The hip joint is impressive looking. With 21 muscles that provide stability, keep the femur in the pelvis, and allow for an incredible range of movements, it’s a unique part of our anatomy.1
The joint itself is located towards the front of the pelvis. If you find the two front hip bones and trace a line down to your hip crease, you will be close to the actual joint. If you stand up and place your hand there, when you move the thigh, you should feel movement under your hand. This is where the head of the femur, the long upper leg bone, is cupped neatly by the pelvis.
The muscles on the outside of your hip (which is often where people gesture when they are discussing the hip) are heavily involved in movement of the femur, allowing the upper leg to swing backward, out to the side, and in and out. More muscles are located in the front that move the leg forward and up, and still, others are located on the inside of the leg, bringing it in and allowing it to rotate.
It is difficult to create a sense of balance in this joint, which leads people (including some who outwardly appear flexible), to experience a sense of tightness or restriction in the hips. Tight hips don’t have to limit your movement potential; however, it does take a little bit of work to create an equilibrium of stability and mobility in this area.
Basic Hip Mechanics
A group of six muscles stabilize the hip in the socket. Much like the rotator cuff muscles of the shoulder, these muscles, along with the ligaments, provide the hip with a balanced sense of stability. From there, layers of muscles allow the femur (thigh bone) to move in all directions. Many of the hip muscles do several things, like bring the hip forward and rotate it inwards, or move it backward and into external rotation. Instead of focusing on what each individual muscle does, you can create a sense of balanced strength and mobility throughout the hip’s range of motion. Once you do, everything tends to work (and feel) a whole lot better.
Often, people I train struggle with understanding the difference between movement at the hip and movement at the pelvis. This effects overall coordination between the two areas. Teaching the hips and pelvis how to interact a little bit better can increase balance, coordination, and mobility at the hip joint.
Hip Mobility and Low Back Pain
It’s probably not a coincidence that there appears to be a correlation between hip mobility and low back pain.2 In fact, including isolated hip exercises in a physical therapy setting led to a dramatic decrease in low back pain (and increase in hip mobility) in a recent study performed in Korea.3
When there is a lack of clarity regarding how the hip actually moves, the pelvis will pick up the slack. If you think things like “lift my right leg,” your brain will figure out a way to lift the leg. If your brain isn’t quite sure how to lift the leg from the hip, either because the muscles don’t have the strength, mobility, or there simply isn’t a clear understanding of how to do that, your neuromuscular system will figure out another way, usually by using the pelvis. This isn’t very efficient, and if it’s a regular occurrence, can lead to the muscles around your pelvis feeling fatigued, and leave you with a back ache.
Separating the hip from the pelvis improves movement quality and allows load to be dispersed a little more evenly. It also lets your back muscles do the things they were designed for, like providing stability, rather than moving your leg. It’s kind of like using a fork to make a peanut butter and jelly sandwich—it works, but isn’t necessarily the most efficient way to spread the peanut butter.
Understand the Hip and Pelvis Relationship
Let’s think about the two front hip bones for a moment. They are actually part of your pelvis, named the anterior superior iliac spines (or ASIS for short), for those of you that want to impress people at parties with your random anatomy knowledge. If you place your fingers on them, you can move them into your fingers and away from your fingers. You can move the bone under your right finger up and down or forward and back, or the bone under your left finger up and down or forward and back. Whenever we walk, there are subtle variations of these movements that happen in order for the leg to move.4
Now, keeping your hands on your ASIS, see if you can keep them completely still and lift your right foot off the ground. Did you feel the movement underneath your right finger as soon as you began to lift the foot? If so, you initiated the foot lift with your pelvis instead of your hip joint.
If you really want to test your ability to differentiate your pelvis and your leg, come into a tall kneeling position. Take your hands on your ASIS. Feel that they are level. Step your right foot forward so you are in a lunge position with your left knee on the ground. How much shifting occurred in your pelvis? Look down at your hands. Is one higher than the other? Can you figure out a way to balance them out and make them even?
Let’s say your right ASIS moved up when you stepped your right foot forward, and you couldn’t figure out how to bring it back down. What do you think happens when you do walking lunges? Or side angle pose? Usually, the same habit will show up in different positions.
Keep a Stable Pelvis
It’s not that we want to keep the pelvis fixed; however, you should have the ability to consciously decide, “pelvis, don’t move” and for it to respond accordingly. Things tend to work better during spontaneous movement when you also have the ability to control your movement.
Maybe you’re thinking, “None of this has been difficult for me. My pelvis stays still, I can lift knee up to my shoulder and my pelvis doesn’t move, but I still have a sense of tightness in my hips. Why?”
The answer to this can be two-fold. First, what happens when you perform the above movements really, really slowly? Is it still easy, or do you feel areas you want to move through quickly? If it’s challenging to slow things down, it could be that, while you have a lot of hip flexion flexibility, you don’t have strength throughout the range of motion. Slowing things down and continuing to work on isolation will likely lead to an increased sense of strength and control.
The second question to ask yourself is do you have a sense of strength in your hamstrings (the back of the thighs) when the knee is extended, flexed, and everything in between?
Let’s say you can fold forward and touch the floor with your hands. You are proud of your hamstring flexibility; whether it’s something you were born with, or it’s something you’ve worked hard to achieve, it lets you get into a variety of positions while others look on enviously.
Now, ask yourself how strong your hamstrings are. Standing with your knees close together, what happens if you bend your right knee? Glance down and make sure your right knee didn’t move forward. It should stay on the same line as the left knee. Check your back. Are you arching to bend your knee? If so, can you adjust yourself so your back isn’t arching and you are isolating the movement to the hamstring? Is the back of your leg turning into one giant cramp? This is a great way to begin creating strength when the hamstring is flexed.
Work on Pelvic and Hip Movement
Strengthening the hamstring in other positions with load is also helpful. Deadlift variations (both double and single leg) and supine bridge positions are great ways to create a sense of balance in your hips. Just remember to pay attention to what your pelvis is doing, and make sure you are moving from the hip and not from the back.
You can look at the same thing in a squat or single leg squat. Can you keep your pelvis level and isolate movement at the hip? If yes, can you move through the movement slowly? The shrimp squat variation below is one of my favorite ways to strengthen the hamstring in a shortened position while working on strengthening the squat position in the front leg.
Once you have mastered the ability to move forward and back at the hip, introduce movements that work abduction (when the thigh moves away from the center of the body), adduction (when the thigh gets added back to the center of the body), and internal and external rotation. These are the movements that allow the femur to move in a circular manner. Can you isolate each of these movements keeping the pelvis still? What happens when you let the pelvis move? I bet the movements get bigger. By learning how to control movement, the theory goes, during athletic movement we have more coordinated, safe options to choose from.5
The Role of Your Feet
The feet can often be a way to improve overall coordination in the lower extremity and can be a powerful way to access hip strength and mobility. They could be an entire discussion on their own, but I want to give you a glimpse into the interaction between the foot and the hip.
There are many sensory receptors in the foot and ankle that let our brain know where we are located in space. The feet provide the vestibular system (our balance system), with a sense of stability. They literally keep us grounded.6 If, for some reason, our feet aren’t providing our brains with a sense of stability, there won’t be a sense of ease when we stand. The entire lower extremity will be a little more tense, trying to keep us upright.
Try this:
- Stand up and bend over to touch the floor. Observe how far down you go.
- Place a golf ball under your right foot.
- Apply pressure (I know, it’s a bit uncomfortable), and roll the ball back and forth five times.
- Do the same with the left foot.
- Set the golf ball to the side, and bend over to touch the floor.
I bet some of you can bend over a little bit further than you could a moment ago.
There are a number of possible reasons this usually works, one of which is the fact that you woke the part of your brain up that says, “The feet! I remember where they are. I can use them to keep me upright.” Proprioception is our body’s sense of where we are in space; when we can more fully tap into that, all of the parts of the body work better together.
Freedom of Movement Starts With Awareness
The point is, we can stretch and mobilize and strengthen an area all we want, but sometimes it takes shifting the perspective and working in a different area to fully achieve the freedom of movement we all desire.
Strong and mobile hips enable you to experience the world in a different way. Often, the tightness that is limiting us comes from an incomplete understanding of our movement options and the connections that exist between one area and another. Slow things down, fully experience how you’re working, and learn to isolate to begin tapping into your movement potential.
References:
1. Neumann, D.A., (2010). “Kinesiology of the hip: a focus on muscular actions“, Journal of Orthopaedic & Sports Physical Therapy, 40(2), 82-94.
2. Harris-Hayes, M., Sahrmann, S.A., & Van Dillen, L.R., (2009). “Relationship between the hip and low back pin in athletes who participate in rotation-related sports“, Journal of Sports Rehabilitation, 18(1), 60-75.
3. Lee, S.W., & Kim, S.Y., (2015). “Effects of hip exercises for chronic low-back pain patients with lumbar instability“, Journal of Physical Therapy Science, 27(2), 345-348.
4. Abernathy, B., Kippers, V., Hanrahan, S.J., Pandy, M.G., McManus, A.M., Mackinnon, L., (2013). Biophysical Foundations of Human Movement, Third Edition. Human Kinetics: Champaign, IL.
5. Latash, M.L., Levin, M.F., Scholz, J.P., & Schoner, G., (2010). “Motor control theories and their applications“, Medicina (Kaunas), 46(6), 382-392.
6. Roden-Reynolds, D.C., Walker, M.H., Wasserman, C.R., & Dean, J.C., (2015). “Hip proprioceptive feedback influences the control of mediolateral stability during human walking“, Journal of Neurophysiology, 114(4), 2220-2229.
