Hip Strengthening

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Luke
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Hip Strengthening

Post by Luke » Sat Jan 11, 2020 1:27 pm

A physio suspects an ongoing L knee issue is down to a weaker left hip. Indeed, when doing single leg work, my left side seems way shakier than the right (just like politics, heeyyooooo).

I can't stand the Mike Robertson et al. corrective exercise crowd...all of whom suffer injuries themselves ironically:
  • Are there any tried and tested methods that don't involve "Fire Hydrants"?
  • Can I box squat out of this? Really nostalgic for Westside in these early days of 2020 since I'm back at a gym with bands and chains. Can't seem to find anything Louie prescribes outside box squatting that doesn't need a special machine?

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newguy
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Re: Hip Strengthening

Post by newguy » Sat Jan 11, 2020 4:21 pm

The hip isn't a muscle. So I don't know about really strengthening it as opposed to the muscles around it. And muscles are strengthened through movement. (Or iso but same concept). And I'm not trying to be a condescending bastard here, but helps to sort of frame how to approach the issue on your own.

So what single leg work do you do that the left side is shakier? My first thought is to just do more of that......start light, depending on the move that probably means less reps and work up. Lunges....bulgarian squats, that sort of thing. Think about the muscles that drive hip movement and make sure to work on all of those.

Don't through fire hydrants out too quickly. Do the old broken table (bird dogs) from YRG and then stick the leg and arm out to the side instead of forward.

The band stretches from Dick Hartzell work good to build flexibility AND strength.

Don't ignore joint mobility.

I'm thinking this is a great excuse to head to the gym and get on the good girl/bad girl machine. Focusing on being a bad girl......

Question - did this physio give you any ideas what you might do to strengthen the hip? I would start with those.

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Re: Hip Strengthening

Post by riotboo » Sat Jan 11, 2020 7:07 pm

^^^ what he said. is it extension, adduction, abduction, etc, etc.?

Here is my daily rehab/prehab routine. I'm 7 months out from a hip replacement -- you can obv add resistance of course
Band good mornings
Hip circle (mark bell product but you could use bands) bw squats
Hip circle forward / backwards/ side to side walks
Single leg rdls
walking lunges
mobility

got me back mountain biking, box squatting and deadlifting (albeit lightly) I recently tried a few hang cleans for laughs and was pleasantly surprised.
Most importantly: Nothing hurts.

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Re: Hip Strengthening

Post by syaigh » Sat Jan 11, 2020 10:15 pm

The biggest deficit I saw in many of the powerlifters I trained was glute medius. When it was weak, the knees caved in. It could only be fixed with a combination of direct abductor work or lots and lots of squat volume with good form. This is also the biggest deficiency I see in the runners I train who have knee pain, and really anyone. Yes, box squats are awesome if you make sure you are pushing your knees out to be in-line with your feet. However, as we age, there is absolutely nothing wrong with doing some banded side walks or getting on the abductor machine at the gym. I developed knee pain after running a half marathon and besides working on strengthening the distal ends of my quads and hamstrings (hamstring curls and quad extensions), abductor work has been the third part of that holy trinity and I primarily use barbell squats (which I always think adding a box to is fantastic) ,goblet squats or abductor work for now.
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Re: Hip Strengthening

Post by Alfred_E._Neuman » Sat Jan 11, 2020 11:17 pm

I'll agree with everything said above, and ad a bit of my own experience from dealing with knee pain traced to weak glutes/hips.

One good way to tell if you have a weakness in the muscles around the hips that's translating down to the knees is to run and have someone video you from behind. Best done on a treadmill but can be someone running behind you with a phone as well. If the glutes are weak, the knees will move almost directly under your center of gravity. This is due to the weakness of the hip muscles that should be supporting the load, and the body's response is to try and use the skeleton to build support that the hip muscles can't handle. With properly functioning gluets (esp. glute med as syaigh said) the feet/knees will be on railroad tracks, staying about hip's distance apart or maybe slightly narrower.

On to some of the strengthening exercises other than goblet squats and direct banded abductor work that have helped me:
Stepping up onto a low box or step from the side holding a weight in the "outside" hand. So standing with the low box on your left, hold a 'bell in the right hand. Step up to the left onto the box while keeping the hips level. Same thing on the step down. This seems to work much better than simple hip drop drills since it's focus is on the stabilizing use of the muscles rather than moving them through a ROM.
The other is what I call Speed Skaters but they may have a different name. I do these on our wood floors with a towel. Squat down into a 1/4 squat like you're skating, with one foot on the towel. Slide that foot out to the side and then back. This one has really helped.
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Re: Hip Strengthening

Post by Bram » Sun Jan 12, 2020 3:34 am

Luke wrote:
Sat Jan 11, 2020 1:27 pm
A physio suspects an ongoing L knee issue is down to a weaker left hip. Indeed, when doing single leg work, my left side seems way shakier than the right (just like politics, heeyyooooo).

I can't stand the Mike Robertson et al. corrective exercise crowd...all of whom suffer injuries themselves ironically:
  • Are there any tried and tested methods that don't involve "Fire Hydrants"?
  • Can I box squat out of this? Really nostalgic for Westside in these early days of 2020 since I'm back at a gym with bands and chains. Can't seem to find anything Louie prescribes outside box squatting that doesn't need a special machine?
I think the hip muscles are a bit complicated, you've got:

glute medius: e.g., band side walks
adductors: e.g., standing band adduction
hip extensors: e.g., glute bridges
vmo: e.g., band tke's.....this is not a hip stabilizer, but it is a good knee one.
knee extensors: I prefer a slow front kick, keeping the thigh up throughout the set. This targets the hip flexors and leg extensors, in conjunction with one another, without the patella loading of a leg extension machine.

on top of your standard lunge, squat, hamstring curl, and deadlift moves.

I'm not saying you need all those categories, just that it can be a mix of them to get your hip solid.
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Re: Hip Strengthening

Post by Luke » Sun Jan 12, 2020 1:03 pm

Thanks all! Very useful reminder to think of the hip as being a group of muscles.

The shaky work was on single leg squats (decline boards etc.) If I do 1 leg extensions, the left leg jackhammers on lighter loads than the right - so leg and hip perhaps?

I think I've probably let the glute medius work slip (likewise mobility). I do recall the pain disappearing during squats after warming up with banded walks.

Will try these drills and report back! Thanks for the responses.

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Re: Hip Strengthening

Post by Ryan » Sun Jan 12, 2020 6:40 pm

I really like Andrew Lock's stuff. He's an Australian physical therapist who also powerlifts. He can come across as arrogant, but he knows his shit.

Try this hip routine: https://www.instagram.com/p/Bx_6py3Afhr ... 66kclf4kwv

Also try this version of hip clams: https://www.instagram.com/p/BfX1Af8hyyG ... hk2lcleusz

Position of the hip and leg is important to use the correct muscles you want to target.
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Re: Hip Strengthening

Post by Alfred_E._Neuman » Sun Jan 12, 2020 7:33 pm

Ryan wrote:
Sun Jan 12, 2020 6:40 pm
Also try this version of hip clams: https://www.instagram.com/p/BfX1Af8hyyG ... hk2lcleusz

Position of the hip and leg is important to use the correct muscles you want to target.
I'm going to try the rolled forward hip position from this video when I do clamshells next. I wonder if there's a good way to ad resistance to it?
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Re: Hip Strengthening

Post by Ryan » Sun Jan 12, 2020 7:44 pm

It's awkward with a band. A plate or small dumbbell on the knee would probably be better due to the angle. That's why he has them done lying on a bench with a band in the first video (hip angle at 0 degrees). I did the 3 in the first video as a warm-up and they worked quite well. His shoulder 3 are also very good.
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Re: Hip Strengthening

Post by Ryan » Sun Jan 12, 2020 7:50 pm

Something I didn't mention, but how does he know it's the hip causing the instability?
It could be the foot/ankle. Glute medius function is dependent on foot/ankle function. If you're not stable on the ground, you'll just be spinning you wheels targeting the glutes. Peroneus longus is the major contributer to that.
Improper core stability could also contribute. If you can't keep your pelvis stable, it can transfer forces down to the knee, since the hip muscles might be firing ineffectively.
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Re: Hip Strengthening

Post by Ryan » Sun Jan 12, 2020 11:12 pm

He just posted a new video on his clam version.

https://www.instagram.com/tv/B7PGXoEAp6 ... fg5lmkz7l8
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Re: Hip Strengthening

Post by aussie luke » Mon Jan 13, 2020 1:06 pm

Have you done any work on your quads? I had knee pain for years when squatting, running, kicking and just about anything else. A run would leave my knees in agony all night after.

Then one day I foam rolled my quads, and that was the end of two decades of issues.

Lay down on a hard EVA roller, one leg at a time, starting right up the top by the hip, roll, rest your weight on it, then lift your foot up and down while applying weight, and work your way down to close to the knee.

It was literally an instant fix for me. Over time I didn’t have to do it anymore and now I can just roll them occasionally if things start feeling tight.

Some deep quad stretches help too, but it was the rolling that released years of tension in there that pulls the hip and knee out of whack.

It’s free and worth a shot.

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Re: Hip Strengthening

Post by aussie luke » Mon Jan 13, 2020 1:10 pm


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Re: Hip Strengthening

Post by Fat Cat » Mon Jan 13, 2020 5:55 pm

aussie luke wrote:
Mon Jan 13, 2020 1:10 pm
...this:

Image
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Re: Hip Strengthening

Post by aussie luke » Mon Jan 13, 2020 11:22 pm

Haha thanks. I tried.

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Re: Hip Strengthening

Post by nafod » Tue Jan 14, 2020 4:01 pm

aussie luke wrote:
Mon Jan 13, 2020 1:06 pm
Lay down on a hard EVA roller, one leg at a time, starting right up the top by the hip, roll, rest your weight on it, then lift your foot up and down while applying weight, and work your way down to close to the knee.
Pain on a scale of 1 -10?
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Re: Hip Strengthening

Post by aussie luke » Tue Jan 14, 2020 11:56 pm

nafod wrote:
Tue Jan 14, 2020 4:01 pm
aussie luke wrote:
Mon Jan 13, 2020 1:06 pm
Lay down on a hard EVA roller, one leg at a time, starting right up the top by the hip, roll, rest your weight on it, then lift your foot up and down while applying weight, and work your way down to close to the knee.
Pain on a scale of 1 -10?
Somewhere between a laughing 6 and trying not to vomit

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Re: Hip Strengthening

Post by Fat Cat » Wed Jan 15, 2020 12:03 am

Every time I try foam rolling I'm like six seconds in and thinking WTF is this shit?
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Re: Hip Strengthening

Post by powerlifter54 » Wed Jan 15, 2020 3:50 am

https://youtu.be/EN6HAheRHYQ

This is good stuff. On the hip side to side also do it forward fully contracting the glute with the knee on the ground.

Then box squat with a band doubled around your thighs above your knees.

My go to after hip replacement when rehabbing a fully shut down and atrophied left side.
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Re: Hip Strengthening

Post by Luke » Wed Jan 15, 2020 6:14 am

Ryan wrote:
Sun Jan 12, 2020 7:50 pm
Something I didn't mention, but how does he know it's the hip causing the instability?
Good call, Ryan. I don't know. I am very skeptical of those fields these days (https://startingstrength.com/article/aches-and-pains).

To your point, sometimes the ankle and peroneal on that side have felt set in cement. I'm addressing those too.

In the days since starting this thread, I've been doing a lot of stretching and a bit of rolling. Feeling much better and last night was able to squat without pain! It was great because for ages I've felt like my right side could handle 1000lbs and my left side 135lbs without aching.

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Re: Hip Strengthening

Post by Luke » Wed Jan 15, 2020 6:19 am

powerlifter54 wrote:
Wed Jan 15, 2020 3:50 am
https://youtu.be/EN6HAheRHYQ

This is good stuff. On the hip side to side also do it forward fully contracting the glute with the knee on the ground.

Then box squat with a band doubled around your thighs above your knees.

My go to after hip replacement when rehabbing a fully shut down and atrophied left side.
Thanks Jack! I've used the Spud Inc. "Squat Buddy" once this week and will keep it in the rotation - it's like a Slingshot but for your hips. I have been intrigued when using bands beneath the knee, because whether it's cueing the right movement or making the knee feel protected, the pain seems to diminish significantly.

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Re: Hip Strengthening

Post by Luke » Wed Jan 15, 2020 6:21 am

aussie luke wrote:
Mon Jan 13, 2020 1:06 pm
Have you done any work on your quads? I had knee pain for years when squatting, running, kicking and just about anything else. A run would leave my knees in agony all night after.

Then one day I foam rolled my quads, and that was the end of two decades of issues.

Lay down on a hard EVA roller, one leg at a time, starting right up the top by the hip, roll, rest your weight on it, then lift your foot up and down while applying weight, and work your way down to close to the knee.

It was literally an instant fix for me. Over time I didn’t have to do it anymore and now I can just roll them occasionally if things start feeling tight.

Some deep quad stretches help too, but it was the rolling that released years of tension in there that pulls the hip and knee out of whack.

It’s free and worth a shot.
I needed to come back to this by the looks of things, thanks Luke.

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