The Squat Fix: Hip Mobility Pt 2

Welcome back to Squat University! Last week we introduced the hip as a naturally stable joint that could benefit from more mobility. When we squat, mobile hips allow us to reach to full depth. Having full hip motion allows us to produce a tremendous amount of power.

With adequate mobility at the hips, our knees and lower back remain stable. The main idea behind the “Joint-By-Joint” concept is that our bodies consist of ever-connecting parts. A weak link in our chain of movement will cause a breakdown in the entire system. Stiff hips limit our ability to squat with good technique.

A test was introduced last week as a tool to uncover missing hip movement. What I want to do today is discuss the results of the Thomas test. If you didn’t test your hip mobility yet, take a minute and check out last weeks lecture.

After performing the test, what did you notice? Did you pass? Don’t worry if you failed! It is important to understand the different reasons for developing stiffness at the hips so that we can appropriately treat the problem. There is no ‘one size fits all’ approach to fixing stiff hips.

Stiff hips are primarily caused by two different factors

• Joint Restriction
• Soft Tissue Restrictions

Joint Restriction

Joint restriction is simply defined as a loss of space between the bones that connect at the hip. Essentially they stop moving appropriately over one another. This tightness creates a roadblock in the joint. This bony blockade halts the forward movement of the femur (thigh bone) in the hip joint when we try to bring our knee to our chest (like in the Thomas test). This movement restriction is called FAI or femoroacetabular impingement (1). This mobility problem is usually the result of repetitive strain, such as the wear and tear effects of pushing through pinching pain in the bottom of a squat. It can also be caused by long-term adaptation to a sedentary lifestyle.

If you had difficulty pulling your knee up to your chest and felt a “pinch” in the hip, there is a possibility that you have FAI. We previously discussed the analogy about the roundabout in a restricted ankle joint. With FAI, the femur will actually hit a “blockade” causing that pinching sensation in the front of the hip.

Our bodies however are a little smarter than we think and will naturally compensate our movement pattern in order to get the job done. As a result of the hip restriction, the low back is forced to move! This low back movement decreases our stability during squats, preventing optimal power and strength gains.

We can go about resolving this problem through two methods. First we can use joint mobilization exercises to increase space in the hip joint. Second we will ensure our posterior chain (glute and hamstring muscles) is working efficiently. An inability to properly activate the glutes during movements like the squat is commonly seen. We will discuss how to mobilize the hip joint and how to fire the posterior chain in net week’s lecture.

Soft Tissue Restriction

Soft tissue restrictions at the hip joint include muscles (iliopsoas and quadriceps), the IT band and fascia. These structures can become stiff and inflexible over time. For example, a sedentary lifestyle such as sitting for long periods will often lead to stiffness and tightness. Excessive inactivity can cause fascia to loose its elasticity thereby making it difficult for surrounding tissues to glide easily over one another. Plain and simple, excessive sitting decreases our natural hip flexibility and degrades normal movement patterns (such as the squat).

This type of limitation will usually be felt as tightness in the front or lateral part of the free hip during the Thomas test (refer to bottom of page). Some common findings during the Thomas test are: the free leg remains off the bed, falls out to the side, or your knee is unable to relax into a bent position. If this is the case for you, we will go about addressing these types of restrictions with two different tools – stretching and foam rolling.

Hip mobility is a very important aspect in achieving a full depth squat. Stiff hips decrease our ability to properly activate the appropriate muscles in our hips. Essentially, we bleed out a good amount of power during heavy squats. Understanding the cause of our restricted hip mobility is the first step in establishing effective ways to fix the problem. Join us next week as we address different methods for improving our stiff hips!

Until next time,

Dr. Aaron Horschig

With

Dr. Kevin Sonthana

References

1) Leunig M, Beaule PE & Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Cin Orthop Relat Res. 2009 Mar; 467(3): 616-622