Hip Rotator Cuff

Hip Rotator Cuff

Hip Rotator CuffThe latest Inner Circle webinar recording on the Hip Rotator Cuff is now available.

Hip Rotator Cuff

This month’s Inner Circle webinar on the rotator cuff of the hip was great.  We discussed how our knowledge of the hip has continued to increase over the last decade and has resulted in a much better understanding of how the hip is involved in the mechanics of the lower body and stabilization in multiple planes of motion.  We then broke down the hip musculature as either prime movers or prime stabilizers, and discussed how different positions and exercises impact both of these different muscles groups.

If this sounds familiar, it is, we use the analogy of the shoulder to show the similarities between the hip and the shoulder.

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8 replies
  1. John
    John says:

    If the gluts are good external rotators between 0 and 45 degrees of hip flexion, where most of our functional activities and dynamic stabilization needs occur, why focus on training the deep lateral rotators in 90 degrees of hip flexion? In activities like walking and running, or jumping and landing in sports, we often see a lack of hip dynamic stabilization with the hip at less than 45 degrees of flexion. Wouldn´t it be fair to say it´s the gluts that aren´t doing there job well enough? It seems more functional to train in the position where the weakness occurs. The deep lateral rotators are small and have short moment arms, and would need to develop a lot more force than the gluts to have the same stabilizing effect.

    Another thought. Given that glut.med and glut.min are primary abductors more than rotators as you show, could it be that the internal rotation of the femur often seen with hip adduction is not a case of lack of external rotation force, but a result of adduction with a fixed foot and slight knee flexion – so the femur has no option but to internally rotate when it adducts? Simply put then an adequate abduction torque would prevent the internal rotation, and is what´s needed more than an external rotation force in order to dynamically stabilize during stance phase.

    • mikereinold
      mikereinold says:

      John, I think that is fair to say. Both muscle groups are active in every position, that is an important thing to consider.
      Another way of thinking of it is this – what if you have an imbalance between your larger muscle groups (glutes) and your smaller muscles groups (deep rotators)? If you only train at lower angles, it is easier for your larger imbalances muscles to take over and continue to create an imbalance. Training at 90 degrees could help strengthen the deep rotators easier.

      In regard to your second thought, I like it. I would also say your anatomy and joint dictate the combined ADD/IR too.

      Thanks for the great thoughts!

  2. Bob Wondolowski
    Bob Wondolowski says:

    Mike your stuff is very good but when I get 1/2 way through the webinar I get an echo, a double audio that makes it unintelligible. Is it my computer? Or your production? Please advise. Thanks!


      • Joseph Trambulo
        Joseph Trambulo says:

        Mike great webinar….if you can’t fix the sound, is there any way to get a transcript of the echoed auto? Unfortunately as Bob mentioned I can’t make any sense of the audio. Great content keep up the great work!

        • Mike Reinold
          Mike Reinold says:

          Sorry about that! Essentially I say that you need to work glute strength and frontal plan control, but you can’t forget the deep lateral rotators to turn them on first. You have to work ER in both hip flexion and extension. Hope that helps!

  3. dabpt
    dabpt says:

    Good webinar Mike. A couple of inputs about the THA questions you had. The direct anterior approach has no precautions as it cuts no muscles. They go in between your TFL and Sartorious and anterior capsule is repaired. For posterior approach, whether minimally invasive or not, most up to date surgeons repair the external rotators and post capsule now and it is to help with stability and to help prevent posterior dislocation not anterior. By not repairing them, you have a greater chance of dislocating posteriorly. You have precautions for a certain time, although not always, to allow the soft tissue to heal. Unfortunately I have direct experience with both :) It’s definitely different to rehab with a big chunk of your abductors and external rotators gone due to metal necrosis.

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