Hi. Dr. Cobb back with you.
We are continuing on this little series we’ve been doing looking at hip pain during squatting or lunging.
I’ve done two videos on this so far.
If you haven’t watched those please go back and watch them.
Video 1 we talked about utilizing the vestibular system to facilitate extensor activity.
We’ve talked about problems in hip extensors and external rotators as a big driver of hip pain and knee pain and also back pain while squatting, lunging, doing other exercises or during walking.
In video number 2 we showed you some different loading strategies.
And what we’re going to cover today is probably my favorite kind of graduation exercise if you want to call it that for really beginning to load the gluteus medius, the deep hip rotators on the problematic side.
So I would not recommend that you start with this one.
You want to make sure that your hip is feeling pretty good, that you’re getting out of pain, and you feel like you’re ready to begin doing some strengthening.
This is a very simple-looking exercise, but when done appropriately and correctly, it’s pretty intense.
So as a quick reminder, whenever we’re doing lunge work, let’s say I have a problem on my right hip and we’re trying to use a lunge to help increase activity in the extensors and rotators, we want to make sure that we’re utilizing a specific lunge position, which is more of a forward lean, rather than a traditional upright lunge position.
I want to get a body lean.
I want to keep my heel on the ground and my knee locked.
Because as I move my center of gravity forward, this is going to cause the extensors to become more active.
Once we’re in this position we’re driving the heel down and back and also adding in a small amount of rotation against the ground.
As you do all of that you’ll feel your butt and the deep rotators of the hip, really starting to become active.
Now to make that more intense.
We’re going to use loads in the hands.
I’m using little small five-pound dumbbells.
Depending on your size, your strength level, your conditioning level, you may need to use nothing or a 1 pound dumbbell or a can all the way up to something that’s quite heavy.
I just typically find these are easy to demo with and for a lot of people, this is the most weight, I will have them use.
So what we’re going to do is we’re going to get into that lunge position.
We’ll drive forward.
Again heel to the ground, knee locked, heel pushing back, foot slightly turning out.
Mentally we’re not letting the foot slide. We’re creating that external rotation force.
We’re going to hold the dumbbells in front of us.
We’re going to drive them out and then we’re going to rotate to the side. When I rotate toward that side.
I’m going to be causing a lot of additional stabilization work to occur in that hip.
So, we’re combining an isometric of the hip with a rotation and then that anterior load. You will feel this through your shoulders.
You’ll feel it through your back, you’ll feel it through your hip.
Normally when I give this exercise to people, I have them do somewhere between five and ten reps.
Relax, put the dumbbells down, walk for a minute, and then squat, lunge, or in some other way, test the problematic hip to see how it’s responding.
If it has responded well, you want to aim for maybe three to five sets of five to ten reps with the dumbbells.
Again, this is not a kind of true strength training.
We’re basically utilizing this for a lot of intense activation.
So you can continue to take the reps up somewhat high, but just make sure that you’re giving yourself appropriate rest, and you’re moving in between your sets, to make sure that your brain is accepting the changes that you’re asking it to make.
So as a reminder, we have our lunge position.
We have our isometric, combined with a rotation toward the problematic side and we’re using those dumbbells to add some additional leverage to make everything work a little bit harder.
So like I said, this is a graduation exercise for a lot of our hip clients.
Give this a shot. Let us know how it works for you.