Healthy Hips for Athletes

May 26, 2017

Matt Midkiff

by Matt Midkiff
PT, DPT, CSCS | Gilbert-Mesa Location

I treat too many athletes with hip injuries that require them to miss practice time from their sport or give them pain with activities. I refer to hip injuries as “the new knee,” as knee injuries get most of the attention but hip injuries are becoming as prevalent.
Types of hip injuries range from strains of the hip muscles to surgical cases. An athlete could miss up to 6 weeks of practice for a simple strain, or in the worst-case scenario, may require surgery to fix the damaged hip joint and be sidelined for 6-9 months. For those with minor hip injuries, the quickest way to get back on the field is through physical therapy for hip pain. Examples of the more serious injuries are muscle and bone avulsions, hip labral tears, and changes in bone structure.
The majority of hip injuries I see happen either early in the season when a player’s body is adapting to the stresses of the sport, or late in the season when fatigue and overuse becomes a significant factor. A young player who has recently gone through a growth spurt, and who is getting used to their new body, is easily susceptible to these injuries. Gaining balance in mobility and stability from the feet to the shoulders is important to keep hips healthy.
Body Balance
The hip is centered in the middle of the body so what happens above and below it contribute to its success. The key to hip injury prevention is to get all of your muscles working together to help the hip. Like the shoulder, the hip is a ball and socket joint that allows for a wide range of motion. The hip is the center of how an athlete moves. The muscles at the hip, as well as above, and below all share an important role in athletic performance.
The goal of hip injury prevention is to create balance in the hip musculature among all local muscle groups. To further avoid injury, a combination of strength, flexibility, stability, endurance, and overall body control is required. An imbalance of muscle dominance or tightness can put you at risk of injury, especially when an athlete exceeds their own performance envelope. It’s important that an athlete takes the time to widen their performance envelope by working all of the muscles of the chain during training.
Stretching and Strengthening to Avoid Hip Injury
A good way to start improving hip mobility is by integrating exercises that place emphasis on movement and stability. These include yoga, dynamic stretching, and somestatic stretches. Strengthening exercises, including lunging and squatting, are also a great way to improve hip mobility.
We often joke that we are making the world better and stronger, one butt muscle at a time. A joke yes, but very true of how important hip and torso strength is for an aspiring athlete. As hip muscles are critical to body movement, they must be strong through full range of motion. Some athletes are very strong in one direction, but weak in another, which can put them at risk of injury. It’s also important to train with single leg motions so that the dominant leg doesn’t have to compensate for the weaker one.
We like to use different matrix exercises where the athletes lunge, squat, hop, and deadlift to improve strength and flexibility. This activates the athlete’s hip muscles so they can be ready for whatever their coaches throw at them. It’s important to build through repetition from controlled motions to explosive motions where the hip musculature and joints can be under high stress.
Our goal is to keep athletes healthy, and to get them back in the action as soon as possible after injury. Remember, sports by nature can lead to overuse, and the hip muscles are usually at the center of this issue. An athlete must train to build hip strength and flexibility to avoid injury and to realize their full potential. Stop by Foothills Sports Medicine to learn how physical therapy for hip pain can help you get back to the activities you love.

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