The hip joint is a weight bearing joint and thus is subject to large
biomechanical forces, especially during sport and exercise. From the
outset, the weight-bearing function of the hip joint means it will be
less flexible than say, the shoulder joint, yet more stable. There is
always this trade-off in joints between strength and flexibility.
People often complain of tight hips. From the patients perspective
this might be due to one or a combination of hip pain, reduced range of
motion (for example during squatting), or perhaps uncomfortable clicking
in the hips. For the treating practitioner however, what does this
actually mean?
The most obvious reasoning for a person complaining of tight hips
would be due to a shortened state of the hip musculature (tight
muscles). Examples include: bending forward reduced because of tight
hamstrings and gluteals; restricted thigh abduction due to tight thigh
adductors on the same leg; or reduced hip extension because of tight hip
flexors. What is more difficult for the patient to perceive on their
own however, is the possibility that their hip range of motion may first
be limited by the ligaments binding the bones of the hip joint or the
very shape of the bones themselves.
It is much easier for the patient whom has little understanding of
joint anatomy to assume their condition is related to superficial
structures (the muscles). What most people do not realise however, is
that hip range of motion is first determined by the shape of the bones
of your pelvis and your thigh bone, specifically the femoral head and
the acetabulum.
In short, because of anatomical variations of the hip joint, some
people will always be more flexible at the hips compared to the next
person, regardless of how much stretching, exercise or mobilisation they
receive. Here is a great article that covers this in greater detail Why people have to squat differently.
The second determinant of hip range of motion is the joint capsule.
The joint capsule is formed by the major ligaments of the hip joint.
These ligaments serve to fasten the femoral head securely to the inside
the acetabulum. The muscles then overlie this capsule and contract in
various sequences to bring about movement. As the capsule is so tightly
adhered to the surface of the bones of the hip joint, any tightness
within the joint capsule will limit range of motion before that of the
muscles.
Unfortunately there is little to nothing one can do to alter the shape of the bones forming their hip joint. In extreme circumstances, hip replacements are carried out where the hip has become biomechanically unsound due to degenerative change resulting in hip pain. One would be severely misinformed to consider opting for surgery to alter the shape of their hip articulations – if it ain’t broke, don’t fix it!
Tight hip capsules are likely in those individuals who perform
repetitive tasks throughout the week. For example, prolonged sitting
will lead to reduced ability for the hip to extend. Prolonged sitting is
also commonly blamed for tight hip flexors. Both are likely results of
prolonged sitting, but the tightening of the joint capsule is often
overlooked.
Similarly, people seldom have much reason to squat these days. In
western society, we have chosen to sit during activities which once saw
us squat such as eating meals, desk work or even going to the toilet.
This lack of folding our bodies to the ground sees a general tightening
of the posterior hip capsule, not to mention the capsules of other
joints too. Again, the muscles overlying these joints ultimately become
tight as well.
The following exercises are taken from a chapter on hip flexibility out of H. David Coulters book, “The Anatomy of Hatha Yoga”. These exercises begin with very basic movements of the hip joints and steadily progress to more advanced stretching postures. The exercises explore all possible movements at the hip joint. Never stretch into pain, stretch to the border of pain then try gradual try to extend this border through regular practice. When you are not performing these exercises, attempt to spare a thought for the movements occurring at your hips throughout your normal day. Treat your body from time to time by squatting more regularly, doing exaggerated breast stroke kicking movements, running or just plain moving – your body will thank you.
Posture 1. With the knees together, pull them toward
the chest with interlocking hands and fingers, at the same time prying
the pelvis away from the floor.
Posture 2. With the knees apart, pull on them from the sides with the hands, providing a slight stretch for the adductors.
Posture 3. Grasp the knees from the inside and pull them down and laterally for more stretch of the adductors.
Posture 4. Grasp the ankles and pull the feet toward
the head, pressing the elbows sharply against the thigh muscles. This
tends to lift the shoulders, and you may want to have a pillow to
support your head.
Posture 5. Grasp the lateral aspects of the feet and
pull them toward the head, against the calf muscles. This provides the
fullest stretch for the adductors in this series.
Posture 6. Grasp the soles of the feet from their
medial borders and pull the knees toward the floor on either side of the
chest. Be careful, because the arms can pull more powerfully than is
temperate for the hip joints.
Posture 7. Supine half-lotus hip opener – bring the
left ankle to the near side of the right knee, resting the ankle against
the thigh and pressing the left knee away from the body. Pass the left
hand into the triangle formed by the two thighs and the left leg, lift
the right foot off the floor, and grasp the right shin with the left
hand just below the knee. Pull the left foot down closer to the pelvis
with the right hand, place the right forearm above the left ankle, and
interlock the fingers around the right shin just below the knee.
Posture 8. With the left foot placed against the thigh, come forward in an initial trial to feel and evaluate hamstring tightness.
Posture 9. Pressing the left forearm against the
left knee, reach out at various angles (in this case 20 degrees) to
stretch the adductors on the right side.
Posture 10. Notice the improvement. This is due to
having lengthened the adductors, some of which have a hamstring
character and which limit the forward bend for the same reasons as the
true hamstrings.
Posture 11. The kneeling adductor stretch – start on
all fours with your head resting into your crossed forearms. Slowly
slide the knees apart, letting the feet move to whatever position is
most comfortable as the body weight abducts your flexed thighs, possibly
to an angle of about 120 degrees from another. Stay here for a while.
Yu can then move the torso forward slowly. This may permit you to slide
the knees further apart. Then slide the knees closer together again but
sink into your hips a little deeper creating more flexion, you will be
stretching different parts of the adductors than when you bring your
weight forward.
Posture 12. Preliminary pigeon – start on your hands
and knees and pull the right foot forward to flex the right hip joint,
and thrust the left foot back to extend the left hip joint. Allow the
right foot to end up wherever it naturally falls. Keep the elbows
extended and the shoulders pressing the hands against the floor. Pull
the hard up and back, thrust the chest forward and feel the essence of
the pose.
Posture 13. Folding into a forward bend from the
previous posture is a comfortable and richly rewarding posture. The pose
increase flexion of the right thigh and lessens hyperextension of the
left thigh.
Posture 14. And if you’re really game
The above postures, or hip stretches if you like, give a very
comprehensive mobilisation routine for all degrees of freedom at the hip
joints. Practice these regularly and with caution, and you will likely
reduce any hip pain and certainly maintain, if not increase, range of
motion at the hip joint.
HAPPY HAPPY HIPS HOORAY HOORAY!!!
If you are experiencing any hip pain and would like to come in and see our friendly practitioners for some relief, give us a call on 02 9922 6116 or book online with us here.
*DISCLAIMER: This discussion does not provide medical advice. The
information, including but not limited to, text, graphics, images and
other material contained in this discussion are for informational
purposes only. The purpose of this discussion is to promote broad
consumer understanding and knowledge of various health topics. It is not
intended to be a substitute for professional medical advice, diagnosis
or treatment. Always seek the advice of your physician or other
qualified health care provider with any questions you may have regarding
a medical condition or treatment and before undertaking a new health
care regimen, and never disregard professional medical advice or delay
in seeking it because of something you have read in this blog.
