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The True Hip Flexor Stretch

The hip flexor stretch has become a very popular stretch in the fitness and sports performance world, and rightly so considering how many people live their lives in anterior pelvic tilt.  However, this seems to be one of those stretches that I see a lot of people either performing incorrectly or too aggressively.  I talked about this in a recent Inner Circle webinar on 5 common stretches we probably shouldn’t be using, but I wanted to expand on the hip flexor stretch as I feel this is pretty important.

I’ve started teaching what I call the “true hip flexor stretch.”

I call it the true hip flexor stretch as I want you to truly work on stretching the hip flexor and not just torque your body into hip and lumbar extension.  It’s very easy for the body to take the path of least resistance when stretching.  People with tight hip flexors and poor hip extension often just end up compensating and either hyperextend their low back or stress the anterior capsule of the hip joint.

I explain this in more detail in this video:

 

The good thing is, there is a simple and very effective.  Once you adjust and perform the true hip flexor stretch, most people say they never felt a stretch like that before, hence the name “true hip flexor stretch.”

 

True Hip Flexor Stretch

To perform the true hip flexor stretch, you want to de-emphasize hip extension and focus more on posterior pelvic tilt.  Watch this video for a more detailed explanation:

 

Key Points

  • There is a difference between a quadriceps stretch and a hip flexor stretch.  When your rationale for performing the stretch is to work on stretching your hip flexor, focus on the psoas and not the rectus femoris.
  • Keep it a one joint stretch.  Many people want to jump right to performing a hip flexor stretch while flexing the knee.  This incorporates the rectus and the psoas, but I find far too many people can not appropriately perform this stretch.  They will compensate, usually by stretching their anterior capsule too much or hyperextending their lumbar spine.
  • Stay tall.  Resist the urge to lean into the stretch and really extend your hip.  Most people are too tight for this, trust me.  You’ll end up stretch out the anterior hip joint and abdominals more than the hip flexor.
  • Make sure you incorporate a posterior pelvic tilt.  Contract your abdominals and your glutes to perform a posterior pelvic tilt.  This will give your the “true” stretch we are looking for when choosing this stretch.  Many people wont even need to lean in a little, they’ll feel it immediately in the front of their hip.
  • If you don’t feel it, squeeze your glutes harder.  Many people have a hard time turing on their glutes while performing this stretch, but it is key.
  • If you still don’t feel it, lean in just a touch.  If you are sure your glutes and abs are squeezed and you are in posterior pelvic tilt and still don’t feel it much, lean in just a few inches.  Our first progression of this is simple to lean forward in 1-3 inches, but keep your pelvis in posterior tilt.
  • Guide your hips with your hands.  I usually start this stretch with your hands on your hips so I can teach you to feel posterior pelvic tilt.  Place your fingers in the front and thumbs in the back and cue them to posterior tilt and make their thumbs move down.
  • Progress to add core engagement.  Once they can master the posterior pelvic tilt, I usually progress to assist by curing core engagement.  You can do this by pacing both hands together on top of your front knee and push straight down, or by holding a massage stick or dowel in front of you and pushing down into the ground.  Key here is to have arms straight and to push down with you core, not your triceps.

 

 

I use this for people that really present in an anterior pelvic tilt, or with people that appear to have too loose of an anterior hip capsule.  In fact, this has completely replaced the common variations of hip flexor stretches in all of our programs at Champion.  This works great for people with low back pain, hip pain, and postural and biomechanical issues related to too much of an anterior pelvic tilt.

Give the true hip flexor stretch a try and let me know what you think.

 

 

How to Perform Lower Body Plyometrics

The latest Inner Circle webinar recording on How to Perform Lower Body Plyometrics is now available.

How to Perform Lower Body Plyometrics

This month’s Inner Circle webinar is on How to Perform Lower Body Plyometrics.  In this presentation, I demonstrate the different types of plyometric exercises you can perform for the lower body and show some of my favorite progressions.

This webinar will cover:

  • The different types of plyometric exercises you can perform for the lower body
  • How I progress from two leg to one leg drills
  • How I progress different planes of motions
  • The keys to choosing the best exercise for your goal

To access this webinar:

 

Should We Delay Range of Motion After a Rotator Cuff Repair Surgery?

Over the last several years, there has been a trend among orthopedic surgeons to delay the start of rehabilitation, specifically range of motion exercises, following rotator cuff repair surgery.

It’s my opinion that this trend started in response to the research that has been reported in the past that show issues with tendon healing rates and a large percentage of rotator cuff repairs are not intact at follow up examination.

For example, I previously discussed the outcomes of arthroscopic rotator repairs and noted that at the one year follow up after surgery, 68% had an intact rotator cuff. 32% had a full thickness tear again.

So physicians did what they tend to do… They started to get more conservative and delayed the start of rehabilitation. I’ve discussed a similar to approach to rehabilitation following total shoulder replacement.

But does delaying the start of range of motion after rotator cuff repair surgery even help improve outcomes?

Does immobilization after rotator cuff repair increase tendon healing?

A systematic review was published in the Archives of Orthopaedic and Trauma Surgery that looked at 3 randomized control trials comparing immediate versus delayed range of motion follow rotator cuff repair surgery.

The authors reported a few findings.

Most importantly, there was no difference in tendon healing rate, showing that early range of motion is safe to perform and not the reason why people may retear.

Range of motion improved earlier in the immediate range of motion group, but was similar at the year mark. This is consistent with many past studies. Again physicians read into this and use this stat to favor delayed range of motion, stating that patients are all the same at 1 year postoperative. However, as we all know, restoring motion is key to the patient’s’ subjective and functional outcomes. Similarly, functional outcomes were achieved sooner in the immediate range of motion group.

Based on this systematic review, I would continue to recommend performing control range of motion following rotator cuff repair surgery as it appears to be safe and effective at restoring motion and function sooner than if we delay rehabilitation.

Learn More About How I Evaluate and Treat the Shoulder

I’m pretty excited to announce I have revised my acclaimed online program teaching you exactly how I evaluate and treat the shoulder to now include a lesson on the arthritic shoulder! If you want to learn more about how I work with rotator cuff repairs, and everything else related to the shoulder, you’re going to want to take my online course.

 

Should We Delay Range of Motion After a Total Shoulder Replacement?

Total shoulder replacement surgery is being performed more and more each year.  Our current patients were more active in sports in their youth, potentially increasing the chances of developing an arthritic shoulder.  They also want to remain active as they age, potentially increasing the likelihood that they want to have a total shoulder arthroplasty surgery to allow them to remain active.

Over the years, the surgical technique for a total shoulder replacement has improved, though I’m not sure our rehabilitation approach has also improved.  If our patients are younger and want to be more active after total shoulder replacement, then perhaps our rehabilitation programs should adjust based on their goals.

Rehabilitation Following Total Shoulder Replacement

Historically, a conservative approach was appropriate for many patients, as their needs and activity goals were less aggressive than many patients today.  It was acceptable to have a moderate loss of range of motion in exchange for less pain in their shoulder.

Many surgeons continue to recommend a conservative approach to the restoration of range of motion following surgery.

It is true that one of the primary goals of the postoperative rehabilitation following total shoulder replacement is to protect the subscapularis.  The subscapularis muscle is taken down to some extent during the surgical procedure and the integrity of this muscle has been correlated to the overall outcome of the procedure.

Other motions, such as behind the back and shoulder extension behind their body, also place the arthroplasty in a disadvantageous position and can lead to dislocation of the joint.

But even with these precautions, I am still an advocate of early range of motion, especially if you respect these restrictions.

Passive ROM and Active ROM are Not the Same

A recent report was recently published in Journal of Shoulder and Elbow Surgery that may actually be causing some confusion on when to start range of motion.

In the study, the authors compared a group of patients that began range of motion immediately versus a group that delayed 4 weeks.  The authors reported that the immediate range of motion group gained more motion, restored it earlier, and also showed an earlier increase in functional outcome scores.

However, 96% of the patients that delayed range of motion showed healing of the lesser tuberosity osteotomy, while only 82% of the immediate range of motion group showed healing.  Furthermore, functional outcomes scores 3 months and 1 year after surgery were similar between the groups.

This has led to many recommending a delay in range of motion.  But…

When looking deeper at the methods, the authors chose to use the rope and pulley and stick elevation range of motion exercises.  As we all know, these are not passive range of motion exercises, they are active assisted range of motion exercises.

There’s a big difference between passive and active range of motion exercises!

Previous EMG studies have shown the rotator cuff to be between 18-25% active and the deltoid to be between 21-43% active during these exercises.  Not very passive.  Conversely, passive range of motion exercises have been shown to be between 3-10% active.

This is a big difference.  I believe passive range of motion is appropriate, as long as you respect the restrictions on restoring external rotation to protect the subscapularis and avoid behind the body and behind the back motions to protect the replacement.
Immediate Range of Motion Restores Function Faster

Since we all work with these patients after surgery, we know that they are always happier when they restore their motion sooner.  And this increase in range of motion is likely related to the earlier improvement in functional outcome scores.

I think there is a middle ground of immediate, yet cautious, passive range of motion.  Again, I want to reiterate, “passive” range of motion.  Not active.

By focusing on this, I believe our patients will have much better outcomes.

Learn More About How I Evaluate and Treat the Shoulder

I’m pretty excited to announce I have revised my acclaimed online program teaching you exactly how I evaluate and treat the shoulder to now include a lesson on the arthritic shoulder!  If you want to learn more about how I work with the arthritic shoulder, patients following total and reverse shoulder replacements, and everything else related to the shoulder, you’re going to want to take my online course.

 

Dry Needling for Scapular Winging

This week’s article is a guest post from Michael Infantino.  Michael reached out to me on Facebook and sent me the below videos of a patient’s improvement in scapular winging after dry needling the serratus anterior.

I wanted to share the below article that Michael wrote showing the videos, but also talk about how trigger points may be involved.

I’m not sure what to make of these videos, if trigger points are involved, or exactly how dry needling the serratus anterior helped this patient’s winging.  But I am sure that I was impressed with the results.  I wish we knew more about the reasoning and mechanism, but in the meantime I’m happy we can help people feel and move better.

Dry Needling for Scapular Winging

Can we correct scapular winging in a matter of minutes?  This obviously depends on the cause of the scapular winging.

It is well documented that injury to the long thoracic nerve or cervical spine may lead to medial border scapular winging or dyskinesia of the scapula (Meininger, 2011). These are always challenging.  Ruling out neuromuscular cause can be done with a nerve conduction velocity test or EMG.  

But a recent patient of mine, made me think…

Research has continually shown that muscles with trigger points demonstrate the following:

  • Altered muscle activation patterns on EMG (Lucas, 2010; Wadsworth, 1997)
  • Reduced muscle strength (Celik, 2011)
  • Accelerated muscle fatigue (Ge, 2012)
  • Reduced antagonist muscle inhibition (Ibarra, 2011)  
  • Increased number of trigger points on the painful side (Alburquerque-Sendin, 2013; Bron, 2011; Fernandez-de-las-Penas, 2012; Ge, 2006; Ge, 2008)

Appreciating these findings would lead most to conclude that treatment of trigger points could improve scapular mobility and timing. This was my immediate thought when I noticed a significant medial border scapular winging while watching my patient raise and lower his arm.

It wasn’t until I read this research that I began using dry needling to do more than just manage pain. The results seen following dry needling to the serratus anterior were remarkable.

After seeing this amount of scapular winging, I dry needled his serratus anterior muscle.  Note the remarkable improvement:

How Trigger Point Dry Needling May Impact Scapular Winging

It is well documented that appropriate muscle activation patterns (MAP) surrounding the shoulder is necessary for efficient and pain free mobility (Lucas, 2003). Lucas and group actually gauged the effect of trigger point dry needling on MAP in subjects with latent trigger points (LTrP).

“Latent myofascial trigger points (LTrPs) are pain free neuromuscular lesions that are associated with muscle overload and decreased contractile efficiency” (Simons et al., 1999, p. 12). MAP’s of the upper trapezius, serratus anterior, lower trapezius, infraspinatous and middle deltoid were compared in a group with LTrP’s and one without. Following surface EMG, the LTrP’s were treated with trigger point dry needling. Surface EMG was performed after treatment as well.

Findings from this study were as follows:

  • Muscle activation of the upper trapezius in the LTrP group pre-treatment.
  • Early activation of the infraspinatous in the LTrP group pre-treatment.
  • Increased variability of muscle activation in all muscles assessed in the LTrP group pre-treatment compared to the control group.  
  • Altered MAP of distal musculature (infraspinatous and middle deltoid) were consistent with co-contraction, a finding that has been attributed to increased muscle fatigability (Chabran et al., 2002).
  • Improved muscle activation times in the LTrP group following dry needling.
  • Significant decrease in the variability of muscle activation in the LTrP group following dry needling, except for the serratus anterior.
  • The serratus anterior and lower trapezius showed increased variability in both the control and LTrP group, which may be why the results did not reach significance. This is also consistent with the latest research in JOSPT that found dyskinesia to be normal in asymptomatic populations. (Plummer, 2017).

Based on the both my clinical experiences and the research presented in this paper, it would seem highly valuable to focus on the treatment of trigger points to restore muscle activation patterns surrounding the shoulder complex.

Being able to press the “reset button” on a muscle is important for re-establishing normal muscle activation patterns prior to exercise. Inclusion of other manual therapy and exercise techniques is important for optimizing function of the local musculature (range of motion, hypertrophy, strength and endurance).

No research that I am familiar with has compared dry needling to other manual therapy techniques for restoring MAP in muscles adjacent to the shoulder. Future research that compares various trigger point treatments for restoration of normal MAP would be beneficial.

 

About the Author

Dr. Michael Infantino, DPT, is a physical therapist who works with active military members in the DMV region. You can find more articles by Michael at RehabRenegade.com.

References

  • Alburquerque-Sendin, F., Camargo, P.R., Vieira, A., Salvini, T.F., 2013. Bilateral myofascial trigger points and pressure pain thresholds in the shoulder muscles in patients with unilateral shoulder impingement syndrome: a blinded, controlled study. Clin. J. Pain 29 (6), 478e486.
  • Bron, C., de Gast, A., Dommerholt, J., Stegenga, B., Wensing, M., Oostendorp, R.A., 2011a. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med. 9, 8.
  • Chabran, E., Maton, B., Fourment, A., 2002. Effects of postural muscle fatigue on the relation between segmental posture and movement. Journal of Electromyography and Kinesiology 12, 67–79.
  • Celik, D., Yeldan, I., 2011. The relationship between latent trigger point and muscle strength in healthy subjects: a double-blind study. J. Back Musculoskelet. Rehabil. 24 (4), 251e256.
  • Cummings, T.M., White, A.R., 2001. Needling therapies in the management if myofascial trigger point pain: a systematic review. Archives of Physical and Medicine and Rehabilitation 82, 986–992.
  • Ge, H.Y., Arendt-Nielsen, L., Madeleine, P., 2012. Accelerated muscle fatigability of latent myofascial trigger points in humans. Pain Med. 13 (7), 957e964.
  • Ge, H.Y., Fernandez-de-las-Penas, C., Arendt-Nielsen, L., 2006. Sympathetic facilitation of hyperalgesia evoked from myofas- cial tender and trigger points in patients with unilateral shoul- der pain. Clin. Neurophysiol. 117 (7), 1545e1550.
  • Ge, H.Y., Fernandez-de-Las-Penas, C., Madeleine, P., Arendt- Nielsen, L., 2008. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle. Eur. J. Pain 12 (7), 859e865.
  • Hillary A. Plummer, Jonathan C. Sum, Federico Pozzi, Rini Varghese, Lori A. Michener. Observational Scapular Dyskinesis: Known-Groups Validity in Patients With and Without Shoulder Pain. J Orthop Sports Phys Ther:1-25.  
  • Ibarra, J.M., Ge, H.Y., Wang, C., Martinez Vizcaino, V., Graven- Nielsen, T., Arendt-Nielsen, L., 2011. Latent myofascial trigger points are associated with an increased antagonistic muscle activity during agonist muscle contraction. J. Pain 12 (12), 1282e1288.
  • Lucas KR, Polus BI, Rich PS. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. J Bodyw Mov Ther. 2004;8:160-166Lucas KR, Polus BI, Rich PS. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. J Bodyw Mov Ther. 2004;8:160-166
  • Lucas KR, Polus BI, Rich PS. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. J Bodyw Mov Ther. 2004;8:160-166Meininger, A.K., Figuerres, B.F., & Goldberg, B.A. (2011). Scapular winging: an update. The journal of The American Academy of Orthopaedic Surgeons, 19(8), 453-462.
  • Simons, D.G., Travell, J.G., Simons, L.S., 1999. The Trigger Point Manual, Vol 1, 2nd Edition. Williams and Wilkins, Baltimore, USA.
  • Wadsworth, D.J.S., Bullock-Saxton, J.E., 1997. Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. International Journal Sports Medicine 18, 618–624.

 

The Kettlebell March Drill for Functional Core Stability

We’re big fans of farmer carries and suitcase carries at Champion.

Carries do a great job of developing functional core stability by adding an offset weight to the center of rotation of the body. But carries also offer so many other benefits – from grip strength, to upper body development, to overall athleticism.

Often times, clients with poor core strength or control will compensate during the carry.

If the core can not stabilize the trunk with the added load of the carry, it will compensate by relying on the static stabilizers of the body and rocking back into hyperextension of the back or leaning to the side.

In the below video, Kiefer Lammi, our Director of Fitness at Champion, shows how we have started to modify the carry in these individuals by adding a march. Not only does this promote better core control, it also facilitates training the trunk to remain stable while the distal extremities move functionally. This is one of the fundamental principles to enhance how well people move and perform.

Follow Champion For More

If you enjoyed this video, the team at Champion and I have been producing a ton of great content on Champion’s social media profiles, including regular content for #MovementMonday and #TechniquesTuesday, plus a ton more:

 

5 Reasons Why I Don’t Use the Sleeper Stretch and Why You Shouldn’t Either

Ah, the sleeper stretch.  Pretty popular right now, huh, especially in baseball players?  Seems like a ton of people are preaching the use of the sleeper stretch and why everyone needs to use it.  It’s so popular now that physicians are asking for it specifically.

I don’t like the sleeper stretch and I rarely use it, in fact I haven’t used it in years.  I don’t think you should use it either.

There, I said it, I felt like I really had the get that off my chest!

Every meeting I go to, I see more and more people talking like the sleeper stretch is the next great king of all exercises.  Then I get up there and say I don’t use it and everyone looks at me like I have two heads!  Call me crazy, but I think we probably shouldn’t be using it as much as we do.

In fact, I actually think it causes more harm than good.

 

5 Reasons Why Shouldn’t Use the Sleeper Stretch

I haven’t used the sleeper stretch in over a decade and have no issues restoring and maintaining shoulder internal rotation in my athletes with safer and more effective techniques.

If you have followed me for some time, you know that I rarely talk in definitive terms, as I always strive to continue to learn and grow.  I know my opinions will change and things aren’t black and white.  However, over the years my stance on NOT using the sleeper stretch has only strengthening.  As I learn more and grow, I actually feel more strongly that we shouldn’t be using this common stretch.

So why don’t I use the sleeper stretch?  There are actually several reasons.

 

It’s Often Performed for the Wrong Reason

The sleeper stretch is most often recommended for people with a loss of shoulder internal rotation.  When a person has a loss of internal rotation, it can be from several reasons, including:

  1. Soft tissue / muscular tightness
  2. Joint capsular tightness
  3. Joint and boney alignment of the glenohumeral joint and scapulothoracic joint
  4. Boney adaptations to repetitive tasks, such as throwing a baseball and other overhead sports

You must assess the true cause of loss of shoulder motion and treat accordingly.

Of the above reasons, you could argue that only joint capsular tightness would be an indication to perform the posterior capsule.  But see my next point below…

Performing the sleeper stretch for the other reasons could lead to more issues, especially in the case of boney adaptations.  The whole concept of glenohumeral internal rotation deficit (GIRD), is often flawed due to a lack of understanding of the normal boney adaptations in overhead athletes.

I can’t tell you how many people think they have GIRD that I evaluate and that they in fact do NOT have GIRD.  Click here to learn more about how I define GIRD.

 

It Stretches the Posterior Capsule

If you have heard me speak at any of my live or online courses, you know that I am not a believer in posterior capsule tightness in overhead athletes.  Maybe it happens, but I have to admit I rarely (if ever) see it.  In fact, I see way more issues with posterior instability.  Please keep in mind I am talking about athletes.  Not older individuals and not people postoperative.  They can absolutely have a tight posterior capsule.

But for athletes, the last thing I want to do is make an already loose athlete looser by stretching a structure that is so thin and weak, yet so important in shoulder stability.

Urayama et al in JSES have shown that stretching the shoulder into internal rotation at 90 degrees of abduction in the scapular plane does not strain the posterior capsule.  However, by performing internal rotation at 90 degrees of abduction in the sagittal plane, like the sleeper stretch position, places significantly more strain on the posterior capsule.

Based on the first two points I’ve made so far, if you have a loss of shoulder internal rotation, you should never blindly assume you have a tight posterior capsule.

Assess, don’t assume.

But be sure you know how to accurately assess the posterior capsule.  Many people perform it incorrectly.  Click here to read how to assess for a tight posterior capsule.

 

It is an Impingement Position

This one cracks me, check out the photos below, if you rotate a photo of the Hawkins-Kennedy impingement test 90 degrees it looks just like a sleeper stretch.  I personally try to avoid recreating provocative special tests as exercises.

sleeper stretch impingement reinold

 

This is a provocative test for a reason, by performing internal rotation in this position, you impinge the rotator cuff and biceps tendon along the coracoacromial arch.  If you actually had a tight posterior capsule, you’d get subsequent translation anteriorly during this stretch and further impingement the structures.

So based on this, even if you have a tight posterior capsule, I wouldn’t use the sleeper stretch.  I would just perform joint mobilizations in a neutral plane.

 

People Often Perform with Poor Technique

So far we’ve essentially said that people often perform the sleeper stretch for the wrong reasons and can end up torquing the wrong structure (the posterior capsule) and irritating more structures (the rotator cuff and biceps tendon).

Even if you have the right person with the right indication, the sleeper stretch is also often performed with poor technique, which can be equally as disadvantageous.

People often roll too far over onto their shoulder or start in the wrong position.  If you are going to perform the sleeper stretch, at least follow my recommendations on the correct way to perform the sleeper stretch.

 

People Get WAY too Aggressive

Despite the above reasons, this may actually be the biggest reason that I don’t use the sleeper stretch – people just get way too aggressive with the stretch.  The whole “more is better” thought process.  Being too aggressive is only going to cause more strain on the posterior capsule and more impingement.  You may actually flare up the shoulder instead of make it better.

I always say, if you have a loss of joint mobility, torquing into that loss of mobility aggressively is only going to make it worse.

 

When the Sleeper Stretch is Appropriate

There are times when the sleeper stretch is probably appropriate.  But it’s not as often as you think and it’s most often not in athletes.  The older individual with adhesive capsulitis or a postoperative stiff shoulder may be good candidates for the sleeper stretch.  But I honestly still don’t use it in these populations.  There are better things to do.

But of course, there are good ways to perform the sleeper stretch and there are bad ways, technique is important.

For more information on some alternatives to the sleeper stretch, check out my article on sleeper stretch alternatives.

 

6 Hip Mobility Drills Everyone Should Perform

Recently, I have seen dozens of social media posts with “advanced” hip mobility drills that made me stop and think…

Should we actually be seeking to perform these advanced variations?

I would argue most people still need the basics, and should incorporate just a handful of more simple drills as the foundation of their mobility drills.

The internet is famous for sensationalizing the drills that look “fancy” rather than the ones that are likely the most effective.  It’s probably another case of the Pareto Principle, where 80% of the drills seen online should only be performed 20% of the time, and conversely, 20% of the drills seen online should be performed 80% of the time!  Heck it may be even less than that when it comes to hip mobility.

To make matters worse, the more advanced hip mobility drills are probably inappropriate for most people.  In my experience, limitations in hip mobility seem to be more related to the individuals unique anatomy, boney adaptations, and alignment rather than simple soft tissue limitations.  So, forcing hip mobility drills through anatomical limitations is just going to cause more impingement and issues with the hips, rather than helping.

Sometimes less is more.

 

My Favorite Hip Mobility Drills

I wanted to share my favorite hip mobility that I use with most of my clients.  I think you should really focus on these hip mobility drills before proceeding to more advanced variations.  If these don’t do the trick, it’s probably best that you seek out a qualified movement specialist to assess the reason behind you hip mobility limitations, rather than forcing more drills.

 

Quadruped Rockbacks

The first drill is a quadruped rockback.  This is one of my favorite drills for the hips, and feels great to loosen up the adductors and hip joint into flexion.  Plus, I do these barefoot to get more dorsiflexion and great toe extension.

 

Adductor Quadruped Rockbacks

The adductor quadruped rockback is a variation of the rockback that involves straightening out one hip.  This takes away a little bit of the hip flexion benefit, but enhances the effect on the adductors.  Performing this on both sides is the best of both worlds.

 

True Hip Flexor Stretch

The true hip flexor stretch is probably the most fundamental hip mobility drill we should all be performing.  I started calling it the “true” hip flexor stretch because the more common versions of this do not lock in the posterior pelvic tilt and just end up torquing the anterior capsule.

 

Posterior Hip Stretch

The posterior hip stretch feels great on the glutes and hits the posterior hip area, which is often tight.  Many people feel like the can get into a hip hinge much better after this drill.

 

Figure 4 Stretch

The posterior hip is a complicated area of muscles, I often pair the figure 4 stretch with the posterior hip stretch above to get different areas.  For me, I simple go by the feedback from my client on what feels more effective for them.

 

Spiderman

The Spiderman hip mobility drill is likely the most advanced of this list, which is why I have it last.  This is something I don’t always perform right away, but is a goal of mine to integrate with everyone eventually.  This requires more hip mobility that the others, so acts as a nice progression to put these all together.

 

How to Get Started with Hip Mobility Drills?

So wondering how to get started?  Start with the quadruped rockbacks and hip flexor stretch.  Those two are very foundational and will be the most impactful for most people.  Once you get those down, progress to the posterior hip stretch and figure 4 to hit more of the posterior aspect of the hip.  Lastly, progress to the Spiderman drill.

I honestly don’t think you need much more than that, and if you seek to get too aggressive with hip mobility drills, you often make things worse.