6
Chapter
The basic exercises
- Basic exercises for the hips 8. Basic exercises for the hips
- Basic exercises for the hips 8. Basic exercises for the hips
- Basic exercises for the hips
The hip joint is formed by the head of the femur and
the hip socket; the fused bones ilium, ischium, and
pubis meet in the hip socket. Viewed from the front
the joint lies halfway between the pubic tubercle
and the anterior superior iliac spine. The hip joints
and the axis through the hip joints are essential for
balance and movements of the whole body. “The
hip joint is a fulcrum upon which the whole body
pivots” (Kingston 2001, p. 160).
The balance between mobility and stability
through good cooperation of all the hip-moving
muscles is crucial for the hip. It is particularly
important to strengthen the abductor muscles and
lengthen the iliopsoas and hamstrings. In standing
posture the head of the femur does not fit ide-
ally into the hip socket. This is best in 90° flex-
ion with some abduction and external rotation.
To balance the hip muscles and strengthen the
abductor muscles the following points are partic-
ularly relevant:
• standing symmetrically
• making the hips narrow, as if squeezing them
together
• lengthening around the hip joints before bending
• maintaining the position of the pelvis and
keeping the line of the iliac crests horizontal
while standing on one foot
• keeping the thigh perpendicular to the floor and
the pelvis horizontal in the one-leg variations of
four-point kneeling.
For precision of movement the following can be
practiced:
• Hip flexion lying supine: Lie on your back;
bend one leg, holding the shin bone with
both hands. If the ilium stays unchanged,
the movement is in the hip joint. If the ilium
moves so that the sitting bone is moving away
from the floor, the iliosacral joint is involved.
If the knee is moved even closer so that the
lumbar area becomes flatter, the lumbar spine
is also involved.
• Hip extension standing: Stand on one foot,
and raise the other leg backwards. Control the
anterior superior iliac spine on the side of the
raised leg with one hand, and the sacrum with the
other hand. Move the leg backwards, so long as
the iliac spine does not change – the movement
is in the hip joint. If the iliac spine is moving
forwards and downwards but the sacrum does
not move, the movement is in the iliosacral joint.
If the sacrum is tilting forwards, the movement
is between the sacrum and the fifth lumbar
vertebra, probably also further up into the lumbar
spine, particularly in a hypermobile segment.
With all its multiple tasks the hip joint is vulner-
able for degeneration with associated loss of mobil-
ity. Hypomobile hip joints often affect the lumbar
spine, the knees, and the feet. In mild cases mobi-
lization, particularly the rhythmic type, gives relief.
“Restoration of even a small part of lost mobil-
ity can be very successful in relieving many of the
symptoms of hip disorders, even if the progress of
the degenerative state has not been changed at all”
(Hartman 2001, p. 227). For more serious degen-
erative changes hip replacement surgery is now very
successful, and has greatly improved patients’ qual-
ity of life. Throughout our practical experience we
have observed that patients who were already in
the habit of exercising before the operation recov-
ered quickly. They reported that their surgeons and
rehabilitation therapists were very pleased.
Exercise 8.1: Rhythmic external and
internal rotation
Aims: mobilizing the hip joints into external and
internal rotation.
- Sit on the floor with straight legs, the feet at
least two foot lengths apart; either use a back
support or support yourself with your hands
behind your buttocks. Keeping your thighs
relaxed, move your legs rhythmically, oscillating
into external and internal rotation for 1–2
minutes (Figures 6.161 and 6.162).
- To finish sit quietly for a few breaths.
