Injury Prevention – Hip
Throw Your Hips into Injury Prevention
How to improve the balance and strength in your hips to keep your body healthy and in the game
By Jerry Shreck, Head Strength & Conditioning Coach, Bucknell University
When most people think about training for injury prevention, the first thing that comes to mind is movements for the core, the shoulders, and the ankles. But one of the most important body parts is often altogether forgotten. The hips. Yet of all the areas of the body, I typically find the hip musculature of athletes to be not only the weakest but typically the most unbalanced. This is disturbing as I’ve found that once athletes learn neuromuscular control of the hips, the percentage of injuries, especially of the knee, can be significantly decreased.
In fact at Bucknell University, our athletic training staff has reported an overall decrease of major injuries over the last four years. Much of the credit has been attributed to the focus of our Functional Injury Prevention exercises that are done weekly during our weight-training sessions.
Unfortunately, with sports, injuries can never be completely eliminated. But if we prevent even one percent, I believe it’s worth it. And we’ve experienced significantly better results than just one percent!
Why the Hips?
The hip complex is astonishingly, well, complex. There are 24 muscles responsible for the movement of the hips. Consider all your hips can do: shift side to side, rotate forward and backward, twist (i.e., flexion, adduction, medial rotation, abduction, lateral rotation, extension), as well as the numerous combinations of the above. Just like the rotator cuff of the shoulder, it takes small intrinsic muscles, which act like stabilizers in the hip joint, to move so well and be so flexible.
Of course, most of us already use squats, dead lifts, lunges, step-ups, and various triple extension movements. And all of these, if done correctly, will hit various muscles of the hips. But for the purposes of injury prevention, we are looking for specific functional patterns. Always keep in mind that you are only as strong as your weakest link.
The exercises in this article are strength exercises, but neuromuscular control is just as important. Maybe some of you are saying right now, “That’s the same thing!” True, but I relate neuromuscular control to the amount of isolation and firing of an individual muscle to produce a certain movement and lessen the amount of stimulation of the surrounding musculature, which would normally be stimulated. This takes strict amounts of focus and practice at first. However, when mastered, the benefits pay off BIG TIME!
To learn this focus, I recommend the use of therabands (in a 9″x 2″ loop) to do the following circuits of exercise. The first circuit is the “Standing Hip Circuit.” For all of these exercises, you, the athlete, will stand with the band around your ankles. Your feet should be hip-width apart, and your knees slightly bent with the weight back on your heels.
Point your toes directly forward throughout every exercise. We do not want the hip to externally or internally rotate. This is important because as you do the exercises, you’ll automatically want to rotate at the hip.
There are five patterns of movements which consist of 10 reps each, equaling 50 total reps per hip.
Theraband Hip Forward
To perform the first exercise (above), step one leg forward while maintaining a slight bend in the knees, isolating all of the stimulation to the front of the hip. Pause for a two-second count, and return to the starting or “athletic” position.
Theraband Hip 45 Degree
The second movement (pictured above) is very similar to the first. However, instead of stepping forward, you’ll step out to a 45-degree angle.
Remember to keep your toes pointing directly forward with a slight bend in the knees. The legs should not straighten at any time throughout the exercise.
Theraband Hip Side
For the next movement, you’ll step out to the side.
Theraband Hip 135 Degree
Again, similar to the above exercises, but this time you’ll step out to about 135 degrees.
Theraband Hip Backward
Throughout all of these movements, make sure your form is strict and focus on exactly which portion of the hip (musculature) doing the work. Your focus should correlate to the direction of the movement. The last or fifth movement is straight back.
These exercises can be performed in consecutive sets or circuit training style (Around the World). Start with the standing hip circuit in consecutive sets per hip twice a week. After two weeks, progress to an “Around the World” circuit. This involves doing one rep and progressing to the next movement until you’ve gone all the way through the ten patterns and repeat until 50 reps are achieved. Then run the order counter-clockwise for 50 reps. This style or circuit will usually be done for two weeks.
The first week or two, you’ll very likely experience DOMS (Delayed Onset Muscle Soreness) in the hips. After all, these are muscles most of us haven’t focused on in the past. Just remember, this is a good sign that they are isolating and getting the neuromuscular firing we’re looking for.
After you’ve learned these controlled movement patterns, it’s time to progress to the “Walking Hip Circuit.” This is a series of four different movements related to the standing hip circuit. The first movement is a forward 45-degree step. But instead of returning the lead foot back to the athletic position, step forward with the trail leg (maintaining good form) until the foot reaches the athletic position. Then repeat starting with the opposite foot out to a forward 45 degree angle (toes forward!). Continue this for 15-20 yards. Then reverse direction and come backward, stepping out at 135-degree angles. The third movement is side stepping for the 15 to 20 yards and then finish side stepping back for the distance.
Forward 45 Degree Walk
Backward 135 Degree Walk
Hip Side Walk
It’s easy to start getting careless with your form during the walking circuits, so it’s important to constantly remind yourself to focus on form throughout the series of movements.
Additional exercises for the hips are always emphasized. These would include manual resistance adduction/abduction, manual resistance hip flexion, glute/ham raises, reverse hypers, and various other exercises.
Also try jogging, cutting, jumping, carioca, and bounding speed exercises while wearing the theraband loop around the ankles. You could even try to play five minutes of basketball while wearing the bands. These can be fun drills that help you focus on using your hips when it counts most—during your sporting and skill-building activities.
Across the board, I’ve seen improvements in all types of athletes: from basketball players to power lifters to track and field athletes. This type of training can really help you break through training plateaus. And, most importantly, reduce the number of injuries as you strengthen a weak area and gain neuromuscular awareness of the hip complex.
Take a one-month challenge and try these exercises. I guarantee you will notice improvements in all your lower body and triple extension exercises. And help keep you in whatever you call your game.