Every year, approximately 450,000 hip replacements are performed in the United States (1). Similarly, there are around 500,000 spinal disc surgeries annually. Notably, about 80% of patients experience discomfort in their spine post-surgery, and 20% will continue to experience pain.(2)
If you want to avoid being part of these statistics, this blog is for you!
In this blog I will outline some of the best exercises to help your hips, pelvis, and spine move better, feel stronger, and live longer.
The Hips
What are the hips? The term "hip" is commonly used but does not refer to a specific bone or joint. It generally describes the lateral side of our upper femur and pelvis. For this blog, we will specifically focus on the hip joint, where the head of the femur (the thigh bone) meets the socket of the pelvis (the acetabulum).
In the pictures provided, notice that the hip joint is shaped as a ball-and-socket joint. This design grants the hip joint a large range of motion and allows for multiplanar movement (movement in more than one plane).
ANTERIOR VIEW OF HIP JOINTS
POSTERIOR VIEW OF RIGHT FEMUR. FEMORAL HEAD CIRCLED
ANTERIOR VIEW OF RIGHT FEMUR. FEMORAL HEAD CIRCLED
RIGHT SIDE PELVIC ACETABULUM (SOCKET)
POSTERIOR/LATERAL VIEW OF THE LEFT HIP JOINT
To prevent joint degradation and maintain joint health, it is crucial to restore the joint's innate ability to move freely. Training the hip to move effectively in multiple planes is essential.
Exercise 1: Seated Hip Internal Rotation
The ability to perform internal rotation is crucial for hip health. This is because the tissues that control hip movement in this direction are deep tissues (meaning close to the bone). If these tissues become restricted and fibrous, they will create less joint space leading to things like arthritis and bursitis. On top of the inflammation that occurs, no matter the strength of the superficial tissues (ie glutes, adductors, Hip flexors) there will not be enough space in the joint capsule to move the bone. We must work from deep to superficial when prioritizing hip joint exercises. It is this loss of joint space and all of its negative side effects that can lead to hip replacement surgeries.
Check out the coaching video here: https://youtu.be/TFVqwuF4o5w?si=8Gs5V4JLx0GQt-8r
When performing this exercise, it is normal to experience some cramping in the hip initially. Think about squeezing a pillow between your legs and moving slowly. Keep tension in the glutes, inner thighs, and the hip pocket area. Over time, the cramping should subside.
Exercise 2: Seated Pike to Straddle Hover
Once you have started strengthening and mobilizing the deep tissues of the hip you can begin to strengthen and mobilize more superficial tissues. The seated pike to straddle hover strengthens various superficial tissues, including the hip flexors and hip ab/adductors. The abductors move your leg laterally, while adductors move it medially.
Check out the coaching video here: https://youtu.be/V9FObJjfmeM?si=EYpCtu87cwwb5fBO
If sitting on the floor is a difficult position for you, sit in a chair and straighten your knee so that just your heel is on the floor and your toes point to the ceiling. This setup makes the hover more manageable. While performing this exercise, be sure to keep your knee straight by maintaining tension in your quadriceps. This will demand more work from the hip tissues, which is our goal.
The Pelvis
Understanding the shape of the pelvis is essential before figuring out how and why to train it. Notice three things about the pelvis from the pictures provided:
1. It is bucket-shaped, with a rim around a hollow center. The posterior part is the sacrum (technically part of your spine that consists f fused vertebrea), the sides are the ilium, the bottom is the ischium (commonly referred to as the sit bones) and the front is the pubic bones.
2. It comprises six bones (three on each side), and there is some movement between these bones, specifically at the pubic symphysis and the SI joint where the sacrum and ilium connect.
3. The pelvic floor is a set of tissues at the bottom of the pelvic bucket. These muscles help control urine and feces but also play a crucial role in the mobility and stability of the pelvis and spine. Activating the pelvic floor muscles contracts them, bringing the SI joint and pubic symphysis closer and tighter, increasing core strength.
TOP VIEW OF PELVIC LOOKING DOWNWARD INTO THE PELVIC FLOOR SPACE (FEMUR & LUMBARS REMOVED)
ANTERIOR VIEW OF PELVIS WITH SACRUM
TOP VIEW OF PELVIC LOOKING DOWNWARD INTO THE PELVIC FLOOR SPACE (WITH SOFT TISSUE PRESENT)-MALE
TOP VIEW OF PELVIC LOOKING DOWNWARD INTO THE PELVIC FLOOR SPACE (WITH SOFT TISSUE PRESENT)-FEMALE
ANTERIOR VIEW OF PELVIS WITH SACRUM REMOVED
POSTERIOR VIEW OF PELVIS WITH SACRUM REMOVED
ANTERIOR VIEW OF PELVIS, SPINE, AND HIPS
Exercise 3: Activating the Pelvic Floor Muscles
This video is a great introduction in learning how to activate some of your pelvic floor muscles. The video focuses on the muscles used to hold back the need to urinate. While these are not the only pelvic floor muscles, they are a great starting point for learning to control the width of your pelvis.
Check out the coaching video here: https://youtu.be/VpoozsFsPBo?si=8kAfkodyodqvZIWJ
The Spine
The spine is one of the most important skeletal structures in the body. It provides a wide range of motion for our torso, and its stability allows for extensive limb movement. In the pictures below it is important to note:
The way the spine curves. A neutral spine is not a straight line but rather has multiple curves that balance themselves out.
Each bone connects to the bone above and below it allowing for movement of individual vertebra.
ANTERIOR VIEW
POSTERIOR VIEW
LATERAL VIEW
Exercise 4: Floor Cog
The purpose of this exercise is to increase awareness of how positioning in one part of the spine is reliant on another part. Altering one part of the spine (through injury, rehabilitation, strengthening, or increasing flexibility) will cause other parts to adapt. This is the reason that posture is so difficult to consciously change but also why our posture changes with age.
This exercise also helps restore ideal biomechanical movement of the spine in the sagittal plane. Our daily movement patterns, influenced mostly by the environment, can change how the spine moves and absorbs and transmits force.
Check out the coaching video here: https://youtu.be/JsEPQ3xhDn0?si=HmOdXgA2PniYRXHz
If you cannot get down to the floor, try the seated sagittal plane cog exercise here: https://youtu.be/O1MEtpy3_es?si=YX1E6PwAN7DUl74P
Exercise 5: Floor Peel
This exercise is similar to a glute bridge but differs in intention and performance. The spinal column comprises multiple bones with multiple joints (95 joints to be exact), indicating that it can and should move. The floor peel helps bring awareness to how different vertebrae move in relation to each other while using the floor as a helpful feedback tool.
Check out the coaching video here: https://youtu.be/mkBOvm-0vSo?si=fb1O2hjuKFgAigbW
Conclusion
The hips, pelvis, and spine are complex structures. There are numerous ways to train them to ensure they function efficiently, helping you move better, feel stronger, and live longer. The exercises discussed in this blog are great starting points that you can do at home. However, they may not be suitable for everyone. If you experience any pain, discontinue the movements and contact us to discuss your specific needs and limitations, as every body is different.
Ready to take control of your mobility and strength? Schedule your No-Sweat Intro Call today! Our expert team is here to help you understand your unique needs and guide you towards a healthier, more active life. Don't wait – take the first step to prevent joint issues and enhance your overall well-being. Book your call now and start your journey to a stronger, pain-free you!
The Triad Team