Posted on Wednesday, October 13, 2021

Advanced Techniques on How to Treat Hip Impingement

Hip impingement pain is commonly felt in the groin, front of the hip or sometimes the side of the hip or deep in the buttocks. Like many lower extremity injuries, hip impingement is often multifactorial stemming from muscle strength imbalances (often due to weakness in the deep hip external rotators) and/or hip mobility imbalances. These mobility imbalances combined with muscle strength imbalances lead to altered hip biomechanics and ultimately, pain and inflammation in and around the hip labrum. These issues can be accelerated or started by a traumatic event or an overuse situation. The biomechanical imbalances cause the labrum of the hip to become inflamed and painful. This inflammation makes the biomechanical issues causing the impingement worse which just perpetuates the problem. Addressing these muscle imbalances can lead to the permanent resolution of your pain and symptoms.

In a previous video, Treating Hip Impingement: Basic Techniques, I addressed the basics of how to self-treat hip impingement syndrome. In this video, I go over advanced techniques of how to utilize a EDGE Mobility Band or a pull up assistance band to help self-mobilize the hip and very quickly eliminate your hip impingement.

CLICK HERE TO WATCH NOW

If you work on your deep hip external rotation strength (as demonstrated in this video) along with the mobilizations you are likely to see results even faster.

If you’re interested in a more thorough guide along with other videos on how to self-treat lower extremity injuries and pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by following The Physical Therapy Advisor!

Posted on Wednesday, September 15, 2021

Basic Techniques on How to Treat Hip Impingement

A common reason for anterior hip pain, groin pain or even side of the hip or deep buttock pain can be hip impingement. Hip impingement, like most hip pain, is often multifactorial stemming from muscle strength imbalances (often due to weakness in the deep hip external rotators) and/or hip mobility imbalances. These mobility imbalances combined with muscle strength imbalances lead to altered hip biomechanics and ultimately, pain and inflammation in and around the hip labrum. These issues can be accelerated or started by a traumatic event or an overuse situation. The biomechanical imbalances cause the labrum of the hip to become inflamed and painful. This inflammation makes the biomechanical issues causing the impingement worse which just perpetuates the problem.

In this video, I go over the basics on how to treat hip impingement. I discuss what to stop doing immediately and what you can start doing to eliminate your pain in order to get back to activity quickly without surgery or painful injections.

CLICK HERE TO WATCH NOW

Be sure to check out my other video, Treating Hip Impingement: Advanced Techniques.

Posted on Wednesday, September 16, 2020

How to Perform a Key Lower Leg Stability Exercise

Weakness in the deep external rotation muscles and poor lower extremity single leg balance are commonly associated with many lower extremity overuse injuries. A simple and effective exercise to improve strength, balance, and general stability of the deep hip external rotator muscles is the clock exercise (also called the star drill).

The important points to remember in this exercise are to keep the stance knee unlocked (the leg you are standing on) with the patella (knee cap) slightly externally rotated (usually pointing towards the 3^rd or 4^th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators needs to be the primary focus.

Slowly touch the ground very gently with the opposite leg. The amount of pressure touching the ground should be so slight that if there were a package of crackers taped to the bottom of the foot the crackers would not break. Performing the drill on a balance pad will significantly increase the difficulty level of the exercise.

In the following video, I demonstrate how to use a balance pad to perform the clock exercise, a key lower leg stability exercise for treating knee pain, hip pain, and foot and ankle related issues as well as balance.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

For prevention strategies and to learn more about on how to self-treat the most common lower extremity overuse injuries, be sure to check out the Resilient Runner Program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

Have you performed the clock exercise before? If so, what was your experience like? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

Posted on Wednesday, September 2, 2020

How to Perform a Key Hip Stability Exercise

Hip pain, knee pain, and even foot pain (such as plantar fasciitis or posterior tibialis syndrome) can have an associated hip external rotation weakness. An important yet often overlooked component to proper lower extremity stability is how the deep hip external rotator muscles need to work along with other hip external rotators and hip abductors, such as the gluteus medius, to insure proper lower extremity positioning when the leg is in full weight bearing. Particularly, in a single leg stance position during walking, running, skipping or landing from a jump as the leg accepts full weight bearing while the opposite leg is in swing phase.

The deep hip rotators, also known as the short external hip rotators, are a group of muscles consisting of the superior and inferior gemelli, obturator internus, quadratus femoris, and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

Weakness in these muscles is often associated with many of the more common lower extremity overuse injuries:

Foot injuries: Plantar Fasciitis, Achilles Tendinitis, Posterior Tibialis Syndrome
Knee injuries: Patella Femoral Pain Syndrome (PFPS), Iliotibial Band Syndrome (ITBS)
Hip related issues: Piriformis Syndrome, Hip Bursitis, Hip Impingement

A simple and effective exercise to improve strength of these muscles is the standing hip 3-way exercise. The important points to remember in this exercise are to keep the stance knee unlocked and in a “soft” stance with the patella (knee cap) slightly externally (laterally) rotated (usually pointing toward the 3^rd or 4^th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators should be the primary focus.

In the following video, I demonstrate how to use an exercise band to perform the standing hip 3-way exercise, a key hip stability exercise for treating hip pain, knee pain, and foot and ankle related injuries.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

Do you suffer from hip, knee or foot pain? If so, hip external rotation weakness may be part of the reason for the ongoing pain as you overload and overuse other structures trying to gain extra lower leg support. Additional discussion can help others to manage this condition more effectively. Please leave your comments below.

Posted on Wednesday, May 6, 2020

The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain

Do you suffer from foot, hip or knee pain? If so, hip external rotation weakness and poor single leg balance may be part of the reason for the ongoing pain as you overload and overuse other muscle groups in order to gain extra lower leg support. Weakness in the deep external rotation muscles is commonly associated with many lower extremity overuse injuries.

Injuries commonly associated with hip weakness include:

Foot/ankle injuries such as plantar fasciitis, Achilles tendinitis or posterior tibialis syndrome.
Hip related issues including piriformis syndrome, hip bursitis, and hip impingement.
Knee injuries such as Patellar Femoral Pain Syndrome (PFPS) and Iliotibial Band Syndrome (ITBS).

The deep hip external rotator muscles need to work along with the hip abductors (such as the gluteus medius) to insure proper lower extremity positioning when the leg is in full weight bearing. (Particularly, in a single leg stance.) One leg bears the full weight while the opposite leg is in the swing phase while walking, running or skipping.

The deep hip rotators (also known as the short external hip rotators) are a group of muscles including: the superior and inferior gemelli muscles; obturator internus; quadratus femoris; and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively.

In the following video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

In order to engage the deep hip rotators, you should feel the muscles working deep into the buttocks and directly behind the greater trochanter (the hard bone that pokes up at the top of the hip).

This exercise should be performed very slowly. I advise a count of 5 seconds up, a 5 second hold, and then a 5 second slow return to the starting position for at least 10 repetitions.

If you aren’t feeling the deep hip rotators activate, then you may need to reposition your legs. Usually, repositioning the knees and moving them up toward your head into a more fetal position will do the trick.

CLICK HERE TO WATCH NOW