For the past few weeks, we have discussed in detail on how the mobile ankle is crucial for the perfect squat technique. Today, we’re going to skip the knees for now and move onto the hips. This is another area of the body that tends to develop stiffness. A sedentary lifestyle and excessive sitting are a couple reasons for why we develop stiff hips. Limited range-of-motion at the hips can limit our ability to squat to full depth. Most of us could benefit from working on our hip mobility issues.
When the hips lack adequate mobility a few things can happen. First the knees will lose stability and start to bow inward. Second, the lower back will fail to remain stable and collapse into a rounded position. Each of these movement problems wreaks havoc on our power and increases our risk for injury.
Adequate hip flexion and hip internal rotation is needed to reach a full depth squat (hips below parallel). You can measure flexion of the hip by drawing a line with the torso and another line with the outside of the upper leg. The smaller or more closed the angle is, the more hip flexion the athlete has. Internal rotation is a little harder to judge on your own and will be a topic of a later lecture.
If you are unable to squat to full depth with toes relatively straightforward, hip mobility is likely a limiting factor. Today I want to introduce one of my favorite tools for assessing hip mobility. It is called the Thomas test (1).
This test is performed while lying on your back. The Thomas test’s main purpose is to look for either Iliopsoas (hip flexor muscle), Rectus Femoris (quad muscle) or Iliotibial band tightness. All of these soft tissue structure can contribute to hip mobility issues.
Start by standing next to a bed or a bench. Your hips should be in contact with the edge. Grab one of your knees and pull it towards your chest as you gently fall backwards. The knee you grab should be pulled as close to your chest as possible. As you lie on your back while holding onto your knee, allow your other leg to relax completely.
What position does your body end up? Having a friend help you with this screen is extremely beneficial. Once you screen one leg, perform the same movement on the opposite leg and see what you find.
Did you have checks in every box of the ‘pass’ column? If so you show adequate hip flexion mobility. However if you had any checks in the ‘fail’ column for this screen, you have a hip mobility restriction.
If you were unable to pull your knee fully to your chest, we are dealing with a possible hip flexion mobility issue. This could be caused by a number of factors including tight or restricted soft tissues, or even hip capsule restrictions.
If you were unable to pull one of your legs as far towards your chest as the other, you have a possible asymmetry in hip mobility. This is a red flag. Asymmetries are very important to take care of as they can negatively influence barbell squats. Often these small side-to-side differences go undiagnosed. Left untreated, asymmetries can lead to over-use injuries.
The Thomas test also allows us to screen for mobility restrictions in the opposite hip. An inability to keep your opposite leg flat on the bed and in a straight line can also point towards hip stiffness. These types of restrictions can often be due to soft tissue tightness and will be a part of the discussion in next weeks lecture.
Next week we will learn how to decipher between soft tissue issues and joint mobility issues of our hips. In addition, we will talk about a few ways to improve hip mobility with the goal of improving our squats.
Always assess movement first. If you found a problem in your single or double leg squat, we can then use different tools (like the Thomas test) to find out the cause of the breakdown the movement.
Until next time,
Dr. Aaron Horschig
Dr. Kevin Sonthana
1) Harvey D. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
19 thoughts on “How to Screen Hip Mobility”
[…] Lectures […]
[…] Lectures […]
[…] Before we start, these tools come with a caveat. Improving knee stability must only be attempted after the ankle and hip joints have been cleared of mobility restrictions. Any stiffness in the ankles and/or hips will cause a breakdown in the stability of the knee. If you have not yet screened your ankles and hips for stiffness, check out our previous two lectures: Ankle Mobility Pt 1 and Hip Mobility Pt 1. […]
[…] If the lifter continues to descend, the pelvis will be pulled underneath (posterior pelvis tilt) causing the lower back to round as well. The subsequent rounding of the back has been justly termed “butt wink”. Improving hip mobility will decrease the likelihood of the “butt wink”. If you have not yet cleared your hips, check out the lecture article “The Squat Fix: Hip Mobility Pt 1-3.” […]
[…] The hip joint is an area of the body that shows a tendency to benefit from increased mobility due to its tendency to become immobile and stiff. If the hip loses its mobility it will affect the role of the joint complex directly above (the low back) and the below (the knee). What we’ve come to find is that the all too common ‘low back pain’ is caused by a lack of hip mobility (1). For this reason, it wouldn’t matter how much strength and stability work you perform on the ‘core’ – if the hip mobility is never addressed, no change in pain will occur. […]
[…] fact, research has shown that low back pain can be attributed to a lack of hip mobility (4). For this reason, it wouldn’t matter how much strength and stability work you perform on the […]
[…] fact, research has shown that low back pain can be attributed to a lack of hip mobility (1). For this reason, it wouldn’t matter how much strength and stability work you perform on the […]
[…] role. One group of researchers found that athletes with more quad flexibility (as assessed with the Thomas Test) were 70% less likely to suffer a hamstring […]
[…] modified Thomas test is often used to determine the flexibility of the hip flexors and quads. Start by standing next […]
[…] order to squat to full depth with the toes straightforward, an athlete must have adequate ankle and hip mobility and sufficient pelvic/core control. They must also have acceptable coordination and balance. By […]
[…] you found stiffness in your hip flexors during the Thomas Test, your first line of treatment should be to work on improving this flexibility. We can go about this […]
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[…] Doctors Note: For example, those with tight hips may not be able to open them fully. Try using a screen called the Thomas test. […]
[…] La cadera : Esta articulación es un area del cuerpo que muestra la tendencia de beneficiarse del incremento de la movilidad, debido a la tendencia de volverse poco móvil y rígida. Si la cadera pierde su movilidad esta afecta completamente todo el complejo de articulaciones superiores (espalda baja) y por debajo ( la rodilla). También hemos encontrado que los dolores de espalda baja suelen estar relacionados con la falta de movilidad en la cadera. Es por esta razón, que no tendría importancia cuan fuerte y estables seamos de «core» – si nuestra cadera es poco móvil, ningún cambio en la sensación del dolor debe ocurrir. […]
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I am 59. I face pelvic pains,siatic pains, weak ankles and knee issues. I also have a bad right shoulder so presses are an issue. I lift on deads close to 4-5 hundred pounds at a body weight of 160. Squat 2-3 hundred. Bench 210
I also have tennis elbow