The hip/pelvic region is one of the most important parts of our body. It is vital for functions like walking, sitting, standing, jumping, etc. So much of our daily lives are affected by the usage of our hips.
Over time, when you stack things up like a growing family, work, and other responsibilities you end up with some weird new pinching in that area. It may be dull at first, but it builds to more. Finally, you head to the gym ready to undo it all but that’s when it reaches a boiling point.
Ow, my hip hurts. What is wrong with me? Am I getting too old to exercise? Do I need to get an MRI?
You are not alone.
The hip region is responsible for so many movements that, without it, you would struggle getting through normal tasks. We can save the causes and theory for another article down the road. The purpose of this article is to highlight what actionable steps you can take right now to address the pain you’re having. Truthfully, even if you’re not feeling symptoms at the moment you can still benefit from all of these exercises.
I can break down how to address your hip issue in four parts. But first, as with anything joint related we need to do a quick assessment. It’s impossible to know exactly why your pain is present without knowing more context. Do you lack internal rotation of the hip? Is the pain coming from hip flexion? Once we know what the joint is capable/not capable of we can pinpoint how to address it.
Assess your Squat
Squatting is a vital part of any program helping someone improve their hip/pelvic region. The motion itself seems to be medicine. In teaching someone to properly squat, they are now moving with greater efficiency and building strength in often underdeveloped areas. By building strength and efficacy in this pattern, you are now more capable of moving correctly and less likely to put stress on your back.
Actionable Info: To assess yourself, you will need a small dowel or PVC pipe and a small 1/2″ piece of wood or square object. Start with your toes pointed forward and, holding onto the dowel with both hands, press it straight over your head. This is the starting position. Now, maintaining your upright posture descend into a squat. Did your toes or knees start to move out? Were your arms able to stay it that starting position the whole way? Did you feel any pain? Below is a generally accepted rubric for you to use in grading how well you performed in the overhead squat. It’s important to mention that if your squat is not perfect after the first rep, place your heels on top of the 1/2″ wood board and try again. If elevating the heels allowed you to perform a better rep, you may need to target ankle mobility in your program.
Score of 0- A zero in the overhead squat means pain was present in the assessment. Due to this, you need to see a medical professional to look deeper at the quality of your hip joint. If pain is showing itself in a bodyweight assessment, you will definitely have issues down the road if you do not address this now.
Score of 1- A one would indicate you are free of pain, but do not possess great strength or movement quality. If you fit into this category, you need to perform bodyweight squats either holding onto a TRX or something stable. You can also perform a bodyweight squat with a target object below you like a box or a bench. These two things allow some support for you while you learn to perform this movement correctly. In this situation, we would ask you to elevate your heels onto a board and perform the squat again. If your form improves, you would be rescored a 2. If it does not improve, you need to address a couple of things immediately.
Score of 2- A two means you probably do possess the strength necessary, but have a compensation preventing you from performing the movement with maximum efficacy. Do your arms fall forward? Do your toes shoot outwards? Do your heels raises off the ground? These are all things that cause you to lose tension into the ground and probably cause parts of your body to do more work than necessary possibly leading to injury or other problems down the road. A score of a two is very close to a three, but you need to work on improving some compensations. Work with light to medium loads until these compensations are done away with. Think of a two like your car being out of alignment. You can still drive it, but the wear on the tires will lead to problems.
Score of 3- My friend, you are in good company. A score of three in an overhead deep squat assessment means you move pretty darn well. If you can do this movement, you are free of most restrictions that people feel in their ankles, shoulders, or low back and you can perform just about any movement with good quality under load. This, of course, doesn’t mean you shouldn’t work to maintain your good movement quality. Continue to do this assessment once a month to make sure you are keeping the quality movement skill.
Learn how to hinge properly
Learning how to move properly is one of our goals in becoming athletic again. The hinge movement is vital to athletes and non-athletes because of it’s prevalence in daily life. If you bend over to pick something up, you are performing a hinge movement. If you are carrying groceries inside your house and put them down by the fridge, that’s a hinge. How many times have you heard of someone throwing their back out while bending over? It’s not that one time they picked something up, but the years and years of hinging improperly and that one time was the straw that broke the camel’s back. We can learn to do this movement properly and incorporate the lower body instead of relying on the lumbar spine to do something it’s not meant for.
Actionable info: If you can’t bend over without rounding your back or feeling pinching in your hips, you DO NOT need to be lifting weights in this pattern. The answer is not getting stronger, it is freeing up space in your hips and learning how to bend properly WITHOUT weight. You need to learn how to sit into your hips first because chances are when you add loads you compensate with your low back. If you have the movement down, try the same hinging movements with a dumbbell in each hand. Can you maintain good posture and movement quality with weights? If so, you can progress to loaded movements. If no compensations are present with light loads, you are clear for things like RDL’s and deadlifts. If not, stay with the light loads and build strength in that pattern before progressing. There’s no shame in this as it will save you problems down the road.
Moving in circles
This category is one of my favorites when I’m talking to an athlete or client because the it’s “simple, but effective” nature. You can’t really mess this one up no matter what age or lifestyle you live. The shoulder and hip joints both really like when you move in small circles. Bigger circles work too, but that’s where some joint limitations come into play and impingement symptoms can rear their ugly head. So, for now, as a blanket statement I can recommend arm and hip circles to anyone. Whether you are a 80 year old recreational tennis player or a 20 year old baseball player, arm and hip circles daily can improve the way the joint feels if done on a consistent basis. Now, how you perform these can be discussed and we can always dive into more detail but for now let’s keep it simple.
Actionable info: Add in 3 sets of 20 arm circles and 3 sets of 15 quadruped (on all fours) hip circles each day to act as a way to grease the joint and feel better. The only disclaimer to this is that you need to do this daily for a few weeks at least. If you do this once a week it will not be effective. The point is that it’s simple and effective, but only if you can do it daily.
Stretching is listed last because it’s actually everyone’s first inclination when trying to fix hip pain. “If my [insert body part] hurts, I need to stretch it”. The funny thing about most joint pain is that stretching by itself will not provide any long-term relief. Second, how do you know if stretching improved anything if you didn’t assess your joint before stretching? See where I’m going with this?
Stretching can be a part of this, but if you still move like crap and don’t improve stability in the joint you are just yanking at your shoulder for no reason. In some cases, stretching can actually have the opposite effect. It’s all about context. If stretching is done correctly, however, and fits with what you’ve found from an assessment then you are going to benefit from it. Sometimes your tense hamstrings are a result of posture, so stretching them without correcting what’s happening with your spine/shoulders means you are only providing temporary relief and will most definitely have tight hamstrings tomorrow too.
Actionable Info: Assess your movement quality first and find out where your limitations are. Then, you can decide what needs to be stretched and what needs to be more stable. If you improve the stability of the joints surrounding a muscle, you may improve your range of motion without even stretching. Assess and then you can truly fix the problem. Once you have identified the problem, general stretching can work.
Take Home Message
- Get assessed by a professional, if not available follow the rules listed above or email me firstname.lastname@example.org. You need to know exactly where you can improve. It’s worth doing before you pay for a program or else you can be throwing money away.
- Prioritize movement quality over strength when starting out. You do not want to load the body when it cannot absorb it efficiently. If the load of a back squat is supposed to be evenly distributed, but 90% is being placed on the spine you will break soon after starting your program.
- If pain is present, do not grind away. Your cartilage is not infinite and will not regrow itself back. Arthritis is something that will follow you forever, so do your best to prevent it. Use your head, help yourself now so your program can help yourself later.