Over the years I have discussed the importance of improving glute strength and maintaining hip mobility in a number of articles, for hip stiffness is attributed to many of the common injuries seen in the lower limbs, and also the back. The best exercises to do this are always the standing functional movements however they can be too difficult and even cause more problems in the beginning of a rehabilitation program. Especially if there is severe pain or weakness. This is where you need a set of exercises to begin with that can help to improve the lack of stability and weakness without aggravating the existing problem. Resting is not good solution for this will exacerbate any existing weaknesses and create more stiffness. Clicking or clunking sounds in the hip, osteoarthritis, and weakness are a sure sign your hip is unstable and needs a corrective strategy using stability and strength exercises. Treatments that focus only on releasing stiff muscles or trying to use NSAID’s or cortisone injections to reduce inflammation will do very little to restore stability to the hip and pelvic region. Finding a way to start with simple strength exercises that have a gradual progression is the secret to getting more stability of the hip and pelvis. In this article, I will show you some great exercises to use in the early stages and how to gradually progress to more effective functional movements without creating more problems.
What Is The Role Of The Hip With Movement?
I mentioned in the introduction that the hip is a big cause of many injuries. From ACL tears, to herniated discs in the lower back, the hip is a huge part of the problem.
This joint is very similar to the shoulder in that it is responsible for providing multi directional movements used in sports, but also for many everyday tasks. Even simple tasks such as walking require a huge involvement from the hip for mobility, but also to absorb our body weight and remain stable.
The simple movement of standing on one leg increases the weight on the hip by two and a half times the body weight and walking upstairs increases by three times! Running and jumping is even higher again.
If you have a problem at your hip you are set up for a stack of future problems.
As with the shoulder, there is multiple muscles that attach to the hip that provide many different functions, sometimes for providing better balance and strength, and at other times required to provide freedom of movement and range of motion. Many people can train for strength or flexibility but understanding how to maintain stability is a key ingredient often missed. It is in this area of exercise, that many of the answers to common injuries are found.
Firstly let’s explain the role of the hip within movements.
If you read Gray Cook’s book titled “Movement” he discusses what he refers to as the joint by joint approach where each of the main joints in the body share different roles and affect the following or preceding joint. What you will see is that every second joint needs flexibility and mobility, and the other joints need the exact opposite being stability and strength.
The one joint that seems to not fit this theory is the hip!
The hip is very unique in that it can be both immobile and unstable at the same time!
How a joint can be both immobile and unstable is an interesting phenomenon.
This means you must have a focus on maintaining or improving mobility but at the same time be working on stability and strengthening of the muscles responsible for providing the multitude of hip movements to ensure it controls the motion.
The video below provides you with some great anatomical animations to see what I mean by this.
Some people actually have too much mobility which is how instability that creates stiffness and wear and tear, eventually leading to osteoarthritis. So it is a combination of restoring mobility and following up with stability to make sure the joint can effectively control the ball in the socket.
I will repeat that for you, for this part is crucial to understand.
YOU MUST RESTORE MOBILITY BUT INSTANTLY FOLLOW UP WITH STABILITY TRAINING TO EFFECTIVELY STABILIZE THE JOINT!
To restore mobility you just need to do some stretches right?
Well it is not that easy, for lying on the floor doing stretches will not change a movement like a lunge or a bending pattern that requires some degree of stability in conjunction with being flexible and mobile.
This is the fundamental flaw of most health treatments that focus solely on manual therapy and stretching. For the person may appear to be improving greatly on the table or on the floor, and perhaps they are, but when they stand up the body has not been taught a better way to stabilize and just resets back to the old settings of stiffness.
This is also why people repeatedly keep hurting themselves, for they think it is all good once the pain has gone and go back to what they were doing and just end up in the same place. You must teach your body how to move better, by remaining mobile in a position that also requires stability. It is your job to teach your body how to “switch on” the stabilizers and not resort back to using the hips to do the work again.
A great quote that sums this up by John Gibbons, author of the book The Vital Glutes is:
“Tight muscles show themselves lying down, whereas weak muscles show themselves standing up”.
The video below shows you several ways to mobilize your hip.
I encourage you to read our detailed articles in the links below for more stretches and mobility ideas to help you.
•10 ways to improve your hip mobility
•How to identify mobility restrictions affecting how you move
What Are The Best Hip Stability Exercises?
Being mobile is one thing but you still have to learn how to control the joint and stabilize it. I hate using the word “best” as to be honest there is no one size fits all best exercise, only the best exercise for you.
But to give you an idea of what we regard as our “go to exercises” here is a list to consider. Just bear in mind you still need to consider things like foot stability and ankle mobility as these joints play big part in creating compensation at the hip. But for the sake of keeping this article simple we will look solely at the hip and pelvic area. Let’s start with the simplest drills first. Also I must define stability really means.
True stability is all about TIMING!
Being able to react with perfect reflexes to be able to maintain joint alignment ready for efficient and smooth movement. This is the secret to teaching the hip how to keep the mobility but maintain the stability of the joint at the same time. So many people neglect this training or just completely misunderstand it and create more problems than they solve due to the fact they are using exercises to create stiffness and not stability.
The video above explains this concept for you, but you also might want to read our article – Stability Training & What It Really Means.
Okay, so let’s get started with the exercises. You will not need any equipment other than a Swissball and a resistance band for these are all body-weight exercises.
Stability Exercise 1 – Inner Unit Function
This is the easiest place to start and really ensures that you know how to create stability at the pelvis using your abdominal muscles and not your hips. This first exercise is all about learning to activate the TVA and helps to learn how to activate your inner unit stabilizers.
The lower abdominal exercise is the progression and is much harder to do when hip stiffness is present as the hip muscles have learned to become the stabilizers to the pelvis. Every time the hips try to fire up to create the stiffness in the spine they move the pelvis into anterior tilt and as a result you lose your lumbar spine stability. The harder you try the worse you make it.
The only way to stabilize is to use your inner unit and gently posterior tilt the pelvis into the floor. I regularly find 90% of people fail this test and can take up to a month to really grasp the concept of using the abdominal muscles to do the work and not the hips.
Do not under estimate the importance of breathing with these exercises too. Far too many people fail this for they do not how to breathe correctly to activate these muscles.
Read this article to see more about this – Why most people fail the lower abdominal exercise
Stability Exercise 2 – Reverse Clam & Closed Clam Exercise
Many people are very familiar with the clam shell exercise used to isolate the glutes and provide the external rotation of the hip. While this can be a great exercise and a form of stability training itself, it can also cause a lot of problems in the beginning. This is because people who present with weak glutes and hip stability problems often preferentially engage the TFL instead of stabilizing the hip using the Glut Medius. Since the TFL continues onto the Iliotibial Band (ITB), symptoms often present along the lateral leg when the TFL is hypertonic.
The open clamshell can exacerbate this problem whereas the two exercises below don’t allow this happen. Read this article to see more – How good is the clamshell exercise for strengthening the glutes?
These exercises can assist in regaining internal rotation of the hip which for many people is the main reason for instability without exciting the TFL and ITB. The first one is the reverse clamshell exercise shown below.
The closed clamshell improves hip centration by activating the hip flexors and abductors external rotators all at the same time. Quite an unusual exercise but can be effective in the beginning to learning better stabilization for the more complex movements to come.
The theory behind this exercise is that you are greatly able to “centrate” the hip by activating the hip flexors, hip abductors and external rotators all at the same time but assist the ball and socket remaining in position as the floor is supporting you.
Stability Exercise 3 – Bird Dog (Horsestance)
This exercise is one that most people are very familiar with but also highly under rated.
I often start with the simple floor exercise but then try to progress to either instability with a BOSU to challenge the stability of the stance leg, and then add resistance using a band to challenge the strength of the gluteus maximus. The gluteus maximus can be very difficult to strengthen at times and this exercise is very effective at doing this without causing problems like many of the other strength exercises.
The BOSU version is where “reflex stability” comes out for the first time and you begin to see cracks appear in how a person maintains stability during movement. It is amazing how difficult people can find this exercise and they must go through the struggle to learn how to effectively move without falling over.
This is great for building the foundation for single leg stance which is what you really want to build up to. The video below shows you both of these versions.
Stability Exercise 4 – Prone Jacknife & Forward Ball Roll
These next two exercises are both known for strengthening the abdominal muscles of the core and great for controlling extension.
The forward ball roll is much easier and the better exercise to start with when you are in pain or have severe weakness. You can make mistakes with this exercise and it will not cause any problems, but on the flip side of this is that it does not do enough to create any significant change. It’s purpose is to get you to the next level which is the prone jackknife.
The prone jack-knife is another unique exercise in that it forces you to find stiffness at the lumbar spine with much more pronounced movement at the hips than the bird-dog as both hips are moving. This exercise is often referred to as hip disassociation for you must separate the hips from the mechanism of stability in order to it right. The quadriceps are very active in this exercise which are often a real problem with other exercises so it forces the person to learn how to use these muscles as movers and not as stabilizers.
Below is a video that shows you how to do this.
Stability Exercise 5 –Hip Extension
Most people would think I should have used this exercise earlier which in many cases I do. However with severe pain it can be very difficult and even painful to do such as with piriformis syndrome and SIJ dysfunction. While the glutes are certainly weak and need to be strengthened and this is a strength exercise it should be a logical choice.
However the reason it can cause problems is that it only strengthens the glutes in a shortened position and not in a lengthened position. It is in the lengthened position that all the problems are being created and where the person is most vulnerable. One of the ways the body learns to compensate is by using the hamstrings more and also using butt gripping which makes problems much worse.
The floor hip extension can contribute to making this worse which is why I might not use this in the early stages. At this point you should be trying to introduce it for it really is a simple exercise, it is just that the body has been learning to compensate for too long that makes it a problem.
This next exercise is also hip extension but a different version of it. This is also quite a simple exercise and can be very effective at helping the person feel the glutes engage in the hip extension we use during walking. Once again this can be very difficult to get right with people who have severe weakness and pain as often the lower back or the hamstrings take over this movement.
Stability Exercise 6 – Kneeling Side Plank
While the side plank certainly does a good job of targeting the core muscles there is much more to this exercise than many realize. In fact there are three unique things to this exercise that make it a superior exercise to many abdominal or core stability exercises.
Firstly, the side plank’s unique position allows it to activate the lateral oblique and Quadratus Lumborum (QL) muscles on only one side of the body, making it an excellent choice for addressing weak links in stability. QL weakness and trigger points are very common with lateral hip pain so finding an exercise that addresses this is extremely useful. It also has quite a high degree of lower abdominal activation which many people are not aware of.
Secondly, while the muscle activation is quite high it places minimal forces on the spine. As the spinal loads are minimized it makes for a perfect exercise to use in the early stages of rehabilitation when pain sensitivity is quite high making it hard to use more functional based movements.
Thirdly, it also engages an important stabilizer of the hip/pelvis on the lateral hip being the glute medius which is regularly linked to problems of the hip and lower back. This is particularly useful with problems like lateral pelvic tilt where there is a significant weakness on one side of the body.
I prefer the kneeling version in the early stages for this reason.
You can read more about the side plank and the other variations you can use in this article – How good is the side plank for improving core stability?
Stability Exercise 7 – Inline Lunge
Have you noticed, we are gradually working our way up to standing?
Again this is another exercise that looks really easy, but if you have hip stiffness, you will be in for a real surprise when you keep falling over. This is excellent to use in combination with lunges for the person who struggles to maintain optimal form and technique. The hips MUST NOT stiffen here or you cannot move. A great exercise with the older client who has lost significant balance and that reflex timing to thrust the hip forward when they encounter a slip.
People with lower back pain usually have great trouble with this as the hips have stiffened up so much to provide trunk stability they cannot move their legs without falling forward.
Stability Exercise 8 – Toe Touch Drill & Hip Airplane
We are now at a stage where we are trying to stand on one leg. These two exercises are arguably my favorite hip stability exercises to use.
The toe touch drill is good to introduce first and you should try to do this early on if you can. This is for the simple fact you need to control the single leg stance when you walk. This particular exercise is very difficult for the person with lower limb injuries like knee pain.
As it does not have too much movement it is reasonably easy to execute and teach the person how to control the single leg stance.
Once you have mastered that I like to introduce the hip airplane which is very similar but has a progression of moving with rotation that further challenges the muscles of the hip and the feet. At first you may need to hold onto something to learn how this works but once you have mastered that you need to do this unassisted so you can learn how to effectively stabilize.
The best part with these exercises is if I you make a mistake there is not a big consequence or compensation that will cause pain. They can be very frustrating but they are not likely to cause more problems and allow you to build the stability and control needed to build strength with more confidence and less risk.
Strength Exercise – Romanian Deadlift (Hip-hinge)
I saved the best for last! Or should I say the most important.
This is the first exercise where I introduce load in a standing position and a bit like the previous exercises you need to get to this pretty early on for we use this movement all the time in daily life. The sooner you learn how to do this correctly the easier it will be to strengthen and stabilize the hips.
Once you are at this point you should be able to do other more functional exercises that will improve the strength of the hip considerably.
You can read more about this and see the various progressions to use in this article – Why The Romanian Deadlift is the Key To Treating Hip & Back Pain
Walking Deadlift
Once you are at this point you should be able to do other more functional exercises that will improve the strength of the hip considerably. Before adding load or trying to do too much with the single leg exercises I like to use the walking deadlift.
While this is quite difficult to learn due to the coordination involved I would still classify this as a remedial type exercise for the strength demands are not intense. The best part about this and what differentiates it from all the other exercises is that it is the first one that is on the move. All the other exercises are stationary which is fine for building stability and strength but it does not teach the body the necessary skills for controlling motion.
Often the hardest thing for people to do when they have significant problems with the hips and pelvis is walking so you need to have an exercise that helps them to regain this control. This exercise is great for doing this as it mimics the same position used with the Romanian Deadlift.
Summary
I hope this article gives you some great insights and ideas on how you can go about improving your hip and pelvic stability to not only reduce pain but be able to move more efficiently. Learning how to look after this joint is critical for maintaining good movement in daily life.
Static stretching will have little affect on improving your mobility if the body does not learn how to effectively stabilize itself, and you cannot do that with planks or lying on your back doing crunches. You must learn how to apply reflex level movements that incorporate multiple muscles in the right order to have any chance. The efforts in doing so are well worth it.
Do You Need More Help?
Throughout the article I mentioned several times specific injuries that will require more in depth assessing and programming. Injuries common to hip dysfunction are back, knee and also piriformis syndrome injuries. We have online video with detailed PDF reports you can download with specific exercises, assessments, stretches, mobility drills and step by step programs for getting rid of these painful injuries.
Click here or on the image below to go to the online shop.
About The Author
Nick Jack is owner of No Regrets Personal Training and has over 20 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.
References
•Functional Anatomy of the Pelvis and the Sacroiliac Joint – By John Gibbons
•The Vital Glutes – By John Gibbons
•Movement – By Gray Cook
•Corrective Exercise Solutions – by Evan Osar
•Back Pain Mechanic – by Dr Stuart McGill
•Diagnosis & Treatment Of Movement Impairment Syndromes – By Shirley Sahrman
•Low Back Disorders – by Dr Stuart McGill
•Ultimate Back Fitness & Performance – by Dr Stuart McGill
•The Psoas Solution – by Evan Osar
•Athletic Body in Balance – by Gray Cook
•Anatomy Trains – by Thomas Meyers
•Motor Learning and Performance – By Richard A Schmidt and Timothy D Lee
•Assessment & Treatment Of Muscle Imbalance – By Vladimir Janda
•How To Eat, Move & Be Healthy by Paul Chek
•Scientific Core Conditioning Correspondence Course – By Paul Chek
•Advanced Program Design – By Paul Chek