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How to Improve Hip Mobility

Welcome back to Squat University! During these past few weeks we have covered the hip joint. Previously, we introduced a screen to test our hip mobility called the Thomas test. Most restrictions are due to either joint immobility or soft tissue tightness (stiff muscles and/or fascia). The goal of this weeks lecture is to introduce a few simple tools to address these restrictions.

Today I wanted to share a few of my favorite tools. I also want to share with you my 4-step process in dealing with hip stiffness.

  1. Mobilize
  2. Foam Roll
  3. Stretch
  4. Posterior-Chain Activation

 

Hip Mobilizations

A restriction in joint mobility should be the first area to address. During the Thomas test, a “pinching” sensation felt in the front of the hip when pulling your knee to your chest indicates possible impingement. This sensation is felt when the femur hits the joint “blockade,” halting the movement at the hip joint. These types of restrictions will not resolve with conventional stretching and foam rolling. Therefore, any pinching sensation in our hip joint must be addressed first before moving onto possible soft tissue stiffness.

One of the easiest ways to improve joint restrictions on your own is to use a band for mobilization. The rubber material of the band is elastic and strong enough to affect the tough joint-capsule of the hip. If you don’t have access to one, I’d check out the Superband from Perform Better.

Band distraction joint mobilizations assist with the way our bones glide over each other. A joint glide is sustained while the athlete actively moves into the specific range-of-motion we are trying to improve. During the squat, the end of our femur glides backwards in our hip joint as our thigh moves towards our chest. These types of mobilizations (simply termed mobilizations with movement) have been used for years by physical therapists. The goal is to alleviate any painful or pinching feelings deep in the joint.

Physical Therapist and founder of MobilityWOD, Kelly Starrett gives an easy explanation for this banded mobilization.

 

Foam Rolling

Once joint restrictions have been addressed the next step is to clear up any soft tissue stiffness. This starts with using a foam roller. I usually recommend athletes spend at least 2 minutes on each area they are trying to address. Every athlete should foam roll on a daily basis!

Our goal with the foam roller is to decrease the stiffness the Thomas test was able to expose. This means addressing our hip flexors, quads, and lateral hips. Start by moving slowly up and down the lower leg muscles until you find a tender area. Pause on this area and ‘tack it down’ with your bodyweight for ~10 seconds before moving again.

I like to use the analogy of kneading bread with a rolling pin. You want to use the foam roller to knead your tissues, rolling back and forth in small rhythmical movements. Lying on the roller and moving quickly in large passes will have little effect on your stiff tissues. You can also add in active knee movement during this pause to increase the effectiveness.

 

Soft Tissue Stretching

Once foam rolling is complete, stretching the muscles is the next step. My first go-to stretch for opening up our hips and improving our mobility prior to squatting is called the “World’s Greatest Stretch.”

This stretch has 4 parts to it. First, start by assuming a deep lunge position with your left leg forward. Squeeze your glutes and drive you hips toward the floor. This movement should cause a stretch to be felt in the front of the right hip. Second, drop your left elbow to the ground. Hold for 5 seconds. Next, use your elbow or hand to drive your left knee out to the side. Make sure to keep your foot firmly planted on the ground.  Finally, rotate the entire upper body up and to the left, ending with the left arm in the air. This last movement helps address the mobility of the thoracic (mid-spine) that is also prone to stiffness.

Another stretch I like to use is the ½ kneeling hip flexor stretch. This is a great tool for addressing the muscles in the front of our hip. The hip flexors and/or quads can become excessively tight as an adaptation to sitting all day. In this video, physical therapist Mike Reinold demonstrates how to perform this stretch.

 

The last stretch I want to share with you today is a more position-specific movement and therefore has good carryover to the squat itself. To start, drop into a deep goblet squat. This can be performed with either a kettle bell or a weighted plate. Holding a weight in front of us allows us to worry less about balance and more on the deep squat position we want to improve.

After reaching full depth, drive your knees out to the side of your feet as far as possible with your elbows. Make sure the entire time that your feet stay firmly planted on the floor in the good tri-pod position. Driving the knees out to the side with your elbows will increase the stretch felt in your hips.

As you open your hips up in this position we can also work on activating our glutes. The glutes are the primary muscle group that drives us up and out of the bottom of the squat. While you sit in the bottom of the goblet squat, try to squeeze your glutes and drive your knees out to the side as hard as you can for a few seconds (make sure to keep your feet flat). Next, relax and allow your body to drop into the stretch again.

This specific type of stretch is called a “Contract-Relax” technique. Physical therapists and strength coaches commonly use these techniques because they are so effective in improving our mobility compared to the classic long duration stretches. After holding for ~30 seconds to a minute, stand up and take a break. I like to perform this movement 2-3 times before moving on.

Posterior Chain Activation

The inability to properly activate the posterior chain (glutes and hamstrings) during the squat is a common finding in athletes. For this reason I recommend athletes perform a quick exercise to prime these muscles after addressing their mobility issues.

The movement I want to show you today is called Unilateral Abduction. The layman term for this exercise is ‘banded lateral kicks.’ To start place an elastic band around your ankles. I like using the mini exercise bands from Perform Better. Next assume an athletic single leg stance. Once in this position, push the hips backwards and allow the chest to move forward. This small movement allows us to engage our posterior chain and remain balanced. The cue I like to use for every squat (even small ones like this) to solidify this idea is: “squat with the hips – not with the knees.”

Once we are in position, kick the non-stance leg out to the side and back in a slow and controlled manner. The distance the leg moves out to the side is not our main concern. Focus on keeping the stance leg in a stable and unwavering position during the entire exercise. This exercise not only primes the glutes for the squatting we will perform after, but will help address core and knee stability problems.

2-3 sets of 10-15 repetitions

Test-Retest

After you have addressed your stiff hips, its time to check and see the progress you have made. Always employ a test-retest strategy when performing mobility exercises. This allows you to see if the tools you are using are effective in addressing the change you desire.

Performing a deep bodyweight squat is a great way to assess any changes. Also attempt a deep pistol squat. Do you notice anything different? Our goal is to make a lasting change in our overall movement pattern of the squat. Mobility tools are only effective if they carry over to an exercise we’re trying to work on.

My hope for this lecture is to give you the tools necessary to address any hip stiffness problems. If you want to remain competitive or move around pain free, it is vital that you improve and maintain good hip mobility.

Until next time,

Dr. Aaron Horschig, PT, DPT, CSCS, USAW

with

Dr. Kevin Sonthana, PT, DPT, CSCS
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