Article Review: All in the Hips

In the December 2005 issue of Training & Conditioning Magazine the article "All in the Hips" by

Jim Kielbaso peaked me interest enough that I have reviewed it several times since it came out in that issue. His interpretation of core strength is very similar to my own phylosiphy on the subject. As he states in the article "Without powerful hips and flexible hips, core strength will not be fuctional for most sports." As an athletic trainer working in a wide viriaty of sports and with numerous coaches and strength coaches and doing my own research on the subject of Core Strength and Stability the one thing that has stuck out to me is without flexibility in the hips and strength thoughout the entire hip joint the athlete will have a faital flaw that usually will lead them to either under produce in their sport or wind up injured and visiting the Athletic Training Room. As stated in the article the hip is a very dynamic joint with over 20 Muscles that directly infulence the movement of the joint. On top of the muscles that act on the hip their are several other muscle groups that act as synergists to hip movement (abdominals, Quadriceps, and Low back muscles). Weakness in the hips is often associated with these synergists picking up the slack. Just like the shoulder the hip is a ball and socket joint with the ability to produce great ranges of motion in all three planes of motion. This being said the hip does not have anywhere near the range of motion the shoulder has. The hip has ranges of motion of 110 to 120 degrees in flexion, 10-15 degress in extension, 30-50 degress in abduction, 30 degress of Adduction, 40-60 degrees of lateral or external rotation, and 30-40 degrees of medial or internal rotation compared to the shoulders ROMs in the same motions (flex 160-180 deg., ext 50-60 deg., abduct 170-180 deg., adduct 50-75 deg., lat or external rot 80-90 deg., med or internal rot 60-100 deg.) (2). The main reason for the descrepancy of these range of motions are that the hip has much more musculature surrounding it and the pelvic girdle has more fixated joints as compared to the mobile joints in the shoulder girdle. Now, the hip needs to be a strong and stable structure and that is why its range of motion is decreased even though it is a ball and socket joint like the shoulder. The Hip needs to be able to withstand significant forces associated with standing, walking, and running. Standing on one limb puts 2.4-2.6 times the body weight through the hip joint and running will put a whopping 4.5 times the body weight or greater.(2)

What I loved about this article is that it talked about how the hip moves in the three planes of motion and how it is typically exercised in only two. The three planes of motion are frontal, sagittal, and transverse. The hip is primarly worked in the frontal and sagittal planes. But, injuries that occur from hip weakness primarly happen from being weak in the motions taking place in the transverse plane. These would be the Internal or Medial and External or lateral rotation. Most athlets are weak and also tight in these movements. Training these movements as the article states will greatly decrease the change of injury to the hip, knee, thigh, and low back. It is the deficiencies in the rotational motions of the hip that the author trys to stress the importance of recognition and addressing in the workout plan. The author gives six reasons why these exercises should be implemented into a training program. They are:

• Help to prevent injuries, especially at the knee.
• Can be used to teach proper movement mechanics
• Take less than 30 seconds each
• Require no equipment
• Have numerous variations so athletes won't get bored
• Incorporate many other muscles that help assist in the proper function of the hips
  

What I also like about this article was how the author presented the matiral. He did not come out and say you MUST add these exercises to prevent injuries. He explained that there is so much out there that it can become difficult to implement everything into a program. The short of it is that when you have x amount of time and z amount of stuff to get accomplished sometimes things like y have to get cut out. Most of the time y is the injury prevention and flexibility exercises. But, where more and more athletes and coaches are taking the time to implement a general and specific dynamic warm up there is a place where these exercises can be implemented. The following are the exercises that the author recommened for training the hip in the transverse plane.

• Single Leg Hip Twister - To improve strength and mobility within hip rotation
• Single Leg Lean Back - stretch and strengthen the hip flexors and abdominals
• Hip Flexor Stretch - just what it says a hip flexor stretch
• Leg swings - gets the legs moving in different planes. The movement and slowing down for countermovement helps to strengthen the muscles eccentricly and also works on ROM
• Twisting Lunge - Engages the glutes more than the standard lunge due to the twisting
• Cutting in Place - teaches cutting and planting mechanics
• Jumps in place - Keeps the athlete emphasizing quickness of the ground.

To learn more about these exercises and to read this great article go to the Training & Conditioning Magazine website or click here for the hyperlink to the article.

References:

1. Kielbaso, Jim. All in the Hips. Training & Conditioning, December 2005.
2. Magee, David. Orthopedic Physical Assessment Third Edition. WB Saunders Company. 1997.