Soft Tissue Considerations For The Hip

Kyle Young

Most all athletes and coaches in their career will at some time deal with anterior hip pain. Not only are tight hip flexors and quads pulling into the equation, but we must consider posture throughout the day both under the bar and outside the weight room! We do understand that no two hips are created equal and thus no two athletes should probably squat the same. Once we refresh on some anatomy, we will look at an individualized assessment that will hopefully open your eyes to the likely imbalances between the left to right. These imbalances are not only creating havoc upstream and downstream but leaving a fair amount of rotational torque to the pubic synthesis. Once we have reviewed and assessed we can utilize some soft tissue interventions with the Kabuki Strength IASTM tools, to get you and your athletes moving better!

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Course Syllabus

Tight hip flexors and quads will help pull the pelvis into an anterior tilt. Something that stretching the anterior and strengthening the posterior will not alone fix! We must look at how much time is spent in a bad posture, driving, working, sitting, and yes lifting. We may not be able to easily out do the time spent in sub-optimal postures.
· Function of the AT- PT musculature
o Psoas
o Iliacus
o Rectus abdominis
o Quads
o Hamstrings
o Glutes
o Adductors

There is a lot of musculature that will affect the position of the pelvis, and we know looking at hip morphology that not all hips are created equal. Therefore, some people can squat with a close stance, feet pointed straight ahead and hit full range of motion no problem. While others will just crush the soft tissue of the anterior hip and likely run into their hip capsule. This person may need a much wider stance with even feet pointed out.

Even less understood or studied is the active posture and positions the body is held in over time. Yes, this will change with external stressors, age and training demands. The body is NOT likely to hold an equal balance of left to right active ROM and levels of tightness. This is true as most people can attest to for the differences between arms or legs one side to the other. Now hips as ball and socket joints are very similar to the shoulders which are also ball and socket joints. However, shoulders act more independently then legs do. The hips will create rotational torsion on the pelvis leading to misalignments, changing knee and spinal alignments.
· Remember in strength trained athletes our goal is to improve the strength and contractile capabilities of the tissue.
· Understanding the overall tightness of the body as a system including the fascia
system and fascia planes

Now that we've addressed and assessed the difference between the anterior tilt of a left and right hip, hopefully you can see why any strength training and movement - mobility program should not be the same bilaterally, when addressing these issues. If we're looking for optimal human movement the goal is to fall within a more neutral range bilaterally. Other key indicators an assessment without fancy tools.
· developing a good eye for postural alignment
· developing good palpation skills
· rotations and shifts during loaded movement
· feedback from the athlete on overall musculoskeletal tightness left to right

The better the marker or indicator we have as a baseline from our assessment will give us much better results for retesting. However, don’t underestimate the power of positive feedback and performance in the athlete. There is no magic rule for time or repetitions as tissue tolerances of athletes are different. We were looking for noticeable change and bringing the body back to a more neutral range of motion.

Tissue Work:
· Vastus Lateralis
· Glute Min
· Psoas
· Iliacus
· Opposite Side Adductors

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