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The #1 thing you can do to keep your HIPS healthy

hip mobility hips injury prevention joint health kinstretch mobility Jan 14, 2023
hip joint demonstrating why work on hip mobility

If I had a dollar for every person that came to see me for tightness, pain, or pinching in the hips, I would be sitting on my own private beach in Hawaii right now, instead of writing this blog :)

Why is it so prevalent?

Modern lifestyle. Let's face it, no matter how much you crush it in the gym, most of us still live relatively sedentary lives. We sit in comfy, ergonomic chairs more often than we stand and squat which means the hips rarely tap into it's ranges of full flexion or extension. And when we are in motion, it's linear (meaning straight line) without a lot of lateral or rotational directions. So our hips rarely get to tap into those rotational ranges either.

Fitness programs. Fitness is our solution to the above mentioned modern lifestyle. It is a way to offset lives that otherwise don't require as much physical activity to survive and sustain. Fitness programs are also heavily linear in nature. Running, squatting, hinging, most weight machines move the targeted muscles and joints in a straight line (bend and straighten). 

But guess what hips needs the most? ROTATION!

 As a ball and socket joint, the hips have tremendous rotational capability. This rotation is often undertrained and underutilized. When the joint is not rotating as it should, the cartilage inside can start to degrade which leads to pain, injury, and globally decreased hip range of motion.

How do we train rotation?

The first step is regaining control over the range of motion that you currently have. What this means is 'Can you rotate your hip independent of the rest of your body?' Clinically, I find that many people lack this basic body awareness and control. When I ask them to rotate their hip- other body regions try to pitch in for assistance. The low back, pelvis, and knee are common compensatory joints. And trust me, you do not want a spine or a knee that is trying to act like a hip!

We begin regaining control by executing hip CARs (controlled articular rotations) regularly. Initially,  I recommend a few reps of CARs several times a day. It takes  A LOT of repetition for your brain to figure out what you are asking it to do. And the more reps you perform, the more your brain has a chance to communicate with the receptors that live deep inside your hip joint (proprioceptors). 

The goal of CARs is not to gain range of motion, but simply to preserve and utilize what you currently have. They are also a great chance to monitor for any compensatory movements or assess for pain or pinch points. Progress over time results in CARs that are smooth, controlled movements that is truly isolated to just the targeted hip joint. 

Here are two of my favorite hip CARs variations: 

1. Axial hip rotations from bear sit base tutorial


2. Sidelying hip CARs tutorial


We then want to maximize rotational mobility- does your hip have adequate internal and external rotation? How much passive mobility does your hip have with these movements and then does your active control match the passive movement? 

Passive stretching, while not the most exciting form of physical training is necessary to improve passive range. But to make meaningful changes in the length of the tissue, you need to hold the stretch for at least 2 minutes! This is what science and research tells us is needed for the structures in the body to start responding to the stretch. Now I want you to think about all those 10 second haphazard stretches you have done over the years in the name of 'mobility'!

 It is also important to understand that passive stretching is not the end of our mobility training. After we have spent time (2 minutes or longer) in a lengthened position, we then need to start doing work there to reinforce that this is a usable range of motion. This is done via PAILs and RAILs which are isometric contractions 

PAILs (progressive angular isometric loading) will ask the tissues that are lengthened on one side of the joint to contract while RAILs (regressive angular isometric loading) will then require the shortened muscles on the other side of the joint to work. This gets our brain and body used to functioning in this new range of motion! 

Last up in our training priorities is to start training rotation both at end range and throughout the full range of hip rotation. We can do this through a variety of exercises such as passive range holds, end range lift-offs, rotational hovers, isometric movement path transitions, advanced CARs, the options are endless!  

Maximizing this rotational capability in a ball and socket joint like the hip, will ensure that the joint maintains the capability to also fully flex and extend (hello squat and deadlift). 

90/90 isometric movement path transitions are a great way to challenge hip rotation both internal and external. Check out this video tutorial:


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