Ounceof Prevention

Hip Training Programs for Endurance Athletes

Jason Brumitt, MSPT, SCS, ATC, CSCS,*D

need to be able to recognize when an the test, place a chair or stool behind trengthening exercises for the athlete is functionally weak in his or her yourself. Stand on a single leg with the hips should be performed in all hip musculature and correct this with opposite leg o the ground. To perform sport specic training programs. the test, squat toward the chair or stool specic exercise strategies. Sports medicine researchers have begun (which is set at a height allowing a knee to recognize that weakness in the hips exion angle of 45 degrees) (gure 1). may contribute to hip injuries or other Identifying Functional Hip When observing either the single leg lower extremity injuries (1,2). Despite Weakness squat or a lunge, pay close attention the signicant role that the hips play Clinically, I have observed weakness in to the lower extremity alignment. One in lower extremity biomechanics and the hip with both the use of manual indicator of hip weakness is the inability power generation, many training pro- and functional muscle testing. While a to maintain the knee in alignment with grams either fail to adequately train the manual muscle test is a test performed the hip or foot when squatting or lunghips or omit core training altogether. by sports health professionals, anyone ing (gure 2). Sports medicine researchers have begun can observe functional hip weakness to recognize that weakness in the hips watching an athlete perform a single leg Training the Hips may contribute to hip injuries or other squat or lunge. If you demonstrate functional hip weaklower extremity injuries (1,2). In particular, endurance athletes, especially A single leg squat can help identify hip ness, begin with the phase I training female cross-country runners are at risk abductor weakness in athletes, especial program (table 2). Perform each exercise for lower extremity injuries (4,5). The female athletes (6). Prior to performing for two to three sets of 15 to 20 repetiaforementioned authors also identied that cross-country athletes may experi- Table 1.Selected Muscles of the Hip (3) ence a recurrence of an injury during the Muscle Functions on Hip Joint same season (4,5). Selected muscles that Gluteus maximus Extends thigh, assists external rotation make up the hip are listed in table 1.
Gluteus medius Abducts and internally rotates thigh

So what can be done to decrease a crosscountry athletes risk of injury? Gone should be the days in which an athletes complete lower extremity routine consists only of the leg press, the knee extension machine, and a hamstring curl machine. Instead, coaches and athletes

Gluteus minimus Piriformis Obturator internus Gemelli, superior & inferior Quadratus femoris Obturator externus

Abducts and internally rotates thigh Externally rotates extended thigh, abducts flexed thigh

Externally rotates thigh Externally rotates thigh

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tions. Once able to demonstrate optimal hip-knee-foot alignment with the single leg squat and a lunge, advance to the phase II exercises.

Hip Training Programs for Endurance Athletes

Conclusion

Isolating weak hip muscles in phase I should help to improve any faulty lower extremity biomechanics. Failing to correct for weakness in the hip may Side lying hip abduction (figure 3) minimize the eectiveness the phase II 5. Rauh MJ, Koepsell TD, Rivara While lying on one side, raise the top leg exercises. The phase II exercises (squats, FP, Margherita AJ, Rice SG. (2006). six to eight inches. Often this exercise is lunges) should be performed as part of a Epidemiology of musculoskeletal injuries performed incorrectly with a substitu- comprehensive lower extremity strength among high school cross-country runtion pattern created by stronger anterior training program. ners. American Journal of Epidemiology, hip muscles. To correct for any form 163(2): 151 159. deviations, lie on the ground with your References back against a wall. Now when you raise 1. Fredericson M, Cookingham CL, 6. Willson JD, Ireland ML, Davis I. your leg maintain your heel against the Chaudhari AM, Dowdell BC, Oestreicher (2006). Core strength and lower extremwall. As able, add ankle weights to furN, Sahrmann SA. (2000). Hip abductor ity alignment during single leg squats. ther develop strength. weakness in distance runners with ilio- Medicine & Science in Sports & Exercise, tibial band syndrome. Clinical Journal 38(5): 945 952. Prone hip extension exercise Sport Medicine,10:169 175. About the Author Assume a prone position and bend one leg to 90 degrees of exion. Lift the 2. Niemuth PE, Johnson RJ, Myers MJ, Jason Brumitt is a board-certied sports thigh o of the surface two to four Thieman TJ. (2005). Hip muscle weak- physical therapist practicing at Willamette inches, lifting from your hip and avoid- ness and overuse injuries in recreational Falls Hospital in Oregon City, OR. His ing spine extension. runners. (2005) Clinical Journal Sport clientele include both orthopedic and sports injury patients. He also serves as adjunct Medicine, 15(1):14 21. faculty for Pacic Universitys school of Single leg balance with one arm 3. Olson TR. (1996). A.D.A.M Student physical therapy program. To contact the row (figure 4) While balancing on one leg, perform Atlas of Anatomy. Williams & Wilkins: author email him at jbrumitt72@hotmail. a one-arm row using a cable or band Baltimore, MD. com. on the opposite side. The key to this exercise is to maintain optimal hip-kneeTable 2. Hip Strengthening Program ankle alignment as you perform the row Phase I against the resistance provide by either a Perform these exercises for 2 3 sets of 15 to 20 repetitions, 2 days a week: pulley or exercise band. Side bridge (figure 5) Assume the position shown with only the forearm and feet in contact with the ground. Perform repetitions on each side. In phase II of this program, perform the side bridge position while abduction the top leg o the bottom leg (gure 6).
Side lying hip abduction Prone hip extension Single leg balance with shoulder row

4. Rauh MJ, Margherita AJ, Rice SG, Koepsell TD, Rivara FP. (2000). High school cross country running injuries: a longitudinal study. Clinical Journal Sport Medicine, 10: 110 116.

Perform this exercise for 2 3 sets of 10second holds each side, 2 days a week Phase II Perform these exercises for 2 3 sets of 10 repetitions, 2 days a week Squats Lunges Perform 1 2 sets of 10 15 repetitions, 2 days a week Side bridge with straight leg raise

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Figure 1. Single leg squat test

Hip Training Programs for Endurance Athletes

Figure 2. Poor lower extremity biomechanics observed during a lunge

Figure 4. Single leg balance with one arm row

Figure 3. Side lying hip abduction

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Figure 5. Side bridge

Hip Training Programs for Endurance Athletes

Figure 6. Side bridge with hip abduction

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