Hip internal rotation is a crucial yet often overlooked aspect of lower body mechanics. Recently, Dr. Chloe has been grappling with high hamstring and glute pain, which has led her to wonder what are other underlying issues related to her hip function. This blog will delve into her journey, the importance of hip internal rotation, and the exercises she’s implementing to regain her mobility.
Understanding the Issue: The Ripple Effect of Hip Dysfunction
Dr. Chloe’s mechanical hip dysfunction has had a cascading effect, that seems to have been going from the bottom up! It began with discomfort in her foot and calf but is now working it’s way up to the hamstring and glute. If you’ve been following along with us for a while you’re familiar with the Fix Your Foot series that we recently did. Her calf and foot issues are directly correlated to this current high hamstring/glute pain.
Despite diligent efforts in rehab maintenance—stretching, foam rolling, and dynamic flexibility—she noticed that her kneecap was slightly misaligned, facing outward. This misalignment is often a sign of tight glutes and external rotators. It may seem minor but these things can add up! It can lead to different compensations throughout the entire lower body (hence the foot and calf pain).
The Importance of Hip Internal Rotation
Great for improving your walking and running gait as well as back pain, hip internal rotation is often overlooked! We generally have a tendency to focus on not having too much external rotation but not really thinking about internal rotation. However, it plays an important role in maintaining proper alignment and function in our lower body. A key point here is that it’s not just your knee cap that is facing towards the outside. It’s actually your entire femur (thigh bone). That’s why the misalignment is very impactful and affects your knee, foot, and ankle. Loosening up those external rotators can help your femur rest in a more neutral position. From there we need to re-teach it where neutral really is. This is easy to say and harder to do. Re-teaching your body how to move properly is no easy feat!
Strengthening the Foundation: Addressing Foot and Hip Mechanics
If you stand up and try to move your knee cap closer to midline, your foot and arch typically collapse or roll to the inside. Therefore, it’s important to take a comprehensive approach by focusing on both hip and foot mechanics. This dual focus matters. Strengthening the foot can support proper alignment and function in the hip and keep that knee from collapsing in.
The Role of Stretching and Mobility Work
Before diving into strengthening exercises, Dr. Chloe is prioritizing improving her range of motion (ROM). This foundational work is essential for ensuring that her muscles and joints can move freely and effectively. Even though we aren’t covering them all here, she is working on the flexibility of her glutes and external rotators by foam rolling her glutes, doing pigeon stretch (all variations), and dynamic hamstring work.
Key Exercises for Hip Internal Rotation
To specifically target hip internal rotation, Dr. Chloe is implementing the following three exercises:
Seated Internal Rotation Activation
This exercise involves sitting on the floor with legs extended in front. Keeping your legs straight, focus on moving from the femur. You want to push the hip down towards the ground and rotate inwards. Hold for a moment and then release back to neutral. This movement helps build awareness and activates the muscles to improve the range of motion. Be careful!!! The first time I did this I ONLY moved from my ankle. Really concentrate on moving from the thigh bone.
Prone Internal Rotation Activation
In this position, Dr. Chloe lies face down and bends her knee to 90 degrees. She then rotates her hip inward, focusing on engaging the internal rotators. This position is counter intuitive because in order for your thigh bone to move inward, your foot moves to the outside! This exercise can be more difficult because now you’re challenging that hip internal rotation while your hip is extended. Hold for a second in the externally rotated position and then return to neutral.
The Brettzel 2.0
The Brettzel 2.0 is a static stretch that targets the hip flexors, glutes, and thoracic spine. You want to lay both legs to 1 side. Bringing your top heel close to your glute, squeeze your top hip to extend your hip. Lay back onto your elbow and feel the stretch!
For Detailed How To's and More Difficult Variations: Watch This Video About Hip Internal Rotation
Moving Forward: The Road to Strengthening
Improving flexibility is an essential piece of the puzzle before you begin to strengthen. You cannot strengthen before you have the appropriate range of motion otherwise you’re not helping yourself! Do these exercises for 2-3 weeks to improve your range of motion before you begin some strengthening exercises. Stay tuned for upcoming posts, where we will share our strengthening couplet focused on hip internal rotation.
How To Use This Primer
To really feel the benefits, you want to do these exercises every day. They take anywhere from 5-10 minutes! Dr. Chloe is using these exercises pre-run and is seeing less pain in her high hamstring/glute while running after using these for the last few weeks!
Hip internal rotation is a fundamental component of lower body function that can significantly impact overall mobility and performance. Dr. Chloe’s proactive approach to addressing her hip dysfunction through targeted exercises and comprehensive rehab strategies is an excellent reminder of the importance of understanding our bodies. Make sure you pay attention while doing the exercises so you too can tell where your asymmetries are! That way you too can have a healthier, pain-free future!
If you’re experiencing similar issues or want to improve your hip function, try incorporating these exercises into your routine and consult with a healthcare professional for personalized guidance. Your journey to optimal movement starts with understanding and addressing the root causes of your discomfort!
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Learn more about hip internal rotation and how your body alignment can impact your health!
Bulletproof Your Hips
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