There seems to be consistent questions, debate and studies done with respect to stretching. As the thought of more closely analyzing the quality of movement (FMS, Y-Balance testing, SFMA for example) moves to the forefront in the PT and fitness world, many search for the right mix of exercise to maximize mobility.
I count myself as a supporter and follower of the work of Gray Cook and Stuart McGill. While I may not agree 100% with all of their ideas, I generally consider them to be brilliant minds and ahead of the curve. I have been using the FMS in my practice for some time now and have also begun to incorporate Y-Balance testing as well (see pic below courtesy of the IJSPT)
The Y-Balance test may not have significant relevance to hip mobility as much as it does limb symmetry, but I included it here to illustrate my point in observing kinetic chain movement to help determine where the weak link or faulty movement pattern may be. It gives us valuable information with respect to strength, balance and mobility.
With the revelation that FAI is more prevalent than we knew (click here for my post on FAI), I am always interested in hip mobility and how to increase movement in the hip joint. Limitations in hip mobility can spell serious trouble for the lumbosacral region as well as the knee.
I currently use foam rolling, manual techniques, dynamic warm-up maneuvers, bodyweight single leg and hip/core disassociation exercises and static stretching to increase hip mobility. However, I am often faced with the question of what works best? Is less more? How can I make the greatest change without adding extra work and unnecessary steps?
Well, Stuart McGill and Janice Moreside just published a study in the May 2012 Journal of Strength & Conditioning Research that sought to examine three different interventions and how they improve hip joint range of motion. Previous work has been focused on the hip joint alone, and they wanted to see how other interventions impacted the mobility of the hip. Click here for the abstract
The longer I work with clients, the more hip issues I see. Generally speaking, I find the major issues to be related to decreased mobility, poor stability and muscle imbalances. These may occur in isolation or combination.
It is a no-brainer that most people have tight hip flexors and external rotators given all the sitting that takes place in our computer age. This inherently creates weakness and tightness. I feel that a natural propensity to be positioned in hip external rotation may actually reduce the firing of these muscles which in turn allows for more valgus moments at the knee and reduces lower limb stability.
Typically, female athletes fail to adequately fire the gluteus maximus (hip extension and external rotation) and prefer to dominate movement with the quads. So, how do we begin to change this?
Well, first we must focus on better hip mobility. I believe we must work to gain better hip extension by stretching the hip flexor group. I also believe we need to do this dynamically and not just passively. A dynamic approach also allows us to improve knee stability on the opposite side as we work on hip mobility. It will also allow us to resist internal rotation of the femur and the valgus moment at the forward knee.
Look at the images below:
I am demonstrating a BOSU split squat diagonal chop. This is the first of a series of BOSU exercises I am doing for PFP Magazine. The upward chop forces hip extension on the right side and the downward motion reinforces firing of the left glutes to reduce internal rotation and valgus. What a perfect combo right?
To read more about this exercise, click here.
Now, you should start on the floor with just the arms and progress from there. This is a great prehab exercise or warm-up activity, but it cna also be used for strengthening too. I hope you find it as beneficial in your routine as I do.