Hip strengthening should be stable in any rehabilitation or strength and conditioning program. The hip musculature is capable of generating large amounts of torque used for explosive athletic movements. Additionally, the hips are the key to trunk and core stability, and therefore balance. To be simplistic, our trunk sits on top of our hips. Thus, if our hips are weak, it doesn’t matter how much core strengthening we do, because the foundation on which our core sits is weak. Moreover, we need to ensure that our hips are not only strong but stable! In this article, we are going to show you the essentials of how to improve hip stability with prehab exercises!

 

The Importance of Hip Stability

A great analogy in regards to hip stability is that of a house on the cliffs. You could build the biggest and most glorious house (i.e 6-pack) on the cliffs overlooking the ocean, but if the stilts and foundation (i.e hips) upon which this mansion sits are weak, the house will undoubtedly collapse. This is why our hips need to be strong and stable, so we have a solid foundation to move from! The hip joint is not only very stable innately, but also very mobile, as it is a ball and socket joint that moves in all 3 planes of motion. Therefore, when we work on hip stability, we need to stabilize in each of those different planes of motion.

 

Maximize Your Hip Stability With [P]Rehab

Hip Prehab Program The Prehab Guys

Our Hip [P]rehab Program has been specifically designed not only to optimize hip stability but all other components that are essential for optimal hip health. This program consists of all the pillars needed to bulletproof your hips, and prepare you for any activity you want to partake in. Get started HERE. 

 

How To Test Hip Stability

There are a variety of ways to test hip stability. Firstly, you want to ensure that the hip is being tested in all 3 planes of motion: sagittal, frontal, and transverse, as the hip moves in all of these planes! If the hip is lacking stability in one or more of these planes, that needs to be addressed!

 

Single Leg Squat For Time – Saggital Plane Hip Stability

Sample Hip [P]rehab Program Assessment Video

Test Description: The Single Leg Squat For Time Test is a reliable tool developed and used to evaluate lower body performance, muscle power, and muscle endurance. Please watch the video to get a visual demonstration of how to perform the test. Below you will find a description of how to do so.

Test Instructions: Get set-up sitting on the edge of a stable surface that ideally makes your thighs parallel to the ground. Lift one leg off the ground and keep it in the air in front of you the entire time, you will perform the test on both sides. Using a stopwatch or something to keep track of time, the test begins as soon as you lift up from the surface to perform your first single-leg squat. Your final score is the total number of quality single leg squats in 1 minute. Perform on the other side, write down your scores below.

Some rules to remember with this assessment. One quality repetition counts as fully standing up and squatting back down until your bottom touches the surface with good form.

 

Fix Your Pelvic Drop By Improving Your Hip Stability

 

Copenhagen Endurance Test – Frontal & Transverse Plane Hip Stability

The adductors are a powerful group of muscles that are heavily involved in rotational athletics. It is the second behind hamstring strains in regards to the most common muscle injuries at the hip in athletes. These muscles also help stabilize our pelvis in upright, standing positions. To learn more about advanced groin training, read the article below!

READ: ADVANCED GROIN TRAINING AND [P]REHAB

advanced groin training the prehab guys

Progressive Eccentric Single Limb Squat Strength

The single limb squat comes in a lot of variations regarding body position. Building dynamic muscle function must incorporate training every type of muscle action, including eccentrics. The lowering phase towards the ground in all squatting motions requires eccentric muscle strength. The body is essentially a system of cranes (muscles) with multiple integrated pulleys (joints/tendons/ligaments) that can slowly lower the weight of the body.

What’s more important is you need eccentric strength prior to dynamic concentric strength, you must learn to absorb force before you can produce it. If your performance of the task decreases as you increase depth, you’re not ready to progress! Remember to always promote quality over quantity, optimal active performance of a task using muscles rather than tension from passive structures is key to the longevity of your movement system! Stay tuned for a full week of posts focused on the hip, knee, and lower extremity!

Here are some progressions if you are working on improving your single leg squat depth!

Single Leg Squat – Supported

Sample Hip [P]rehab Program Exercise Video

  • HOW: Start in a standing position balancing on one leg with your hands holding onto a sturdy surface/object to help with balance. Perform a skater squat by bending at your hip and knee, also let your upper body lean forward by hinging at your hip. Return to starting position, repeat.

 

  • FEEL: You should feel all the muscles in your leg working, especially your glutes and your quadriceps. You may feel your core working as well to maintain your torso position.

 

  • COMPENSATION: Do not lose balance, try to keep your knee tracking over your foot, and do not let your knee cave in/out. Do not let your pelvis sag on the other side. Do not over-rely on upper body support.

 

Prehab Membership The Prehab Guys

The Prehab membership is the anti-barrier solution to keeping your body healthy. Access state-of-the-art physical therapy, fitness programs, and workouts online in the comforts of your own home or gym! Taking control of your health with exercise & education from the palm of your hand has never been easier. Get access to 50+ programs, 100+ unique workouts, and 3000+ exercises to build your own workout routines. Trial it for free, and learn how to get out of pain, avoid injury, and optimize your health with [P]rehab!

 

Lateral Step Down To Improve Hip Stability

A step down is a large component of most people’s everyday life. This movement can be used as a quick & functional screen for hip stability in the frontal plane (left to right). For optimal mechanics you want the hip, knee, & ankle to be in the alignment shown with the first repetition. Compensations that are common are that one hip falls into adduction forcing the knee to go into a valgus or collapsed position, resulting in the knee being medial to the ankle joint. This is often due to either weak hip abductors or poor neuromuscular control at the hip. This deviation from the optimal movement pattern can lead to an increase in reliance on passive structures. Stay tuned for tips on how to strengthen or improve neuromuscular control at your hip to keep ideal mechanics!

Lateral Step Down

Sample Hip [P]rehab Program Exercise Video

 

Clams To Improve Hip Stability

If neuromuscular control was not the culprit of one’s hip instability, I would bet my lunch money that it is due to hip weakness. Clams are a great way to isolate the hip stabilizing muscles, especially the Gluteus Medius. If you are interested in learning more about where to start with a strengthening program, listen to the podcast episode below.

LISTEN: HOW TO BEGIN STRENGTH TRAINING

How to begin strength training the prehab guys developmental kinesiology

 

The Gluteus Medius is more than just a hip abductor and external rotator; it is used as a dynamic stabilizer during single limb stance activities such as walking, jogging, or descending stairs. Despite clams being such a commonly used exercise, it is very easy to compensate with other muscles during this exercise. To learn the best exercises for the glute med, read this article!

Isometric Side Lying Clam – Band

Sample Hip [P]rehab Program Exercise Video

 

Performing Alternating Dynamic Lunges

A very popular and common exercise performed during training sessions is the dynamic lunge. It is a very functional movement due to the end position (half-kneeling), which is used very often when performing daily activities. It requires hip and trunk strength as well as stability in all planes of movement, thus it is a very functional movement! It also requires neuromuscular control and hip and pelvis dissociation due to having to let your hips flex while minimizing pelvis and spine motion.

 

 

Try Bosu Airplanes To Improve Your Hip Stability!

Bosu airplanes are the perfect exercise for challenging hip stability without any ankle contribution. Bosu airplanes can be used as an assessment test to determine if an athlete is properly recruiting from the hips during single leg movements. Or they can be used as a rehabilitation exercise for foot/ankle patients who are currently non-weight bearing. Additionally, bosu airplanes can be used as a strength and conditioning exercise to dynamically challenge a patient’s ability to control perturbations of balance using only the hip for stability. Bottom line – bosu airplanes are the ultimate exercise for targeting hip stability without ankle contribution!

Bosu Airplanes the prehab guys how to improve hip stability

It’s an extremely challenging exercise, trust me!

 

Closing Thoughts

Hip stability plays a very important role in how we move. If we do not build a proper foundation from our hips, it can lead to issues not only at the hips but above and below the joint as well. When deciphering how to improve hip stability, be sure to work in all 3 planes, and make a progression towards functional movements!

 

Bulletproof Your Hips With [P]rehab!

Hip Prehab Program the prehab guys bridge exercises

To go from stepping to sitting we can thank the 27 muscles that cross the hip joint for their work. After thanking them, we should also thank your core, knees, feet, and really the rest of your movement system as they work together on a team to create movement. Perhaps, the best way to thank them is by giving them what they desire: strength and power!

 

About The Author

Michael Lau, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Product Officer

Michael was born and raised in Northern California but now currently resides in Sunny SoCal ever since attending the University of California, Los Angeles as an undergraduate majoring in physiology. After his undergraduate studies, he received his Doctorate in Physical Therapy from cross-town rival the University of Southern California. As a licensed physical therapist with a strong background in strength and conditioning, Michael likes to blend the realms of strength training and rehabilitation to provide prehab, or preventative rehabilitation, to his patients. A common human behavior is to address problems after they become an issue and far often too late, which is a reactionary approach. He believes the key to improved health care is education and awareness. This proactive approach-prehab-can reduce the risk of injuries and pain in the first place. He is a huge proponent of movement education and pain science. Clinically, he has a special interest in ACLR rehab and return to sport for the lower extremity athlete.

 

 

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

About the author : Michael Lau PT, DPT, CSCS

11 Comments

  1. Rodrigo H April 21, 2017 at 10:30 pm

    Great and valius job for physical therapy practice, thank for your professionalism. i follow them!

  2. Robert April 24, 2017 at 1:34 am

    I’m happy to see you guys addressing the hip abductors!
    In school and during my internships I’ve never heard anyone talk about this or addressing the weakness of hip abductors directly. Not my teachers nor my colleague’s at my internship. Kneeing-in is a common problem and in my opinion as a physiotherapy student, the emphasis should be on the abductors more. Not just using metaphors like ‘push your knees out’ while squatting, because that way you only correct the patient/person’s technique, not his understanding of why he has to do it.

    • Michael Lau April 24, 2017 at 6:32 pm

      Addressing the hip abductors are huge! And the glutes in general, they are a triplanar muscle that affects every motion of the femur involved in non-contact knee injuries or knee overuse injuries.

    • Ignas July 8, 2018 at 4:06 am

      It’s a shame people are forgetting about external rotators and their role in eccentrically stabilising the femur during gait cycle. I’d make an argument that external rotators are more important for hip stability that abductors, purely from an anatomical standpoint as it is excessive internal hip rotation and not lack of abduction that causes knee valgus (apart from feet issues).

  3. Chris Pii December 7, 2017 at 3:37 am

    Agree hip abductors are crucial for preventing knee-in but it’s also down to overall neuromuscular synchronisation / control too hence isolation-integration approach. Loving the posts by the way, come to London sometime, would love to work with you :)

    • Michael Lau January 6, 2018 at 9:03 pm

      Agree, strength is first, but strength is nothing but control! Love to work together too!

  4. Jackie ismail February 3, 2018 at 4:18 am

    I have a question for you. I have done the clamshell excercises – correctly – for a half year, without much if any improvement the last couple of months. Would it be good to substite with the monster walks /side walks or Would it be better to find af thicker band?

    • Michael Lau February 24, 2018 at 11:32 pm

      what are you looking for improvement in? the clamshell exercises isn’t a very challenging exercise, if going for strength gains you’d be much better off doing weighted squats!

  5. Jackie ismail February 3, 2018 at 4:18 am

    I have a question for you. I have done the clamshell excercises – correctly – for a half year, without much if any improvement the last couple of months. Would it be good to substite with the monster walks /side walks or Would it be better to find af thicker band?

  6. Alec September 8, 2018 at 6:53 am

    Do any of this exercises work/challenge the deep six external rotators ? form what I understand clams are more of gmed than external rotators

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