Strengthening the Hip - Why Is It So Important?
Why Is Hip Strength Important? Before answering this question
we need to understand a little more about the muscles and joints that make up this complex.
The same muscle may act in different joints, for example some hip muscles may have direct or indirect action on the knee and lumbar. Since this was studied and disclosed about a major hip muscle group and named Hip Posterolateral Complex (hip CPL).
The muscles that form this complex perform the following functions: hip abduction, hip extension and lateral rotation of the hip. The middle buttock is considered the main muscle that makes the hip CPL, but it can not act alone to prevent inadequate and compensatory movements. Therefore, the Maxillary Muscle, Piriformis Muscle, Twin Muscles (Upper and Lower), Shutter Muscles (External Shutter and Internal Shutter) and Femoral Square Muscle need to be worked and strengthened to act together, treating or preventing various dysfunctions of the lower limbs and spine (mainly the lumbar).
Consequences of Hip CPL Weakness
Because of the weakness of the hip CPL there is a chain of consequences that affect lower limbs and spine. The main ones cited by Fukuda - a physiotherapist studying the CPL of the hip - are:
Femoropatellar Pain Syndrome (PFPS)
Iliotibial Band Syndrome
Anterior Cruciate Ligament (ACL)
Importance of Hip Strengthening
For many years, it was understood that to prevent or treat a knee problem, such as the ACL, it was necessary to strengthen the Quadriceps Muscle and stretch the Muscle Hamstring. But after some studies, it has been found that there is something far more significant than just having a vision specifically for the knee.
It was there that there was a global vision in the cases of knee pathologies, being able to also notice some findings in the region of the hip and pelvis.
Scholars have realized that when the step down test is performed, there is a sequence of movement failures when the CPL of the hip is weakened.
When standing in unipodal support, a contralateral fall of the pelvis was noticed and the knee enters varus, so the trunk tilts to compensate and brings the pelvis back, causing the knee to assume a position in dynamic valgus.
These compensatory movements cause problems in the lower limbs and spine, making activities of daily living, such as going up and down a ladder, painful. But the consequences can also affect a runner, especially at the time of deceleration or a sportsman during a one-way jump. Hence the importance of hip strengthening.
Lesions of the lower limbs can be explained when the femur makes a medial adduction and rotation due to hip muscle disabilities, and may say that dynamic valgus is a cause of knee problems.
The trunk inclination due to pelvic fall is called transient scoliosis, which can be detrimental to the spine. Therefore, the strengthening of the hip and that muscle group, becomes important both in the prevention as well as in the treatment of injuries and to avoid recurrence.
How can Pilates help with Hip Strength?
Pilates has exercises for strengthening the hip and your muscles that work in stability. We can cite the following:
In the lateral decubitus, with knees bent and heels together and aligned with the ischium, perform the opening of the leg that is on the upper side.
The evolution of the exercise can be done by removing the heels from the floor or also with an elastic in the knees.
In dorsal decubitus and flexed knees, ask the patient to lift the body, removing vertebrae by vertebrae from the floor, until the pelvis is aligned with the knees and shoulders, being in a bridge position. Exercise pressure should be felt in the calcaneus, so you will know that your maximum gluteus muscle is being recruited. If you ask the patient to remove a leg from the floor, when the pelvis is aligned with the knees, you will also be recruiting the gluteus medius. This same exercise can be done in Reformer and Cadillac.
On The Side In lateral decubitus, legs stretched and with a slight hip extension, perform abduction with the leg that is on top.
This exercise can be done with ankle weights
4-Side Leg Lifts
In lateral decubitus, legs stretched and together, ask the patient to lift the legs.
This exercise has as an indication who has weakness of the gluteus medius and also strengthens the abductors and adductors of the hip.
5-Side Splits - Reformer With one foot on the fixed platform and the other on the upholstery, perform abduction by pushing the cart.
6- Side Pump - Chair Standing on the side of the Chair, a crossed leg in front of the supporting leg, with the foot on the pedal, lowering the pedal.
Tip: Keep the foot in dorsiflexion to activate more the Medium Gluteus Muscle.
Thank you referencias :
– NAKAGAWA, T.H, et al. A abordagem funcional dos músculos do quadril no tratamento da Síndrome da dor Femoro-Patelar. Fisioter. Jan/mar;21(1):65-72
– www.ojoelho.com.br – Acesso em 28/05/17
– BORGES, N.V.; LEAL; A.G.F. Evidências do fortalecimento dos músculos do CPL do quadril no tratamento da Síndrome da dor Patelofemoral.
– FUKUDA, T.Y.; ROSSETO, F.M.; SILVA, R.M.; APOLINÁRIO, A. Fortalecimento dos músculos do quadril no tratamento da dor anterior de joelho. Revista Ciência & Saúde, Porto Alegre, n. especial, p.96, nov. 2009
– Rabelo NDA, Lima B, Dos Reis AC, Bley AS, Yi LC, Fukuda TY, et al. Neuromuscular training and muscle strengthening in patients with patellofemoral pain syndrome: a protocol of randomized controlled trail. BMC Musculoskeletal Disorders. 2014; 15:157.