The hip is our connection from the trunk to the lower extremity. To meet the high demands, the hip is a stable nut joint. The femoral head at the upper end of the thigh sits firmly in the pelvic socket.
A nut joint is a special form of ball joint and means that the round joint partner, in this case the femoral head, is enclosed by its joint partner, the acetabulum, by more than 50%. Unlike the shoulder, for example, it is fortunately much more difficult for the hip to “dislocate” the femoral head. The normal range of motion of the hip includes approx. 110° flexion and 10° extension, 45° abduction (spreading) and 20° adduction (advancing), as well as 45° external rotation and 35° internal rotation. In spite of this stable device, balanced force ratios of the hip muscles are necessary to keep them permanently healthy.
Exercises from physiotherapy
1. exercise – “hip stabilization” 2. exercise – “hip abductors” 3. exercise – “hip adductors” 4. exercise – “hip extensor” 5. exercise – “hip extension” 6. exercise – “hip flexor” 7. exercise – “tractus iliotibialis extension
Physiotherapy hip exercises
Physiotherapy Stabilization exercise: Stand on one leg and check in the mirror to make sure your pelvis remains straight. Keep the knee of the standing leg slightly bent and make sure that the kneecap does not turn inwards. If you can stand safely on one leg for at least 20 seconds, you may become creative to increase the level of difficulty.
You can, for example, use the free leg to add movement, or stand on a shaky surface (e.g. Airex cushion, balance board, Posturomed). A standing scale can challenge your balance even more. Physiotherapy exercise hip abductors:Specific training for the hip abductors includes lifting the leg in a lateral position and spreading the leg with a Theraband that you tie around both legs.
Tie the Theraband above your ankle joints so that it is taut when you stand with your hips wide apart. Also for this exercise for the hips, make sure that your pelvis is straight. Then spread the free leg outwards against the resistance of the Theraband.
Both exercises are performed in three sets of 15 repetitions. Physiotherapy exercise hip adductors:To train the adductors specifically it is useful to fix a Theraband to an object a few centimeters above the ground. Climb into the loop with one leg and move away from the attachment point so far that the Theraband is stretched with the leg spread apart.
Again, make sure you have a secure stand and an upright pelvis. Then bring your free leg towards your body. Do the exercise in three sets of 15 repetitions.
Physiotherapy hip extensor exercise: The large pomus muscle (gluteus maximus) is primarily responsible for the hip extension, but the back thigh muscles (ischiocrural muscles) also help with the hip extension. When doing exercises for these two muscle groups, it often happens that the long back muscle works a lot. To train the gluteus and ischiocrural muscles in isolation and without major aids, first lie on your back.
A very well known exercise from physiotherapy (also for the lower back) is to form a bridge. You have both legs close to your bottom and lift the pelvis until your body forms a line from your knees to your neck. But as already mentioned, the back extensor is happy to take over a large part of the work here.
To prevent this from happening, you pull one knee towards your chest from the basic position and hold it with your hands. It is helpful to pinch a tennis ball between thigh and torso, which must not fall out. If you now lift the pelvis, the movement is much smaller and can only be a few centimeters, but only the hip extensor muscles are working.
Repeat the exercise for the hips first in three sets of 5 repetitions on each side. After the exercise you should stretch your muscles. For the stretch to be effective, it should be held for at least 30 seconds.
This is how long it takes the tissue to respond to the stretch stimulus. Physiotherapy hip stretching exercise 1: To stretch the gluteus sit on a chair and place one lower leg above the other knee. The edge of the tibia should now be parallel to the edge of the chair.Now gently push your knee, the side to be stretched, towards the floor and lean your upper body forward with your back straight until you feel a feeling of stretching in your buttocks.
Alternatively, you can also do this exercise on the floor in a supine position. The closer you bring your legs to your upper body, the stronger the stretching sensation should become. Again, make sure that the lower leg of the side to be stretched remains at the correct angle.
Physiotherapy hip stretching exercise 2: A frequent cause of hip and lumbar spine complaints is a shortened hip flexor muscle. For this reason, it must usually be stretched rather than strengthened. One part of the hip flexor muscle originates at the front of the transverse processes of our lumbar vertebrae and another originates on the inside of the pelvic shovel.
If the hip is not bent, it is thus able to pull us into the hollow back. To stretch the hip flexor, go to a one-legged knee position. To do this, place one lower leg on the floor and place your other leg significantly further forward on the floor.
The pelvis points straight forward during this exercise as well. Place your hands on the right and left side of the iliac crests and push the pelvis forward until you feel a stretching sensation in the groin. It is important that you remain upright, because as soon as the hip is bent, you can no longer expect a feeling of stretching.
Physiotherapy Hip Stretching Exercise 3 Especially athletes, such as cyclists and runners, and also those with an altered neck angle of the femur may experience problems with the iliotibial ligament. The iliotibial ligament is stretched by a small, strong hip muscle (tensor fascia latae), which is located at the side and front of the iliac crest. From there it runs as a solid connective tissue structure along the outside of the thigh and ends just below the knee on the lower leg.
If there is too much tension, the iliotibial ligament can rub over the greater trochanter (iliotibial ligament syndrome, snapping hip, etc.) and cause, among other things, painful bursitis. Further stretching exercises can be found in the article Stretching exercises.
To stretch this muscle, it is best to use the wall as a support and stand with your back in front of it, cross the leg you want to stretch behind the other leg and tilt your upper body to the opposite side. Make the side long and push the pelvis to the side opposite the upper body. The arm of the stretched side is stretched over the head, with the other hand you can hold on to the wall.
If you have a fascial roll, you can achieve very good effects by rolling out the iliotibial band with it. To do this, place the fascial roll under your lateral thigh and roll it slowly several times from the trochanter to the knee. The large pom muscle can also be worked very well with the fascial roll.
You can use the fascial roller to loosen adhesions in the connective tissue that can cause pain. The anatomy of the hip can have some special features. For one, the angle of the neck of the femur can vary.
The neck of the femur is the part of the thigh between the femoral head and the “large rolling mound” (greater trochanter), which serves as an important starting point for many muscles. The angle of the neck of the femur can deviate from the normal 125° for adults. A steeper angle of 140° is normal for children; with age, the angle can decrease by up to 10°.
However, if the angle deviates in adulthood, this can have consequences for the compression and traction forces required to align the hip joint. Especially the force applied by the abductor group is affected by deviations. Pathologies of the hip are often the result of wear and tear due to incorrect loading or occur after injuries and incorrect/overloading during sports.
Hip osteoarthritis often occurs in older patients. In this case, the joint cartilage has become so worn that the neck of the femur can no longer slide smoothly in the femoral head. This often manifests itself in crunching and cracking when moving the hip.
The pain is mainly localized in the groin, but the pom muscles also become increasingly painful. Likewise, the bursae in the hip region can become inflamed due to incorrect strain or an infectious genesis, resulting in so-called bursitis (inflammation of the bursa). In order to keep the hip healthy and to prevent problems, it is worthwhile to regularly perform exercises from physiotherapy that are functional.
This means that the exercises should be relevant to everyday life.It is especially important to train the hip abductors while standing, because they are responsible for keeping our pelvis upright during gait. If the hip abductors are too weak, a so-called Duchenne hamstring occurs. The patient leans his or her upper body towards the supporting leg while walking to compensate for the lack of strength of the hip abductors. All exercises where balance has to be maintained in the one-legged position are functional to train the interaction between hip abductors and adductors. Further physiotherapy exercises for the hip can also be found under Therapy of a fatigue fracture.