Even if it plays a vital role in keeping the ankle, knee and back injury-free, the hip is the most neglected part of the body in an exercise program. When the hip does become injured, it places greater strain on the joints around it and increases the likelihood of injury to those surrounding areas. In this four hour course, you will learn the key structures of the hip, how to assess the hip to determine exercise readiness, and various progressions for effective exercise rehabilitation for the arthritic hip, hip replacement, piriformis syndrome, SI joint dysfunction and groin strain.
OBJECTIVES:
- Identify the key structures encompassed in the hip
- Assessment of the hip to determine exercise readiness and exercise level
- Exercise rehabilitation programs for the arthritic hip, hip replacement, piriformis syndrome, SI joint dysfunction and groin strain
We all know about the lower back being the number one injury when it comes to clients that exercise.
An injury that I have seen on the rise of late is hip pain.
How Can Hip Injuries Be the New Injury of Choice?
Hip Fractures are on the Rise
With our population getting older and living longer, hip issues will continue to be on the rise. In older adults they estimate that 100,000 people a year will need surgery for fractured neck of the femur by 2033, with a mortality of 8.9 to 9.3% and costing 3.6 to 5.6 billion pounds (White, 2010). This is staggering. After their surgery, they will need exercise in order to fully help them recover from their surgery and get back to life. The exercise program may start with physical therapy, but will need to be continued at home and in fitness centers.
Other hip pain and hip injuries we will see more of are adductor tendinopathy, osteoporosis, and osteoarthritis.
Hip Pain and the Lower Back
The crazy thing is, as I do more learning, research, and training, I see the hip plays a huge role when it comes to lower back pain.
Many times when you address issues of the hip it will lead to an improvement of lower back pain.
It was some time ago when I heard a reference to: Rotator Cuff of the Hip.
I think it was way back in undergrad at Simon Fraser University. I was reading an article on the topic and found it very interesting.
This past weekend, I was at a course and it was brought up again.
Mike Robertson talking about the Rotator Cuff of the Hip:
After hearing about it, it got me thinking.
I went looking for the old article but could not find it.
There was a lot of other information when it came to rotator cuff of the hip that has come out the last few years.
A lot of it had to deal with rheumatologists and orthopedic surgeons coming across a tear when doing a hip replacement.
What is the Rotator Cuff of the Hip?
The rotator cuff of the hip is the hip abductor tendon which is made up of gluteus medius and gluteus minimus.
Gluteus medius has the function of:
Abduction of the hip (femur) – anterior and posterior fibers.
Transverse abduction of the hip (hip flexion at 90 degrees and hip abduction) – anterior and posterior fibers.
Internal rotation – anterior fibers.
External rotation of the hip during hip abduction – posterior fibers.
Gluteus minimus has the function of:
Abduction of the hip (femur).
Transverse abduction of the hip.
External rotation of the hip during hip abduction.
Looking at the above function, you can see how they related, or can be compared to, the rotator cuff of the shoulder.
The muscle of the rotator cuff (supraspinatus, infraspinatus, subscapularis, teres minor) of the shoulder have a function of:
Shoulder abduction of the humerus – supraspinatus.
External rotation of the humerus – infraspinatus, teres minor.
Internal rotation of the humerus – subscapularis.
I know when I had done my masters’ degree in rotator cuff exercises, looking at the research there is all kinds of argument on how much each muscle is involved with each movement. It looks like we see this when it comes to the rotator cuff of the hip.
Looking at Al-Hayani 2009 dissection of the rotator cuff of the hip, these are the functions he suggests:
Gluteus medisu had three distinct parts.
Gluteus minimus had two distinct parts.
All parts of the muscles had separate innervations from the superior gluteal nerve.
Anterior and middle parts of gluteus medius, and anterior part gluteus minimus, have a vertical pull and initiate abduction, which is then completed by tensor fasciae latae.
Posterior parts of gluteus medius and minimus stabilize the femoral head into the acetabulum during different stages of locomotion.
Then I look at course notes from Robertson 2010 and the functions are:
Gluteus medius anterior fibers – hip flexion, hip abduction and hip internal rotation.
Gluteus medius posterior fibers – hip extension, hip external rotation, hip abduction.
I think we can argue about the specific function of each muscle, but it is clear that the rotator cuff of the hip is made up of the tendon that makes up gluteus medius and minimus.
What are the best exercises for a disc herniation?
How do you do core regressions?
What can you do about SI (Sacroiliac) joint issues?
When should you do rotation exercises?
Keys to proper squatting.
What are the key relationships between the knee and hip?
How do you increase (gluteus maximus) function?
What trainer, coach, and therapist does not want to have one or more of these questions answered by one of the best?
So cool.
I am so excited for the weekend.
I am ready to learn and so is the small group of people, ranging from medical doctors to group fitness instructors, that have come from around the world to be here.
Having your questions answered from the best in the world in an intensive weekend seminar/course is so great.
I love bringing the best to Vancouver and can’t wait to bring more of them, like Justin Price.
I will have some more information on what I learned and some video clips from the course.
I am always reading other fitness professionals blogs and learning. One blog I have been reading of late is Mark Young’s.
I connected up with Mark to see if he would do a guest blog post and he was happy to do so.
He did one on psoas. As you know psoas is a huge issue when it comes to muscle imbalances in the lower body.
Take it away, Mark.
If you hadn’t noticed, the last couple of years have seen the hip flexors (particularly the psoas) become demonized to the extent that clubbing baby seals would probably win you more love than suggesting that someone deliberately strengthen the psoas.
While I’m the first to agree that the psoas can contribute to the dreaded anterior pelvic tilt and the problems associated with it, we should still consider that not everyone on the planet has this particular postural deviation. In fact, some actually have a psoas that is underactive.
Symptoms of an Underactive Psoas
In this case, the lack of strength or activation of the psoas can cause the rectus femoris to contribute excessively to hip flexion (since the psoas isn’t doing its job) and result in overuse injuries to this muscle. As the rectus femoris becomes overused trigger points or ischemic tissue can build up and result in referred pain patterns. To take it one step further, if the rectus femoris is over active it can also pull the patella more forcefully into the groove at the base of the femur resulting in anterior knee pain.
Dealing with an Underactive Psoas
The first step in dealing with knee pain is to identify all possible causes (which is obviously beyond the scope of this post), but if your investigation leads you to the psoas, here is a quick fix for you.
Let’s make just one giant assumption and assume that you know all about Wolverine from X-Men.
You know he possesses animal-keen senses.
You know he competes like a super-human weapon.
You know he has retracting bone claws made from space-age metal.
And, perhaps, most importantly, you know he possesses a special healing factor that allows him to quickly recover from virtually any wound, disease or toxin.
Many times fitness professionals focus only on the back when it comes to core stability. What is equally important is to look at the core stability of the hip. Poor activation, low endurance and inadequate strength in the core of the hip leads to greater risk of injury to the lower back, hip and knee. In this webinar, fitness professionals will learn a progressive exercise program that they can use with their personal trainer and group fitness clients in order to improve the core stability in their hip in order to prevent and recovery from back, hip and knee injuries.
What you will learn during the webinar:
- Important cues and techniques for maximum exercise benefits
- Progressive exercises to improve core stability of the hip for any level of fitness
- The exercise to DO and NOT do when training a client recovering from poor core stability of the hip
- Essential components of an exercise program when training a client for maximal gains in core stability of the hip
- Recommended and research backed exercises for core stability of the hip
- Key structures involved in core stability of the hip
DESCRIPTION:
Looking at the above function, you can see how they related, or can be compared to, the rotator cuff of the shoulder.
Nine months of planning and preparation has arrived, and the Mike Robertson’s Bulletproofing Your Client’s Knees and Lower Back seminar is here.
