Ask The Physio … Problem Hips

Published on 1st Nov, 2016

Tight at the front of your hips? Do your hips Click or Clunk?

Try this 10 minute programme that your hips will love

by Sally Harrison from Perfect Form Physio

The dancers hip is subject to even more demand than the average Joe. In normal circumstances, our hips are designed to move us in the sagittal plane (forward) with walking, running and climbing as main forms of locomotion.  The dancer, however, requires their hips to be strong and mobile in extreme turnout, which is not a ‘normal’ position of function.

The extreme ranges of motion required for dance also puts an extra load upon the hips and their structures. Muscular timing and technique is even more important to allow the hips and pelvis to work well and without injury at these end ranges.

Some hip problems that we see in clinic present with catching, clunking and even pain at the front of the hip.

Commonly, we find that the muscles at the back of the hip are overworking from long periods in turnout which causes the hip ball to move forward in the socket, with subsequent inability to re-centralise as the hip bends or flexes, leading to catching at the front.

We need to reduce the over-activity in the turnout muscles of the hip, allow the hip joint to centralise again and then start to re-train both the stability and strength components of the hip in relation to both normal function and dance.

This process will normally be guided in full by your health practitioner but the programme below is a great TLC (i.e. Tender Loving Care!)  guide to get you started.

Remember … prevention is better than a cure so be nice to your hips now before you need to seek treatment!

Melt, Mould and Move

Step 1 - Melt

This exercise sequence is designed to release, decompress and then restore movement back into the hip region. It is particularly useful if you experience catching, clicking or even pain at the front of the hip.  If you experience pain consistently, don’t forget to seek the advice of a trained therapist to get a proper diagnosis.

1. MELT

  • Start by releasing into the hip muscles with the tennis ball.
  • Work initially in a sitting position with the ball resting between the ‘sitting bones’ and the outer hip bone (greater trochanter). You can make a gentle circle around the sitting bone towards your bottom crease and back again.
  • Melt and breathe into any areas of tension.
  • In addition, this can also be done over the piriformis muscle (external leg rotator) lying down with the ball closer to the sacrum.

2. MOULD

  • This exercise aims to ‘gap’ the joint, and create space.

    Step 2a - Mould

  • Place your leg up onto a flat surface, bent at the knee and hip.
  • Place some band over the leg close to the hip joint/crease.
  • Apply a downward pressure to the leg and hold for 3 seconds and then release. Try to feel a light sense of traction and melting. There needs to be no tension at the front of the hip.
  • We can also tilt from the pelvis and lean forwards slightly as we apply the ‘gapping’ movement to increase the stretch. We want to think of sinking deeply into the hip socket and creating space.

Step 2b - Mould

A second exercise to mould and open the hip is this offset decoupling exercise.

  • Start in an offset 4-point kneeling position with the left knee and hand slightly further forwards.
  • Shift your hips back towards the feet as if going to sit back on your heels.
  • Try to keep the movement relatively linear without drifting off to one side.
  • Engage the hands and push the hips back as you melt into the hip creases keeping the sits bones wide.
  • Repeat 6-8 times and then swap sides.
  • If one side is tighter then just work on this side.

3. MOVE

Step 3 - Move

  • We are now aiming to get the hip moving well and integrating with functional activities in standing.
  • Start in standing and move into a squat position, legs and feet in parallel.
  • We want to feel the hip glide back in the socket and feel wide in the ‘sits’ bones.
  • Aim for the pelvis to remain level and not sink deeper or twist to one side as we move.
  • The hip flexors should remain soft throughout.

We can then repeat this in ballet related movements such as plies and even small retires.

I hope you enjoy this 10 minute workout, and you should see an improvement in your hips if practiced regularly. I’d love to hear your feedback also.

For further treatment and rehab for your hips contact us at www.perfectformphysio.com.au or call (02) 9922 7721 for a foot assessment.

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