Much Ado about Hip Mobility

Since I've made a post about shoulder restrictions, I've received a few requests about how to loosen up stubborn hips.

This is my dad, unintentionally showing off his
perfect bottom position and impressive ankle
dorsiflexion.

One thing I'd like to mention, which has been noted in previous posts, is that some people are just genetically and anatomically better suited for squats. Let's take my father, for example. My dad, who does not exercise, and has no notable sports background has a picture perfect squat. He has never mobilized a day in his life, and no one taught him proper squatting mechanics. In fact, I was stunned to watch him squat down to reset our Internet modem with absolute ease. Others will take weeks or months of mobility/motor control drills to execute a partial squat. If you're interested, Dr. Stuart McGill has an excellent video discussing this concept. Unfortunately, there's nothing we can do to change one's acetabulum or femurs.

Don't be discouraged! There's hope for you yet. What we can do, instead, is put someone who may be...inept at squatting into a position that optimizes his or her anatomy. We can play around with foot position, stance, and different squat styles to see what is best suited towards their anthropometry (limb length/proportions). I always recommend that those who are struggling with their squat mechanics work with a qualified coach/movement practitioner to improve. If that is not an option for you, then you should spend some time playing around on your own trying different set-ups.  Record yourself when possible. Remember that your squat will not necessarily look the same as mine.

Once you've settled on your ideal stance and foot position, now we must consider the role of motor control (yay for unintentional rhyming) in the squat. As you can imagine, there are many possible compensatory patterns that one might display throughout the movement. From knee valgus/varus, to shooting the hips back too far, to letting the chest drop, I've seen it all; this is when attention and mindfulness become especially important. Again, it will be invaluable to have a coach review your mechanics in these cases. With just a few simple cues, most errors are immediately fixable, and then you may continue to practice these on your own and engrain the proper sequencing in your head.

One exercise that I typically use with my clients who are learning to squat is the pole squat drill: this allows the person to understand how their weight should be distributed, and helps them achieve a lower bottom position almost immediately. I would also introduce them to the quadruped rock, which mirrors the sequencing in a squat and warms up the hips. These movements are best suited in the beginning of a session.

For clients who still have difficulty squatting after those drills, the goblet squat should become your friend. It is generally easier for individuals to assume a better position in a goblet squat. Holding weight in front of the body forces you to maintain a more vertical torso and achieve better depth. I always prescribe these (typically with a pause at the bottom) before moving clients on to barbell variations.

While many people spend an endless amount of time trying to stretch the hell out of their hip flexors, I find that those efforts are often wasted. Instead, implementing movements such as the goblet squat with a tempo (slow negative and 1-2 second pause) will allow you to kill two birds with one stone. Similarly, tempo single-legged exercises will do wonders for opening the hips. Bulgarian split squats necessitate a decent amount of hip flexibility, so it may be beneficial to start with a traditional lunge, again with a slow eccentric phase.

Finally, at the end of the session, the happy baby pose is ideal. Not only does this provide a nice stretch, but it's actually quite relaxing. You can also use this time to practice your diaphragmatic breathing. Focus on pushing your belly against your thighs as you inhale through your nose. Exhale through your mouth, and repeat. 1-2 minutes should be more than enough.

In the long run, an arsenal of hip flexor stretches isn't going to address the source of the problem. Teach yourself proper squat patterns, train your lower body with an eccentric emphasis, and show your hips some love. If you're diligent in your efforts, you'll be dropping it low on and off the dance floor in no time.

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Getting Rid of the "Butt Wink"

The "butt wink" is a term that has puzzled personal trainers and other movement practitioners. Some people attribute it to tight hamstrings, others have mentioned ankle mobility, some say it's hip flexor strength, or even hip/femur anatomy. My two cents? Motor control. Everyone I've met who had a "butt wink" was able to eliminate it with some proper cuing and movement sequencing.

If you're not sure what a butt wink is, and if you have one, let me enlighten you: this is a term used to describe lumbar flexion in the bottom of a squat (pictured below).

Oof.

Now, let's first touch upon some other theories contributing to this fault...

Dr. Quinn Henoch mentions that the hamstrings cannot be responsible for the butt wink: "The hamstrings are a two joint muscle.  When you descend into a squat, the hamstrings are being lengthened at the pelvis, but shortened at the knee. So it would seem to me that the net length change is negligible." The hamstrings are not a likely culprit.

Hip anatomy makes the most sense out of all theories. Some individuals are just going to be better at squatting, out of sheer, genetic fortune. If you have the right anthropometry (limb length), you're gonna be a better squatter, plain and simple. 

Anatomical factors aside, though, it is possible to eliminate the dreaded butt wink with a little bit of practice and tweaking.

I'm not going to get too much into the hip and femur anatomy here, because I think Dr. Ryan DeBell covers that nicely. If you want to read his article on it, check out the works cited below. What I will say, though is that factors like your acetabulum (hip socket) alignment, femur length, and tibia/fibula length will all influence your squat stance. Some people have to squat wider than others, so playing around with your stance will greatly help your bottom position.

You want to work through a range of motion where you can maximize the integrity of the movement. If, initially, that means that you're squatting just to parallel, then so be it. Over time, the goal is to get progressively lower.

I usually start out my clients with a quadruped rocking drill. This will teach them how to hinge at the hips without load and minimize any lumbar flexion. If you find yourself reverting to the butt wink on this drill, move slower and focus on keeping the core engaged.

Once they grasp this concept, I would then progress them to the assisted squat drill. The goal here is the same as that of the previous drill, but now we're upright and preparing for a load-bearing squat.

Congratulations! Now you're ready to try an air squat without assistance! A couple of things to keep in mind: if my core isn't engaged, and I shift into an anterior pelvic tilt (hyperextension), then it's impossible for me to avoid lumbar flexion. If, however, I maintain a nicely braced position and descend straight down, I should be just fine. You want to imagine "pulling through your hip flexors" as you lower yourself.  If you're squatting high bar or front squatting, you will descend straight down, and if you're squatting low bar, then the hips need to come back more.

With a little bit of reverse engineering, even the most troubled squats can minimize the "butt wink." Sometimes you need to regress in order to progress. When you lay a solid foundation for quality movement, you can get a squat PR without looking like Quasimodo.

Works Cited:

1. DeBell, Ryan. "The Best Kept Secret: Why People HAVE to Squat Differently." Why People HAVE to Squat Differently. N.p., 08 Jan. 2014. Web. 16 Mar. 2016.
2. Henoch, Quinn. "The Bottom Position of Your Squat: A Defining Characteristic of Your Human Existence." Juggernaut. N.p., 05 Feb. 2014. Web. 16 Mar. 2016.
3. Somerset, Dean. "Butt Wink Is Not About the Hamstrings" DeanSomerset.com. N.p., 07 July 2014. Web. 16 Mar. 2016.

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Where Does Your Knee Pain Really Come From?

The knees are the largest joints in the human body. Unfortunately, these large joints also seem to be an even bigger area for pain and injury. In the U.S. alone, surgeons perform around 700,000 knee replacements annually--that's a lot of bionic knees! Other knee-related injuries include ACL tears, MCL tears, patellar tendon tears, patellar tendonitis, dislocated patellas and osteoarthritis. In my opinion, many of these surgeries or injuries are easily preventable. With the proper training protocol, you can avoid knee pain and inevitable surgery down the line.

We use our knees for a lot of different activities from walking and running to jumping, squatting and lunging, and therefore they withstand a lot of impact. It is incredibly important to prioritize solid movement patterns to avoid any further stress.

I should warn you, that this post will be fairly heavy in anatomical jargon. Brace yourself.

The "knee" covers an area of four bones: the femur, the fibula, the tibia, and the patella. As a hinge joint, the knee can only flex and extend. Though its actions are simple, the muscles around it are vast and complex. Some of the important muscles that directly help the movement of this joint are the hamstrings complex (semimembranosus, semitendinosus, and biceps femoris), the quadriceps complex (vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris), the calf muscles (gastrocnemius, popliteus, tibialis anterior, and the peroneals). If you feel overwhelmed with the laundry list of muscles I just mentioned, fear not! I will elaborate.

Now, we need to remember that the body acts as a chain. One part of the body reacts to the feedback of another part. What are the two major joints near the knee? If you guessed the hip and the ankle, high five! We cannot just consider the knee in the case of knee pain, but rather, we must think about how the surrounding joints are compromising the integrity of the knee. If you have poor hip or ankle stability, the knee is going to work a lot harder to compensate for the lack of stability elsewhere.

Let's start from the ground up, at the ankle. The ankle can plantarflex (point), dorsiflex (flex upwards), invert/supinate, or evert/pronate. Check your feet. Are your arches exceedingly high or collapsed? What happens to them as you squat or jump? Ideally, we want to strive for a perfect balance between pronation and supination when standing. Both of these two movements are completely natural ankle movements when walking or running, but we do not want either in excess.

If, for example, you squat and your ankle collapses (pronates) completely, you will likely experience some collapse of the knee with it. The muscles on the inside of your leg (adductors) are over-active or tight, while the antagonists (abductors) will be lengthened. Do you often feel pain in your IT bands? Well, you may fit into this category of people. Your IT bands may be tense because they're working really hard for some other guys. Think about how this position is going to effect the ligaments and tendons in your knee!

Look at the relationship between his knees and ankles in the squat.

Conversely, if you drive your knees out too much and shift your weight laterally (supinate) your feet, the opposite will happen. Your adductors are going to be lengthened while your abductors will work over time. I was one of these people. The lateral areas of my knee always caused me pain, because I was nearly rolling my ankles as I squatted.

Obviously, the ankle position will effect the knee and hip mechanics, and vice versa.

If one lacks sufficient strength in the gluteus medius and the peroneals, the lifter will, again, revert to a valgus (collapse) of the knees. Weak gluteus maximus will result in an abuse of the quadriceps complex, which is going to pull onto the patellar tendon for dear life. Put more simply, if your glutes aren't strong enough, your knees are going to pay the price.

As I said, we want to maintain a balance in how we shift our weight as we move. Too much outward shifting of the hip or ankle is just as counter-productive as shifting too much weight inward. True strength comes from a balance.

Some of these inefficiencies may be a matter of learning. You might not understand what a proper squat should look like, and there for cueing and repetition will go a long way. If cueing has not helped, then you need to follow a strengthening and mobility routine. The exercises I've listed below will be tremendously helpful.

Now that we've made it through the meat of this article, it's time to learn how to correct these faults. Figure out where you lie on this spectrum of movement dysfunction, and correct your mechanics as necessary.

Here are some great ways to mobilize the hips and the ankles:

• Subtalar eversion and inversion
• Resisted half-kneeling ankle mobility
• Soleus and gastrocnemius release
• Gluteus medius release
• Plantar fascia mobilization

Once you've mobilized, the next step is to strengthen the targeted muscles:

• Single leg RDL
• Banded squats
• Ankle step downs
• Squat off of box
• Banded eversion
• Banded inversion
• Barbell hip thrusters

Where there is pain, there is weakness and dysfunction. You don't have to "accept" being in pain. Strengthening the hip and ankle muscles are vital in perfecting your mechanics and preventing unnecessary stresses on the soft tissues of the knee. Pay attention to those stabilizers and you will save your knees for many years of heavy lifting to come.

Works Cited:

1. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 06 Jan. 2015. Web. 29 June 2015.
2. Myers, Thomas W. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Edinburgh: Churchill Livingstone, 2001. Print.
3. Weinstock, David. "Neurokinetic Therapy®." Neurokinetic Therapy. N.p., 22 Apr. 2012. Web. 29 June 2015.

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Your Hips Don't Lie...Or Do They?

We'd all like to move our hips like Shakira (or maybe that's just me). One thing I've noticed, though, in many of my clients, is that the cue "hinge at the hips" usually raises confusion. The fact is that many people I've met do not know the difference between bending at the hips and bending at the waist. I am to put an end to this gray area.

Whether you're picking something up from the floor or preparing yourself for a deadlift PR, it's crucial, for the longevity of your spine, to learn how to properly load the hips.

This guy knows how to drop it low.

Take a look at the photo: which one looks safer? If you were going to pick up your dining room table while moving into a new house, what do you think would be the safest and most mechanically optimal way to do so? Which position would allow someone to efficiently deadlift upwards of 500 pounds?

I'm guessing (and hoping) you picked the photo on the left.

The photo on the right will place excessive shear force on your intervertebral disks and prevent you from properly engaging the powerful forces that are the erector spinae, the gluteus maximi and the hamstrings complex.

Look at that hip hinge...

To help clients learn to hinge at the hips, I have them lift up one leg and place a hand in the crease of the hips. Once they've established this placement of the hands, I ask them to keep their hands there and try to bend and squeeze their hand with their hips as they push their butts back towards the wall. This tactile cue allows them to feel how they should load a weighted movement.

You'll know you're hinging at the hips properly when you feel a nice stretch in your hamstrings at the bottom of the movement--this allows us to use that elastic capacity to extend the hips as we stand.

You should lift both a laundry basket and a barbell in the same manner: loading the hips and bracing the core. When used properly, the hip extensors (like the hamstrings and the glutes) can produce an incredible amount of power. When misused, we run the risk of injury and we are limiting the full potential of the posterior chain.

Your glutes are (arguably) the biggest muscles in the body, so why wouldn't you want to take full advantage of them while lifting heavy weight?

If you want to learn to move like Shakira, the first step is to understand how to prime the hips for movement.

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