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The hip joint is a ball – and – socket joint whose integrity is maintained through tight ligamentous wrapping, as well as strong muscular attachment (unlike the shoulder, which is less stable or protected).
Since the hips and lower limbs are weight bearing joints, it is important that the weight be distributed as evenly as possible into the two legs, since buckling, strain and degenerative changes can otherwise be accelerated. When you consider the effects of hard surfaces and shoes on the feet (see page on Foot Problems), a sedentary lifestyle and lack of exercise; the hip and hence pelvis become weak, distorted and prone to injury.
Since the hip attaches to the pelvis, it must be considered an integral component of posture stability (see section on Lower Cross Syndrome), and is very often involved in cases of back pain and even headaches and other symptoms. Therefore, no back routine can be complete without addressing deficiencies and weaknesses in the hips and legs. To review low back exercises, please visit the page Low Back Exercises.
The following exercises have been put together as a resource for patients at this clinic and are not meant to replace professional assessment and treatment. Be sure to consult your practitioner before attempting any of them, in case they are inappropriate for your situation. Cease if they cause pain and seek professional advice.
The muscles that flex the hip are commonly found to be weak, contracted and stiff, mostly because of the amount of sitting we do, but also in response to various postural irritations as well as internal sagging (ptosis) of the bowel, kidneys and other organs. Lunges are a stretch that is used in many therapeutic systems, including yoga, martial arts, as well as contemporary systems such as Pilates.
When lunging keep your back upright, your pelvis and shoulders in the same plane, suck in your stomach and keep your back leg straight. Hold for 20 seconds then relax. Repeat 3 times each leg.
You can increase the challenge by using a chair.
2. Hamstring stretches
The hamstrings can be easily stretched by sitting with one leg straight, and the other bent at the knee with the foot drawn in to your centre line. Keeping your back straight, lean forward till you feel a stretch, then hold for 20 seconds and release. Repeat 3 times each leg.
It is not necessary to touch your face to your knee!
To increase the challenge, use a towel to pull back on your foot as you lean forward.
Alternative ways to stretch the hamstrings include lying on your back and lifting your leg with your arms, or standing with your foot on a chair. A towel can also be used for more challenge.
When performed standing, it is easy to increase the focus on different fibres of the hamstring by turning the foot in or out as you go into the stretch.
3. Quadriceps stretch
The quadriceps are an important stabiliser of the pelvis, but also play an important role in knee function. Many injuries of the knee including meniscus tears, cruciate ligament tears and collateral ligament tears will result in spasm and guarding of the quadriceps muscle, with resultant knee rigidity.
Using a chair for support, place your heel on your buttock, then slowly push your knee backwards, feeling a stretch along the whole front of your thigh. Hold for 20 seconds, repeat 3 times.
Alternatively the stretch can be done lying face down.
4. Gluteal Stretches
The gluteal (backside) muscles are very important muscles of posture and locomotion. They can also produce symptoms of sciatica when in a state of spasm. Today’s sedentary lifestyle means that for much of the day they are being strained and compressed by the act of sitting. Consequently they can become spasmed, weak and faulty. An easy way to stretch them and stimulate blood flow is to cross one leg over the other and with your back straight, lean forward till you feel a stretch in your buttock. Hold for 20 seconds, then relax. Repeat 3 times both sides. Try changing a couple of variables to explore a better stretch by pushing down or up on the knee, shifting the foot across, or leaning your body slightly to the right or left of centre as you lean into the stretch position.
Alternatively, you can lie on your back, and with one hand on your knee, and the other on your ankle pull the shin smoothly across to the opposite shoulder. As in the sitting version, try to change the pressure and angle you exert onto the ankle, shin or knee till you find a position of maximum tension.
Another alternative favoured by many sportspeople is to lay on your back and cross one leg over the other. Then taking hold of the back of the uncrossed thigh, pull towards your chest, using it to lever the crossed leg up also.
5. Gluteal kickbacks
It is also important to strengthen the gluteal muscles, so try the following exercise.
Stand with your weight on one leg, leaving the other a centimetre or so off the ground, so that it can swing freely. Use a chair for support if necessary.
Remain relaxed and straight with your upper body, while you swing your heel backward. At the end of the backward swing squeeze your backside cheek on that side for a second or two, then release and allow the leg to return to the centre point. Do not swing forward. Make sure you don’t arch your back or twist at the waist as you perform the exercise and keep your upper body relaxed. Perform 20 kickbacks on each leg. Then try turning the foot out a little as your perform the kickbacks. You should find it a little more intense. Perform another 20 kickbacks on each leg with the foot turned out.
6. Iliotibial Band stretch (Tensor Fascia Lata)
The side stabiliser muscles can become quite fibrosed and inelastic with poor posture, or more particularly when carrying a weight on the side of your hip (such as mums carrying babies, or carrying a bucket or shopping in one hand). They can often refer pain down the leg, and are known to cause knee pain as well as backache.
To stretch it, stand beside a wall and then cross the wall-side leg behind the other one, keeping the heel on the ground if you can. Lean your hip into the wall, but push your upper body away. You should feel a stretch on the side of your hip. Hold for 20 seconds, then relax. Repeat 3 times both legs.
7. Calf Stretches
Standing in front of a wall, try to place as much of the sole of one foot as you can up against it. You will probably need to bend the other leag a little to do it. Then, keeping the leg straight (knee fully extended), straighten the other leg, lifting yourself up a little. You should feel a stretch in the calf of the leg against the wall. Hold for 20 seconds, then relax. Repeat 3 times each leg.
Then do the same thing again, but this time keep the wall-leg bent at the knee as you perform the stretch.
There is a superficial and deep calf muscle, and to stretch the calves properly you should perform the exercise with knee bent as well as straight.
8. Knee circumduction
Standing with your feet together and your knees slightly bent. Slowly move both knees in a circle, first clockwise, then anticlockwise. Be sure to trace out a circle cleanly and accurately and keep the knees together as you do so.
For a greater challenge, increase the size of the circles.