Hip Mobility: Evaluation

by Dr. Nathan Hinkeldey on July 10, 2014

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If you have been following our selections, last week’s post explained the impact that the thoracic spine or midback can have on the squat. Today, we will continue down the chain and assess the hip. Many authorities in the world of pain suggest that anyone with low back pain has a hip issue and anyone with a hip issue has low back pain. For this reason understanding and achieving proper hip mobility.

Today, we will start by looking at a couple of hip screens. The purpose of a screen is to be able to categorize the lack of movement. The following screens will illustrate an easy way to assess hip muscle length. An imbalance in muscle length will result in lack of movement, altered movement, and likely pain.

The first screen that we will look at is called the Modified Thomas test.

This test will allow us to evaluate the psoas, IT Band, and quadriceps muscles. In the video, you can see that the patient’s left leg does not reach 90 degrees of knee bend. This suggests tight quadriceps tissue. You do see that the left thigh does continue to contact the table. This leads you to believe that the psoas muscle has appropriate length. If the foot turns out, you would also begin to think that the IT band could be tight as well.

IMG_3753If your patient or friend looks like the picture above, then the muscle lengths are appropriate and little therapy is needed.

IMG_3754This is an example of someone who has too much tension in the left quadriceps. You can also see that the left foot turns out which may also suggest left IT Band tightness.

IMG_3755This picture illustrates an example of someone who would have a tight psoas.

Now that the anterior chain hip muscles have been evaluated, we will take a look at the posterior musculature. Specifically, the hip external rotators like the piriformis. The latter muscle is often involved in cases of sciatica, hip pain, and low back pain.

Hibb’s Test:

When evaluating this screen, it should be noted that the average internal rotation was noted to be 45 degrees. You can see from this video that the patient does have almost 45 degrees of hip internal rotation before the opposite hip lifts from the table.

The reason why these screens are important is so that you don’t waste your time doing one hundred different stretches. Most people have defined areas of immobility and targeting and spending time on those areas is much more productive then doing one hundred different stretches and hoping something works.

Disclaimer: Remember that this series should only serve as an adjunct to your healthcare professionals examination. We are are not your doctors and have not examined you; therefore, the above should not serve as medical advice. Please do not hold us liable for taking our advice as we have just advised you not to.

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