HIP STRENGTHENING By: Vanessa Niemeyer, PT, DPT

Introduction: 

Oftentimes people are surprised to learn that there are many muscles that control and provide stability to their hips.  Our hip muscles play a large role in stability with walking, running, balancing, and all tasks on our feet.  

Hip strengthening is utilized to restore balance, restore abilities to step in/out of a car,  improve sports performance, reduce pain, restore abilities with upright activities, and much more.  The exercises that you require are based on your individual presentation, goals, desires, pain and much more.  

This blog is meant to help you understand the function of the hip musculature, simple ways to strengthen the hip musculature without equipment, and the hip musculature itself.  

Hip Movements and Muscles: 

Hip Abduction

The outward movement of the leg away from midline

Muscles responsible: tensor fasciae latae, gluteus medius, gluteus minimus

Hip Adduction

The inward movement of the leg towards the midline (and can cross the midline)

Muscles responsible: adductor magnus, adductor brevis, adductor longus, gracilis

Hip Flexion 

The movement of your leg up and towards your abdomen

Muscles responsible: iliopsoas, rectus femoris, sartorius  

Hip Extension

The movement of your leg straight behind you 

Muscles responsible: Gluteus Maximus, Hamstring

Hip External Rotation

The outward rotation of your hip joint (causing your foot be closer to midline) 

Muscles responsible:  Piriformis, Obturator Externus, Obturator Internus, Gemellus Superior, and Gemellus Inferior 

Hip Internal Rotation

The inward rotation of your hip joint (causing your foot to be further from your midline) 

Muscles responsible: Gluteus medius, gluteus minimus and tensor fasciae latae

Hip Abduction Strengthening Exercises:  

1. Clamshells: Lay on your side, bend your knees, and stack your legs on top of each other. Lift your top knee up while keeping your feet together.  Remain laying on your side.

*You can add a theraband around your knees to increase the level of difficulty 

1. Side Lying Hip Abduction:  Lay on your side, and bend the knee of your bottom leg. Raise your upper leg straight up and control it back down.  Remain laying on your side.

*You can add a theraband around your knees, or around your ankles to increase the level of difficulty

1. Side Stepping: Stand up tall, slightly bend at the knees, and step sideways.

*you can add a theraband around your knees or around your ankles to increase the level of difficulty

Hip Adduction Strengthening Exercises:  

1. Ball Squeeze in Supine:  Lay on your back, bend your knees and place your feet flat on the surface.  Place a ball (or a pillow) between your knees.  Squeeze your knees together and hold for 3 seconds. 

1. Side Lying Hip Adduction:  Lay on your side, place the foot of your upper leg in front of you. While keeping your lower leg straight raise your lower leg up.  

*To modify, you can utilize a chair to place your upper leg on.  You would then keep your lower leg straight and raise your lower leg up.  

1. Standing Hip Adduction with Theraband: Loop the theraband around a stable surface (such as bed frame) and your leg.  While remaining standing (utilize a stable surface to help if needed) bring your leg in towards your midline and continue pulling your leg across your body past midline.  

Hip Flexion Strengthening Exercises

1. Supine Hip Flexion: Lay on your back, bend your knees, and place your feet flat on the surface.  Straighten the leg you desire to strengthen.  With your toes pointed towards the ceiling, lift your leg straight up (until both of your knees are at the same level), and then slowly lower it back down.  

*Add a theraband around your ankles to increase the level of difficulty

1. Seated Marching: Sit upright on a firm and stable surface.  Have your knees bent to 90 degrees.  Lift your knee up towards your chest (one knee at a time) and then slowly lower it back down.  

*To increase the level of difficulty, add a theraband around your knees

1. Standing Hip Flexion:  Stand upright with your knees straight.  Lift (the leg you desire to strengthen) straight out in front of you (with your toes pointing towards the ceiling).  Slowly control back down.  

Hip Extension Strengthening Exercises:  

1. Prone Hip Extension:  Lay on your belly.  Keep both legs straight.  Raise the leg you desire to strengthen (keeping it straight).  Slowly lower.  (Keep control). Be sure to keep your hips down (don’t rotate your body)

1. Quadruped Hip Extension:  Position yourself on your hands and knees.  Raise the leg you desire to strengthen straight back (keeping your knee bent).  Be sure to keep your back stable.   

1. Prone Hip Extension (Bent Knee):  Lay on your belly.  Bent your knee (on the leg you desire to strengthen) to 90 degrees.  (Keep it bent).  Raise your foot straight up towards the ceiling (Remember to keep your hips down - don’t rotate your body).  

Hip Internal Rotation & External Rotation Exercises: 

1. Supine Hip Internal & External Rotation:  Lay on your back.  Keep your leg straight. Turn your entire leg inward (as far as you comfortably can) and then return to neutral.  Turn your entire leg outward (as far as you comfortably can) and then return to neutral.  

1. Side Lying Hip Internal Rotation: Lay on your side (opposite of the leg you desire to strengthen). Bend both of your knees and stack your legs on top of each other.  Keep your hips and knees stacked, while lifting your foot up towards the ceiling.  

1. Seated Hip External Rotation:  Sit upright in a chair with your feet spread out.  Lift your foot (on the leg you desire to strengthen) up and inward.  Do not lift your thigh and do not allow your thigh to slide right or left.   

Final Thoughts: 

Hip strengthening provides many benefits.  It is important to address any muscle imbalances to ensure that you are moving effectively and efficiently.  If any of these exercises feel too hard, it is probably because they are.  This is in no way meant to be an exercise program.  This is an informative guide on how to strengthen specific muscles.  Each individual's exercises need to be geared towards his/ her specific needs.  If you are having pain it is best to consult a healthcare provider, such as your  physical therapist from Advanced Rehabilitation.  

*All images utilized taken from www.hep2go.com*