Beyond the Squats- Hip Rotators!

Just like your shoulder, your hip is a ball and socket joint. Which means it has a lot of motions to perform. What comes to mind when you think of working on your hip muscles? Squats, Bridging?

Hip muscles help move your leg front and back, out to the side and across midline. And also Rotate In and out. You have probably heard about working your Glutes. The Glutes are a set of three muscles- Gluteus Maximus, Medius, Minimus. But there are more in your butt! There are 9 muscles- some of them are more superficial, some sit deep in your butt. Yes, you need to work your glutes. They are essential for standing, lifting, walking. However, it’s also important to focus on other muscles in your butt as they have very important functions too.

Hip External Rotators (ERs)– These are the muscles that turn the leg outwards, away from midline. These muscles come in play in general when you put weight on one leg and move your upper body. External Rotators are very important for stability of the leg especially when involved in any dynamic activity that involves landing on one leg, quick turns. You guessed it right, most athletic activities will involve firing your Hip ERs. But you do not have to be playing soccer or pitching a ball to have strong ERs. Your Hip ERs come into play everyday- dancing, stair climbing, standing on one leg, running. They help in controlling dynamic valgus in the knee especially with single leg landing tasks.1,2 What that means is, when you stand on one leg, or you jump and land on one leg Hip ERs control the inward movement of your knee. What is commonly know as twisting your knee.

Hip Internal Rotators (IRs)– These muscles do opposite of hip ERs. They turn the leg IN from the hip. When do we really use this motion you might think? The ability of hip to rotate in is extremely important in walking, running.

While you are reading this, get into a split stance replicating a walking pattern. Left foot forward, right foot back and both feet pointing straight ahead. Notice how your pelvis rotates away from front leg- turned clockwise facing the right. While the pelvis rotates we still want the right foot and knee pointing forward to facilitate good mechanics. To achieve this we need adequate Hip internal rotation in the rear leg (right in this case). It is a subtle motion that you cannot really see while running and walking. But in the absence of Hip internal rotation, body starts using a series of compensatory movements that can cause some dysfunctions and injuries over time.

These muscles that perform internal and external hip rotations are often forgotten about. It’s important to strengthen the weak muscles and stretch the tight ones. I will show you some basic strengthening and stretching exercises to achieve Hip ER and IR.

  • Seated IR and ER with a band are a great way to focus and target the muscles. Tie one end of a theraband to a pillar/leg of a table or bed. Seated on a chair, tie other end of the band around the ankle. For ER, bring the foot towards the opposite lower leg. Keep the thigh straight without pulling it in. For IR, turn the lower leg out, away from the pillar. Do 3 sets of 15-20 reps.
Hip External Rotation
Hip Internal Rotation
  • Clamshells– Lie on your side, with legs stacked and knees bent at a 45-degree angle. Rest your head on your lower arm or use a pillow, and use your top arm to steady your frame. Be sure that your hipbones are stacked on top of one another, as there is a tendency for the top hip to rock backward. Engage your abdominals by pulling your belly button in, as this will help to stabilize your spine and pelvis. Keeping your feet touching, raise your upper knee as high as you can without shifting your hips or pelvis. Don’t move your lower leg off the floor. Pause, and then return your upper leg to the starting position on the ground. Do 20 reps on each side. You can up the game by adding a resistance band around both knees.
  • Fire Hydrants– Yes!!! Funny Name, You will see why? Start in a crawl position. Using your outer thigh and glute, lift one knee out to the side. Keep your knee bent at a 90-degree angle. Lower your leg and repeat for a total of 20 reps. Then repeat on the other side. For best results, do 3 sets of 20. You can use a loop band around thighs for some resistance.
  • Prone IR with band– Lie facedown with knees touching and bent at a 90-degree angle and a theraband looped around both ankles. Let your feet fall to the sides, lowering them as close to the ground as possible while keeping your knees together, bent at the same angle, and hips on the ground. Pause and return to the start. Do 3 sets of 15-20 reps.
Prone Hip IR
  • Figure 4 stretch

Lie on your back with feet flat and knees bent. Cross your left ankle on right knee. Bring your right knee towards your chest. Reach your left hand through your legs and interlace your fingers above or under the knee. Using your hands, pull your right knee towards your chest pausing when you feel a stretch in your left glute and hip. Hold for 30 seconds.

Sit at the edge of the chair with your feet flat on the floor. Place your right ankle on your left thigh close to your knee. Gently add pressure from your right hand to your right thigh, pressing towards the floor. If you feel a strong stretch stay in this position for at least 30 seconds. If you have more flexible hips, you can increase the intensity by leaning your chest towards your shin. Do not round your back. Hinge at the hips keeping back straight.

  • Hip IR stretch

Lying on your back, cross one leg over opposite knee and gently pull knee down until a stretch is felt in the hip. Hold long enough to feel a good stretch. If you are a beginner with stretching, start with short duration 10-15 seconds. Hold for longer duration as you get more comfortable with it.

There you go! Squats and lunges are important but not the only ones needed. Try out these exercises and see how you feel!

  1. Dix J, Marsh S, Dingenen B, Malliaras P. The relationship between hip muscle strength and dynamic knee valgus in asymptomatic females: A systematic review. Phys Ther Sport. 2019;37:197-209. doi:10.1016/j.ptsp.2018.05.015
  2. Malloy PJ, Morgan AM, Meinerz CM, Geiser CF, Kipp K. Hip External Rotator Strength Is Associated With Better Dynamic Control of the Lower Extremity During Landing Tasks. J Strength Cond Res. 2016;30(1):282-291. doi:10.1519/JSC.0000000000001069

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