay flat on your stomach with the ball under an outstretched leg. Bend the knee to apply the stretch to the quadriceps area.
The Feeling: For a majority of us, these areas will be sensitive. Use common sense and take it easy to begin with until you know how your body will react to it. This should not be a painful experience. Make sure you are going through a range of motion that does not cause extreme discomfort. This may mean at first that no motion is required to achieve the desired response.
The Exercise: Quadricep/ General Gluteal Band Mobilization
Now that the tone of the tissue is softened, band mobilization techniques can be utilized to create new, temporary expanded ranges of motion. Again, once we have the capacity to move more freely by obtaining space in the joint through mobilization, we can move onto controlling the new ROM. If you stop at this step you are temporarily creating a new and unstable range. If you want to keep this new range, you have to create a neurological load which is the next step in the mobility program.
The Set Up: Place a securely anchored band around the top portion of your leg as close to the hip joint as possible and walk out to a reasonable amount of tension. Like rolling the ball on the bottom of your foot, you can also overdue this one. Make sure you begin with light tension and see how your body reacts.
The position for mobilization of the gluteal muscles is very similar to the yoga pigeon pose. Place the band around the top of the leg near the hip joint. Try to get your lower leg as close to perpendicular to your body as possible. Square your hips and reach the other leg straight out behind you. Use your arms to help facilitate an upright torso position.
The Execution: While in the half kneeling position, engage your core and stack your hips underneath your shoulders. To create tension against the joint, squeeze your back butt cheek (the leg that’s in back) and drive the hip slightly forward. Really work to maintain your core position so there is no excessive arch in the lower back. Reach over your head with the opposite arm. Hold this position for a count of four, then disengage the hip to relax the stretch.
The gluteal mobilization is unique because you are working on both sides of the motion. While in the pigeon position, drive your hips toward the ground. The band should guide you into this motion. Hold at the bottom. Actively drive out of this position by pushing with your back foot to create tension in the band as you move forward and up. Make sure you are under control and are consciously aware of how much stress you are placing on the hip. Remember to work your way into it.
The Feeling: If your hips are tight, these two mobilizations will be uncomfortable, especially the gluteal mobilization. The first mobilization should activate the glute while causing a stretch sensation in the front of the hip. The glute mobilization will cause the internal rotators and adductors of the hip to stretch, as well as cause the glute to stretch into a position that acts upon the three major actions of the muscle group which are extension, external rotation, and abduction. The hip is a major joint with huge muscle attachments. Progress will and should be slow. If you wake up the next day and your hip is sore, then you might have overdone it.
The Exercise: Half Kneeling Hamstring Isometrics
As stated in the first installment of this series, isometric contractions are a safe and effective way to gain strength and control of new ranges of motion at the end of current joint mobility, while teaching the central nervous system how to obtain and keep that new ROM. The hamstrings play a huge role in running mechanics and allow our body to decelerate safely. Most often, the inability to control sudden stops or changes in direction are the mechanism for non-contact injuries. Having a lack of neuromuscular control within the hamstrings is like conducting a speeding train with no brakes.
Your body is an incredible machine and can recognize the instability within the region. The neuromuscular system will not grant permission for more speed than it can comfortably control, therefore working on its capacity can positively impact power production and acceleration.
The Set Up: Create totally body tension in the half kneeling position by tightening the core, squeezing your fists and punching the ground, and actively pushing both feet into the ground like you are going to stand up.
The Execution: Once you have successfully created total body tension, focus on pushing your feet into the ground. This position should activate the hamstrings on the front leg and the quadriceps group on the back leg. Hold this position for approximately 20 seconds. After this interval has elapsed, pull the back heel towards your butt without shifting your pelvis, leaning forward, or losing tension anywhere else, including the front leg. Repeat 3-4 times, reevaluating your position after each heel pull. Make sure that the foot and lower leg maintain their neutral position as the foot pulls off the floor.
The Feeling: This exercise is very taxing on your nervous and muscular systems. You will cramp. Remember that in this situation cramping is not a bad thing. This exercise is also very difficult. I have included a few regressions that utilize a wall and a band to help create tension. The incorporation of tools that will help your body maintain tension more easily will allow you to focus your energy on lifting the foot. Try to work through the entire cycle before resting.
The Exercise: Fire Hydrants
This appropriately named exercise works on strengthening the Gluteus Medius and abduction of the hip. The Gluteus Medius plays a pivotal role in preventing hip drop while running and also prevents lateral shift in your hips. Strengthening this muscle can also prevent knee valgus (collapsing of the knee towards the midline) which has been linked to ACL tears. It also stabilizes the leg through the extension part of the gait pattern and allows the other leg to drive forward.
The Set Up: Find a space along the wall and position yourself in a quadruped stance (knees underneath hips, hands underneath shoulders) with even weight on all six points of contact. Place a ball between your hip and the wall. The ball will act as feedback for any lateral shift in position as well as elicit a static activation of the gluteus medius on the leg closest to the wall.
The Execution: Create tension in your core and push your hands and feet into the ground. Try to prevent any weight shift as you take the outside leg through the motion of abduction. Make sure the motion is led by the hip and not the foot.
The Feeling: This motion is difficult to control especially as you reach end range. You should feel work near the posterior side of the greater trochanter and in your core. Take your time going through the degrees of available motion and really try to get into a groove with this movement.
The Exercise: Stability Ball Dead Bug
The dead bug position is a great way to train posterior pelvic tilt, build core strength, and activate the stabilizers of the hip-lumbar-pelvic complex. Our ability to run efficiently is dependent on how well our upper body coordinates with our lower body as well as how well our body transfers force through the entire kinetic chain. Proper core and spinal stabilization is essential for this to occur. Often we have trouble using our hips without creating extension in the lower back. This exercise trains joint movement isolation while training anti-extension, which will allow your body to function better through the contralateral pattern of running. Proximal stability equals distal mobility. The better your core functions and spine stabilizes, the better your limbs will move.
The Set Up: Grab a stability ball and lie on your back. Extend your arms above your shoulders and bend your knees and hips to 90 degree angles. Place the stability ball against the bent knees and wrists and apply pressure to hold it in place.
The Execution: Engage your core and ensure that your lower back is pressed evenly onto the floor. Take the opposite hand and leg and slowly begin to drop them to the floor in a controlled descent. Continue to reach towards the floor until you feel like you can no longer maintain your lower back position. Going from four points of contact to two points of contact on the ball will also challenge the stationary arm and leg. Make sure you maintain tight contact all the way through the motion. Return the arm and knee to their original positions and switch to the other side. Make sure to maintain your breathing pattern through each repetition.
The Feeling: This exercise may prove to be quite exhausting on your core in a short amount of time. The quality of the movement is more important than the quantity. Make sure you are challenging the range of motion but really pay particular attention to your lower back position. This exercise also may be challenging for your brain as it tests the neuromuscular coordination of the cross body pattern. The key to this exercise is deliberate practice. Make sure you are focusing your thoughts towards completing good reps.
The Exercise: Prone Glute Activation
As mentioned, the three major actions of the glutes are extension, abduction, and external rotation. All three of these motions are important to hip joint stability and health. Combining all three planes of motions into one exercise trains all the fibers of the muscle group to work as a cohesive unit and recruits the most power for better stride performance.
The Set Up: Lie face down with your legs extended and your arms supporting a neutral head position.
The Execution: Stabilize your pelvis by engaging the core. While maintaining a neutral pelvis, push the heel towards the ceiling to its full range of comfortable motion, then rotate the leg at the hip joint, and finally abduct the hip away from the midline. Each motion should be challenging the strength and recruitment of the muscles at the available end range.
The Feeling: The process of deliberate practice is needed to ascertain the difference between glute contraction and lower back recruitment. A shifted pelvis position allows the muscles in the lower back to replace proper glute recruitment, especially in the extended position. Begin with a small range of motion and keep lower back contraction to a minimum. If your hip bones in the front dig into the ground chances are your pelvis position has shifted.
The Exercise: Half Kneeling In-Line Lunge
This activation puts all your hard work together. The small base of stabilization will challenge the communication between your hips and your core. It also requires the activation of the glutes, the maintenance of a neutral pelvis position, and minimal lateral shift to achieve balance. This is also a great regression to relearn or improve the hip hinge position that we use in common big lift exercises such as deadlifts, RDLs, and clean variations.
The Set Up: In a half kneeling position, place your front foot in line with your back knee. Make sure the back foot is also in line with the knee. Place your hands on the floor to gain initial balance as you find a flat back position.
The Execution: Retract the shoulder blades towards the ceiling to create tension in the upper back. Next engage the core. While maintaining the flat back position, pull your upper body backwards to create a stacked position above the hips. Try to keep hip shifts to a minimum as you find a new upright balance point. Slowly return to the start position and repeat. After a few reps, switch the leg that is in front.
The Feeling: This exercise will give you immediate feedback as to how well your hips function within lateral stability as well as how your core functions when you maintain proper pelvic position. When you are going through the upward motion, try to engage your glute to prevent the hip from traveling forward. This exercise should challenge your core strength, hip stability, and balance.
Disclaimer: We all have a starting point. This blog post is intended to provide runners and fitness enthusiasts that function within the range of normal capacity with ideas surrounding the incorporation of mobility into their programs. There are great resources in this blog and on other sites! (Check out @FloFitness and @theMovementMaestro) If you are in chronic pain, have pre-existing orthopedic issues, are currently under the care of a medical professional, or know that you need specific help, let's talk about it. This may not be your starting point. Email me at firstname.lastname@example.org or DM me on Instagram @vdilzer, and we’ll figure out the right direction for you. Just remember, it is your responsibility to evaluate your own medical and physical condition and independently determine whether to perform, use, or adapt any of the information in this blog post. Even though these exercises are safe, there is always a risk associated with any generally prescribed movement program. By voluntarily undertaking in any exercise displayed in this blog, you assume all risk.