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Keys to Hip Mobility

The hip joint is one of the most mobile joints in the body. Healthy hips are vital for athletic performance in all sports, and it is the main joint that connects our legs to the rest of our body. Rotation, sprinting, cutting, and jumping all require massive amounts of controlled range of motion and power at the hip. Not only do hips need to be strong, but they must be mobile as well. When hips don’t move well, something else has to give. Poor hip mobility can lead to low back, knee, and ankle pain.


Anatomy

The hip joint is often thought of as a ball in socket joint. This ball is held in place by a capsule and surrounding musculature and must slide and glide for proper hip function and mobility. The hip can do multiple motions including flexion/extension (moving up and down), abduction/adduction (moving side to side), and internal/external rotation. Although these motions are often thought of as individual movements, the hip joint cannot perform one without the other two occurring at the same time. This is important when considering how to maximize hip function and health.



The ball of the hip can move in the socket, but more importantly, the socket can move over the ball of the hip. This happens when our foot is flat on the ground. When the leg is fixed and the pelvis moves forward in space such as when running, cutting, and jumping, the pelvis changes its shape, and the socket moves over and around the ball. This movement is vital for athletic performance. We can separate hip movements into two categories: midstance, aka standing on one leg (extension, adduction, internal rotation) and early/late stance (flexion, abduction, external rotation). By focusing on these paired motions, we can create range of motion at the hip in an efficient and painless manner.


Steps to Maximizing Mobility
  1. Ensure the pelvis is stable when moving the femur When the leg is lifted (think marching or running), the pelvis must be stable as the thigh bone moves up and down. If the pelvis moves with the thigh bone, movement comes from the spine and not the hip joint itself. Marching activities on your back can be very helpful to teach this basic pattern.

  2. Loaded squat and hinge patterns When we squat, the pelvis must open at the bottom (also known as nutation). If it doesn't, motion has to come from somewhere else in the body and can cause the dreaded butt wink.  A heels elevated squat while holding a ball between your knees can help with this.

  3. Making sure the pelvis is neutral When I say neutral pelvis, I mean can your pelvis change shape equally to the right and left. PRI's 90-90 hip shift is a classic exercise to address any asymmetries in the pelvis and ribcage. The left hamstring, inner thigh, and outer hip working together will make sure that your pelvis can move back on the femur when standing on the left leg.

  4. Ribcage mobility When talking about the hip and pelvis, it's impossible to ignore the relationship the pelvis has with the ribcage. The pelvic floor and diaphragm must work together during breathing in order to create proper movement patterns through the rest of the body. If your ribcage cannot compress on one side, then your hip will also be unable to stabilize itself on that same side.

  5. Tissue restriction After the first four things are working well, only then do we start looking at possible sites of tissue restriction around the hip joint. This can include the glutes, deep hip rotators (eg piriformis), hip flexors, and capsule around the joint.

  6. Sport-specific mobility Some sports like hockey and jiu jitsu require more hip range of motion than the average sport. For these, I like to use the 90-90 side sit position from FRC. From this position, extreme ranges of rotation can be trained and loaded. Note that this position is only useful when more range of motion that normal is required for a sport-specific task.



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