If you take one thing from this series, I hope it is that mobility at the hip is incredibly important.
Maintaining that mobility requires both tissue flexibility and control of movement at the joint. Today we focus on the flexibility component of keeping the hip joint moving so that when you add the exercises for better control of the hip in the future, you are building on a good movement foundation.
Here is an example of a short and easy-to-complete mobility routine for the hip, involving some stretching and movement drills. These activities have been selected because they encompass the majority of structures around the hip that are important for building mobility, and will assist in improving overall movement at the joint — so try to complete them all, not just the ones you think will be most helpful.
As usual, if you feel pain or significant discomfort with any of these activities, try to work only within comfortable ranges, or reset and return to that activity on the next day. None of these activities should make your pain worse! And if you can’t complete an activity due to discomfort that doesn’t subside, please consider having an assessment with a health practitioner.
2A – Quadriceps Stretch
The common activities of daily life for most people usually include a lot of sitting, which means the hip is in a flexed position much of the time. Maintaining a position like this frequently alters the balance of tension in the body at times, and in this case often means the quadriceps develop more tension, or get too tight, at the front of the hip and thigh.
This is a fairly commonly used stretch by runners, gym-goers, and many other athletically inclined people. It is simple to complete, and can be done simply standing on one leg (if your balance allows) or lying on your side.
For standing: Stand on one foot (hold a steady object like a chair for balance), and bend the other knee so you can grasp the ankle or foot with your hand. Gently draw the thigh into extension, creating a mild stretch at its front. Hold this position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
For sidelying: Lie on your side, with the down-side hip flexed to 90°, and bend the up-side knee so you can grasp the ankle or foot with your hand. Gently draw the up-side thigh into extension, creating a mild stretch at its front. Hold this position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
2B – Hamstrings Stretch
The hamstring muscles are located at the back of the thigh. For many people with hip or lower back discomfort, one of the mechanisms used to avoid their discomfort is to use the hamstrings as a sort of “brake” for the body when momentum moves you forward — like simply bending over, walking, etc.
Overuse of a strategy like this creates a lot of tension in the hamstrings that ultimately restricts hip mobility, so in order to restore mobility at the hip a stretch of hamstrings is required as well.
Once again, this can be completed in two manners — seated in a chair, or seated on the ground. A third option, stretching while standing, is less ideal because most people have to continue to contract the hamstring (while trying to stretch it) in order to keep your balance — so this is not recommended.
For the ground: Sit on the ground, with one leg bent and the other straight. Sit tall and reach forward towards the foot of the straight leg. Hold the foot or shin to help maintain a mild stretch at the back of the thigh. Maintain this position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
For a chair: Begin seated at the forward edge of your chair, keep the stretch leg straight and sit tall. Lean forward from the hip (don’t round through the back) and reach towards your foot. Hold when a gentle stretch at the back of the thigh is created. Maintain this position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
A note for hamstring stretches — if most of the stretch feels “brighter”, creates tingling or discomfort into the foot, or feels more like a nerve is being stretched at the back of the knee, allow your knee to bent a few degrees to ease some of the pressure. Keep everything else the same, and you should feel the stretch become more focused into the back of the thigh. This feeling of a stretch at the back of the thigh is more what you are looking for.
2C – Iliopsoas Stretch (Hip Flexors)
Tightness of the hip flexors (iliacus muscle + psoas muscle = iliopsoas) are another common limitation for mobility at the hip in many people. Without flexibility in these muscles, and the ability of the pelvic to tilt slightly to accommodate movement through the hip and lower back that comes with it, the ability to create synergy between the hip and core is very difficult.
In short, freedom of the hip flexors are one of the keys to making sure the hip and lower back are able to support each other and function in a more “normal” fashion.
Stretching these muscles requires a two-step process:
Step one: Begin in a half-kneeling position with the trail leg knee posted under the hip and the forward leg out in front at 90°. Shift your hips towards your forward leg, creating a gentle stretch at the front of your trail leg.
Step two: While maintaining this stretch of the trail leg, tilt the pelvis backwards (ie. draw the belt buckle to the sky, or tuck the buttock underneath your torso) to create an even deeper stretch into the hip flexors of the trail leg. Perform these actions slowly, maintain this stretch position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
2D – Figure-4 (Gluteal) Stretch
Another popular and effective stretch used to create more hip mobility is the Figure-4 stretch, a stretch for the gluteal muscles. The gluteal muscles are some of the largest and most powerful muscles for movement in the body, but they are also conveniently placed to stop the lower back and pelvis from moving when pain is present. Unfortunately, when they are used to stop movement in the presence of pain, it is very difficult to use them for movement (like walking, climbing stairs, getting out of chairs, etc.), and so ironically we have these big powerful muscles for movement that can’t be used.
How do you fix that? It starts with a stretch to free up chronic tension, as described below, and then integrating exercise that will help push more drive through the muscle (this will be in the next posting).
Figure-4 Stretch: Start lying on your back with both feet flat on the floor. Cross one ankle over the opposite knee, and then bring the knee towards the chest. Next, reach through the triangular gap created by your legs and interlock the fingers at the back of the uncrossed thigh with your hands. Pull gently with your arms to bring the knee towards the chest, creating a gentle stretch at the hip of the crossed leg.
Perform these actions slowly, maintain this stretch position for 15-20 seconds, and repeat for 2-4 repetitions on both legs.
2E – 90/90 Hip Mobility Drill
Now that much of the tissue around the hip is in a more flexible state, movement drills like this will be more effective in creating hip mobility. The nice thing about this drill is you can do it without body weight compressing the joint, you work both hips at the same time, and it is easy to complete — no equipment required, just sit on the ground and go.
You might not be very good at this to start! Some people struggle to get into the position at all, others have difficulty keeping both buttocks on the ground at the same time, and others still find one side MUCH easier than the other. That’s okay! Do your best, move slowly, and you will improve with practice. But as always, please do not push through pain or pinching sensations at the hip.
90/90 Hip Mobility: To get into the 90/90 position, sit on the ground and shift your lead leg directly in front of you, bent to 90 degrees at the knee (heel to hip creates 90° angle). The trail leg should be to the side (90° angle created with your front leg), and also bent to 90° at the knee (1).
From here, sit tall and lean your chest towards the forward thigh, creating a gentle stretch at the underside of the hip (2). Do your best to keep your chest tall throughout this small movement — ie. try not to slump through your back.
Then, after an appropriate hold of the stretch, keep the legs in the same position return to sitting tall, and turn your chest towards the knee of the trail leg (3). If you find this is too difficult, lean back slightly and use your hands as support to help make this turn (4). This will create a stretch/pressure into the trail hip.
Perform these movements slowly, hold each position 15-20 seconds, and 2-4 repetitions. Then, reposition so your legs switch places, and repeat the drill (ie. if you leaned into your left hip and turned into your right, now lean into your right hip and turn into your left).
2F – Active Hip Circles
Finally, with improved mobility by stretching muscles around the hip (2A->2D), and an effective drill to move the hip in a controlled manner (2E), we have an active hip mobility drill that both recruits muscles around the hip and creates motion at the joint.
Active hip circles: if you find the steps at all difficult to follow, are essentially just that — moving the hip in a big circle under your control. This can be modified to complete kneeling, standing, under tension, etc., but learning to do this in quadruped first (on hands and knees) will best position you for progressing the activity as you get better with it.
Since you are in control of the movement at the hip here, the slower you can complete the movement the better. It also helps to complete this movement as described, AND in reverse — there is a subtly different feel in each direction.
Active Hip Circles: Begin on your hands and knees, with your arms under the shoulders and knees under the hips. From here, move slowly and deliberately, and try to keep the 90° relation of the knee and ankle in-tact:
- (1) Draw your knee towards your chest.
- (2) Move the hip and ankle away from the body.
- (3) Rotate the hip so the knee points to the floor and the ankle points to the ceiling, and extend the hip backwards.
- (4) Bring the knee and ankle back in-line with the starting position, and
- (5) Return to the start.
Perform these movements slowly, and repeat for 2-4 repetitions. Then, repeat repeat the drill with the other hip. Try the movement in reverse as well, for an additional challenge.
You can work through a hip mobility plan like this every day to open up better movement and function at the hips and relieve strain on other joints in the body (especially the back and core). Work through them slowly, and as movement improves you will be ready to advance to the next phase in addressing the hips: creating activation and resiliency with exercise.
That will be covered in the next post.