Hips are not born to be “tight”, but with the amount of frequency that people lambast about feeling like their hips have more in common with rusty gears than Stretch Armstrong I can see how you think they might.  I’m here to tell you that, for the most part, your hip mobility woes can be a thing of the past with some different perspective on identifying what might be contributing to your outcome of perceived or restricted motion.  Let’s look first at the anatomy of the hips and then break down how we can identify different areas to focus our efforts at making change here.   Anatomy Think of the pelvis as the house around your hip. It’s two wing-like structures called “innominates” connected by a bone called the sacrum. Not shown in Figure 1 is how your lower back is continuous with the topmost aspect of the sacrum, to form a complex between your spine, pelvis, and hip bones.  [caption id="" align="aligncenter" width="877"] Figure 1: Bony Anatomy of the Pelvis[/caption] In a previous post, I talked about why “stretching” a muscle that has the perception of tension, or that might be a contributor to a reduction of joint motion might be a simplistic, reductionist way of viewing how the body creates movement. Muscles are attached to tendons, which then attach to bones. If we just chase a feeling of a stretch in areas that we perceive to have tightness, we might not meaningfully be addressing an issue that could be driving that perception. So first, let’s start to make some buckets for figuring out what could be going on.  Bucket 1: What Does my Total Hip Rotation Look Like?  An easy way to figure out if you’ve got a loss of motion in your hips is to examine your total range of motion between Hip External (Hip ER) and Hip Internal Rotation. (Figure 2).  [caption id="" align="aligncenter" width="882"] Figure 2: Hip ER and IR measured on an examination table.[/caption] A good benchmark to shoot for in most individuals is to have around 100 total degrees between the two measurements. This means that you most likely have good freedom for your innominate bones to move relative to your sacrum, and that you have the potential to get into a lot of different positions. Nice!  If you’re missing quite a bit of total hip rotation in this range, one of the easiest places that we start clients is with learning to move with less tension, and to start to recapture some of the relative motion between their innominates and sacrum, is with some simple rolling.  This Sidelying Rolling with Lateral Compression exercise is a simple and effective way for clients to begin to recapture some of their hip rotation and decrease their muscular effort used to move. It’s also a phenomenal move to start to build some sense of self around how your hips are able to move, to leverage that kinesthetic awareness to be successful in more challenging exercises!  [embed]https://youtu.be/oeLwLrrsSI4[/embed] Figure 3: Sidelying Rolling with Lateral Pelvic Compression Two other popular activities we might use to help clients and patients restore their total hip rotation that also revolve around improving your ability for your hips and pelvis to move relative to each other are the Cross Connect and the Hooklying Two Arm Reach.  [embed]https://www.youtube.com/watch?v=TcsiqnDrd0g[/embed] Figure 4: Supine Cross Connect [embed]https://youtu.be/C7hLRzrWF_4[/embed] Figure 5: Hooklying Two Arm Reach  Like mentioned in the previous Stretching (feel free to adjust whatever the abbreviation for my previous article is, Mike) article, both of these activities do a good job of helping to re-orient the pelvis as a unit and give it the potential to start to recapture a TON of hip rotation quickly!  Bucket 2: What are my Tissues “Calibrated” to Do?  Guitar strings get the tension on them adjusted through use and playing. Each guitarist has their preference for the tension on their strings. Our body is more than just bones and tendons and muscles, it is a network of different connective tissues that are adaptive to the demands put upon our body. Our connective tissues are a significant player in helping our bodies absorb and transmit the forces involved with movement!  Were you just in the camp of missing a lot of total hip motion, but now your hips are incapable of lying after working on the above activities? It’s time to tune your connective tissue tension to facilitate your desired motion.  Try an activity like the Goblet Squat to a Rockback first. It’s an activity where you’re doing the same thing on both sides of the body, so it’s easy to perform, and the relaxation and hold back on the box forces your connective tissues to have to absorb more energy and reduce their stiffness to accomplish that.  [embed]https://youtu.be/R26W48oflok[/embed] Figure 6: Goblet Box Squat with Rockback After working on that, activities like the Lateral Lunge with Hold force the same kind of stiffness reduction, but with an emphasis on side-to-side motion.  [embed]https://youtu.be/wXljK0b7vhM[/embed] Figure 7: Lateral Lunge with Static Hold If you’re missing a bunch of your total hip rotation, work on helping your pelvis get into the shapes it needs to for you to be able to express that first. This helps to restore your potential to be able to move in many directions freely!  Once you’ve got more potential to move, it’s time to start to tune your body’s proverbial springs to get better at what you want it to do: absorbing force and creating more motion or putting on the brakes and stopping motion from happening. I’ll give you a hint: we need to be able to do both to crush all of our active pursuits.  Give these activities a shot to have more success with improving your hip motion without just hanging out and catching a stretch! 

Stretching is something a lot of us do, but have we ever thought about why? Of course we have. The muscle is tight, so to fix it we stretch it. That makes sense, if the only reason why a muscle is “tight” or “restricted” is because it was shortened and we have to stretch it to elongate it. What happens if the reason why it’s “tight” is not because the muscle is actually shortened. If that’s the case what good is stretching it. Hear me out. To help illustrate this and help this make more sense, let’s use the hamstrings as an example.  And don’t worry at the end of this I will show you my Top 3 Exercises To Fix “Tight” Hamstrings.  Almost everyone has tight hamstrings and stretches their hamstrings. Common tests we use to assess the hamstrings are the active straight leg raise or the toe touch. We all probably remember the sit and reach test in physical education class as kids too. Do they still do that?    Anyways, if you couldn’t lift your leg straight, touch your toes or reach far down the ruler, you were told you have tight hamstrings and you had to stretch them.  Just because it’s tight doesn’t mean the solution is stretching!  How many of you have stretched and stretched, but never saw much change or any real lasting change? If stretching doesn’t change it, maybe the muscle isn’t shortened and stretching isn’t the answer. What is it then? “Because I really do feel tension and tightness in the back of my leg when I try to touch my toes or when someone lifts my leg up”. I believe the tension and tightness individuals feel are real, I’m not saying it isn’t, but the reason is not because the muscle is shortened.  One thing we need to look at and appreciate is POSITION. To understand this, it comes back down to anatomy and neuro, like most things do. Let’s take a look at the hamstrings... The hamstrings originate on the ischial tuberosity of the pelvis, or the “sit bone”. They insert across the knee joint at the tibia or fibula, the lower leg bones.   Think of the hamstrings as a rubber band that extends from the butt down to the back of the lower leg.  When you bring the leg up, like in the straight leg raise, we can see how you put tension on, stretch, or elongate the hamstring. Remember though, while it inserts into the lower leg, it originates at the pelvis, so the position and orientation of the pelvis will have an effect on tensioning the hamstrings as well. Pelvis Position: Let’s say someone starts in an anterior pelvic tilt. That means the pelvis is tipped and rolled forward. If the pelvis is rolled forward and anteriorly tilted, that will put the hamstrings on tension. If an individual naturally stands, sits, or lays down with an anterior pelvic tilt, that means their hamstrings are already on tension, and the rubber band is stretched. So when you go and try to reach for your toes or you go and lift the leg up, you feel a pull before you’re able to touch your fingers to the floor or straighten your leg out. This is because your brain and your body is stopping to protect you!  Figure 5: The picture above illustrates the influence of pelvis position on hamstrings. On the left, the pelvis is neutral and balanced. On the right the pelvis is anteriorly tilted and tipped forward. Observe how the black line (hamstrings), is longer. Again, based on your pelvis’s position (anteriorly tilted), your hamstrings are already on a tension and “stretched”, so when you try and ask your body for more and more, eventually it will stop and not let you. If you haven’t found success with stretching, before you stretch and stretch, or have someone jump on your back and push your down, please take a look at and appreciate position.  Get your body into a better position and then check and see if you still have the problem. If this is you, correcting something like an anterior pelvic tilt or getting out of an over extended posture, will not only help your mobility, but probably your pain if you’re experiencing any, and your risk of injury.  Disclaimer: I’m not saying stretching is bad. There are many benefits to and it is necessary to have good tissue quality, elasticity, and durability, but if you aren’t having success with improving your mobility by stretching, you may be attacking your issue wrong. Click here to learn my Top 3 Exercises To Fix “Tight Hamstrings”

Many people are told that their knee pain, hip pain, or low back pain is due to weakness in their hips. This is often determined after strength tests show weakness in the ability to use muscles like your glutes, which are important for hip and pelvis stability. The fix is often doing banded hip strengthening exercises, such as putting the band around your legs and doing sideways steps, or exercises such as clamshells. However, these exercises often fall short and don’t actually help reduce pain. Let’s dig into why that might be, and what would be a more appropriate and successful approach.  The first thing to understand is that all muscles have what’s referred to as a “Length-Tension Relationship”. What this means is that the amount of tension that a muscle is able to produce (aka force or strength) is dependent on its length. An easy way to think about this is to imagine you’re doing a pull up. If you start from a dead hang at the very bottom, it is difficult to initiate the force required to start your pullup. However, if you “cheat” and start with your arms already bent, you’ll notice it’s much easier. At the top of the pullup, you will also notice the last 10% tends to be the hardest, when you are fighting to get your chin over the bar. Here it is clear to see that the range in the middle of the movement is the easiest, and you feel the strongest. The reason for this is when you’re at the bottom of the pullup hanging, your muscles are fully stretched and in as long of a position as possible. At the top, they are fully contracted and shortened. Neither fully stretched or fully contracted are ideal positions to generate force from. Just like goldilocks – something right in the middle is ideal to produce as much force as possible.  The science behind this is simple if you understand how a muscle contracts. Within muscle fibers, there are tiny filaments called actin and myosin. These filaments lie parallel to each other, creating the “fiber” of your muscle. Small arms called “myosin heads” reach forward from the myosin and attach to the actin, then pull the actin together to cause the muscle to shorten and squeeze. The picture below will help demonstrate this.  If a muscle is stretched out there will be less overlap between the actin and myosin, and therefore there cannot be as many cross bridge connections and it is harder to contract the muscle. Likewise, if a muscle is fully shortened or squeezing, there is not much more room for the myosin to pull the actin together, as it is nearly all the way together. In either case, this results in lower force production even with higher efforts. The chart below demonstrates the highest force production happens around the middle point of a muscle length.  Now let’s go back to looking at your “weak” hips. While sometimes there are true weaknesses in the hips, this can easily be exacerbated by the position of your hips. If your glutes for instance are extremely tight and rest in more of a contracted position, it will be hard for them to squeeze any further, and will present as “weak”. Likewise, if your glutes are in a more stretched position there won’t be enough overlap to create a strong contraction. These resting positions are influenced not by “tight” or “loose” muscles, but rather tight or loose muscles are a result of the underlying position that they are held in based on the position of your pelvis. This is something that can be easily assessed and screened for in a discovery session at Next Level.  If we do find that the position of your hips is contributing to your “weakness”, the solution is not to just add a band around your knees and try to strengthen your glutes. If anything, this may even contribute further, especially if you are someone who is already in an over contracted state; this old-school strengthening approach may actually be further exacerbating your inability to create force from your hips.  Instead, the first priority should be getting your hips in that nice middle ground, like the goldilocks example, so that your hips will feel like you’re at that mid range of a pullup – strong, healthy, and supported. The right exercises to do this will require a deeper assessment to determine the position of your hips, where we can determine if the muscles are starting in a contracted or relaxed position, from which we can determine the best next steps to get you back to neutral. After that, then we can reinforce this position with strengthening exercises that will help not hurt you, and get you back to 100%. Whether you have knee, hip, or back pain, or are just feeling like you aren’t able to perform at your highest level, addressing these restrictions can help unlock your ability to finally progress.