How To Do Hip Abductor Strengthening

Hip Abductor Strengthening

The topic of ‘hips’ involves a range of unclear terms in the realm of athletic performance. Terms like tight hips, loose hips, strong hips, and weak hips are commonly used, not just in sports. But do everyday athletes or non-athletes truly understand what these terms mean? This can create a significant problem because if someone doesn’t comprehend an issue, they won’t be motivated to address it.

It’s important to note that when people talk about your hips, they are not referring to the actual bones unless you require a hip replacement. Instead, they are likely discussing groups of muscles that contribute to movement in and around the hip joint. These muscles, totalling approximately 17, are often categorized into larger groups based on their functions.

• Extensors – pull your leg back behind you
• Rotators – cause both inward (internal, pigeon-toed) and outward (external, duck or ballerina stance) rotation of your leg
• Flexors – pull your leg forward in front of you or lift it off the ground
• Adductors – squeeze your legs together or cross your leg over the midline to the other side
• Abductors – pull or lift your leg out to the side away from the middle of your body (your midline)

Research has indicated that even small enhancements in hip muscle strength can yield significant advancements in sprinting and running capabilities. The fundamental basis for optimal running performance lies in the hips. The ability to maintain a strong and athletic posture while moving in various directions, be it forwards, backwards, side-to-side, or rotating, serves as an indicator of robust hips.

The muscles encompassing the hip region not only play a crucial role in performance but also contribute to injury prevention. Studies demonstrate that athletes with stronger hips not only exhibit improved performance but also experience fewer injuries to the lower back and lower limbs. Weak hips restrict the complete range of motion, resulting in muscular imbalances.

Consequently, this can lead to flawed mechanics, inefficient movement patterns, or even strain on opposing muscles, thereby increasing the likelihood of injury. Ultimately, weak hips can have a domino effect on overall mechanics, substantially heightening the risk of sustaining injuries.

WHY DO HIPS GET WEAK?

Weak hips are becoming a widespread issue due to our sedentary lifestyles. Whether it’s sitting for long hours at a desk job or engaging in activities like studying, gaming, driving, or using public transport, most people find themselves in a seated position with their hip flexors shortened and hip extensors lengthened. This prolonged sitting can result in poor posture, muscle imbalances, and overall weakness. One specific area of weakness that is common is the hip abductor muscles, which can have negative effects on the lower limbs and back.

These muscles play a crucial role in everyday movements such as stepping to the side, getting out of bed, or getting out of a car. They not only contribute to standing, walking, and leg rotation but also help in stabilizing the pelvis during activities like climbing stairs or running. When these muscles are weak, it can lead to pain and hinder proper movement. The hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fascia latae.

WHAT CAUSES WEAK HIP ABDUCTORS?

As previously mentioned, a sedentary lifestyle can contribute to weakness in the muscles surrounding the hip. It is unlikely that our ancestors, who were actively hunting and gathering on the African plains 500 years ago, experienced complaints about weak hip abductors. These muscles, closely associated with the core muscles, play a crucial role in maintaining balance and supporting athletic activities. Prolonged periods of sitting during the day often lead to the weakening of the gluteal muscles, including the hip abductors. Inactivity can essentially deactivate these muscles, making them more difficult to engage during exercise.

Consequently, the body may compensate by utilizing other muscles that are not intended for these tasks, which can result in discomfort, diminished performance, and difficulty with certain movements. Weakness in the hip abductors can contribute to overuse injuries such as patellofemoral pain syndrome (pain behind the kneecap) and iliotibial band syndrome (ITBS). The relationship between hip abduction weakness and knee problems is not clearly understood, as findings on this matter are mixed. However, strengthening these muscles generally yields benefits in terms of reducing pain and improving overall function. In many cases, it becomes a question of causality, particularly among athletes or physically active individuals.

Pain or previous injuries in the hip, knee, or even foot can lead to changes in an individual’s gait over time. Consequently, this alters the recruitment and usage of muscles, potentially causing weakness in specific groups. Conversely, underlying weakness in the hip abductor muscles can bring about changes in a person’s biomechanics and joint alignment, leading to pain, joint wear and tear, and potentially causing osteoarthritis in the hip or knee. Playing sports that involve frequent jumping can often result in hip tendonitis, tendinopathy, or abductor tears due to overuse.

This can occur as an acute injury, such as in the case of a weekend warrior, or as a chronic overuse condition. Tendonitis in one of the abductor’s muscles can also arise when nearby supporting muscles are either too weak or too strong, creating a muscle imbalance. Tendon overuse can cause micro-tears in the tendon or muscle itself. Knee valgus, characterized by inward knee collapse and a knock-kneed appearance, is most commonly observed in young women, older adults, or individuals with muscle imbalances or improper exercise form. Hip weakness is associated with knee valgus, and studies indicate that hip abduction exercises can help improve this condition.

The gluteus medius muscle is prone to the development of myofascial pain syndrome, which often arises from repetitive microtrauma caused by activities like running or excessive use of exercise equipment, as well as other repetitive movements that involve hip abduction. Trigger points, which are painful knots within the muscle, can refer to pain in the hip, leg, groin area, and buttocks. This referred pain often leads to misdiagnosis or attributions to other organ systems, resulting in extensive evaluations and ineffective treatment.

Additionally, weak abductor muscles may be caused by other medical factors. Knee valgus, characterized by inward knee collapse and a knock-kneed appearance, is most commonly observed in young women, older adults, or individuals with muscle imbalances or improper exercise form. Hip weakness is associated with knee valgus, and studies indicate that hip abduction exercises can help improve this condition. The gluteus medius muscle is prone to the development of myofascial pain syndrome, which often arises from repetitive microtrauma caused by activities like running or excessive use of exercise equipment, as well as other repetitive movements that involve hip abduction.

Trigger points, which are painful knots within the muscle, can refer to pain in the hip, leg, groin area, and buttocks. This referred pain often leads to misdiagnosis or attributions to other organ systems, resulting in extensive evaluations and ineffective treatment. Additionally, weak abductor muscles may be caused by other medical factors.

• nerve injury or nerve entrapment;
• dysplasia of the hip, congenital dislocation of the hip, congenital coxa vara or coxa valga, slipped capital femoral epiphysis (where the muscle is normal but it is at a mechanical disadvantage);
• following hip replacement surgery, or femoral fixation (after femur or neck femur fracture); and
• muscular dystrophy, cerebral palsy, stroke or hemiplegia.

HOW DO YOU KNOW IF YOU HAVE WEAK HIP ABDUCTORS?

If any of the mentioned situations or scenarios have triggered a thought (even a small ‘aha’ moment), it is recommended to seek assessment from a nearby physiotherapist. A straightforward evaluation to check for the Trendelenburg sign can be conducted in the consultation room. Additional, more complex tests may be performed to assess muscle weakness, although the majority of patients would not require extensive investigations.

MANAGEMENT

Not only can hip abduction exercises help you get a tight and toned backside, but they can also help to prevent and treat pain in the hips and knees.

How to fix weak hip abductors and hip pain?

1. Hip Abductor Strengthening exercises

Clearly, the problem is muscle weakness and therefore it’s a no-brainer that you need to do hip abductor strengthening exercises to restore normal function. Your physical therapist can prescribe these for you based on your needs. As mentioned, hip abductor strengthening training has proven to reduce pain and improve function, as well as improve athletic performance!

2. Sports Massage

Sports massage, myofascial release, trigger point therapy, deep tissue massage, dry needling, and fascial work are effective in alleviating tight and painful hip abductors. When a muscle is weak, it tends to fatigue quickly and can develop spasms, resulting in the presence of taut and painful bands or trigger points in the muscle. Manual therapy applied to the muscle and surrounding areas can provide pain relief and enhance mobility.

3. Mobility

Mobility refers to the capacity to engage in active movement across a range of motion while maintaining stability. While some young athletes may possess significant flexibility, they may struggle with controlling their bodies throughout that range of motion. Conversely, due to our sedentary lifestyle, many individuals experience tightness and stiffness in their hip joints, resulting in limited mobility in their lower back and legs. To address this, a physical therapist can prescribe targeted stretching exercises aimed at releasing tight structures such as hip flexors and rotator muscles.

4. Be More Active

Do not underestimate the potential of a quality stroll. Engaging in a ‘pure’ walk, without any running, enables your body to make subtle adjustments that fortify your feet, knees, and hips. Opting for uphill walks further benefits your hip muscles, therefore, prioritize using stairs whenever feasible.

5. Look at the Cause and Treat It

Find the cause of the problem and also ensure that it is treated:

• The weekend warrior, who subjects his or her body to unaccustomed physical activity – instigates better planning and a progressive training programme.
• Poor posture while sitting at work, computer or watching TV, etc.
• Poor recovery from past injury or surgery – ensure full recovery by completing your rehabilitation programme.
• Other predisposing factors may include poor nutritional status, poor sleep quality or coexisting psychological or behavioural abnormalities, including chronic stress and depression. The gluteus medius muscle seems to be particularly susceptible to stress-induced myofascial pain syndrome.
• Foot orthotics or biomechanics – how you use your feet and your foot posture affects your knee and hip alignment and therefore muscle recruitment.

THE TAKEAWAY

Hip abduction exercises provide numerous advantages. They contribute to the reinforcement of crucial muscles essential for stabilizing the hip and pelvis, thereby reducing the risk of injuries ranging from the lower back to the foot.

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