Low back pain nagging you? Got a trick knee that holds you back? It may surprise you that there’s a simple hip mobility and strength exercise to help both issues – and it involves looking above and below the problem areas – to the hips.
Working the hip rotator muscles is often neglected. And I get it – it’s not as glamorous as bulking the quads or biceps. But utilizing exercises for hip internal and external rotation can decrease pain and increase mobility not just in the hips, but the entire kinetic chain of the body.
Let’s try one simple but effective hip rotation exercise, then we’ll discuss the theory of why it works.
Minding Alignment
Throughout the exercise, focus on maintaining good posture with a slight anterior pelvic tilt. Keep your shoulders and pelvis squared and pointing forward, with your foot and kneecap always pointing in the same direction.
Move slowly so that you can control the movement through the full range of motion. Activate hip internal and external rotation by focusing on rotating your thigh – don’t get distracted by the rotation at your foot.
The Best Hip Mobility and Strength Exercise
To follow along, check out the YouTube video for this hip external and internal rotation exercise.
1) Stand with your feet together and hands on your hips
2) Perform hip external rotation, rotating on your right heel, then your left, so your toes point outwards and your feet move apart. Remember to keep your feet and kneecaps in alignment and generate movement from your thigh.
3) Then perform hip internal rotation, pivoting on the balls of your feet, one foot at a time, so that your heels point farther outwards and your feet continue to move apart.
4) Check your posture, maintaining squared hips and shoulders, slight anterior pelvic tilt,and even weight distribution between your feet.
5) Continue performing controlled hip external and internal rotation, driven from the thighs, pivoting on the heels and balls of the feet, so that your stance gets wider.
6) When you’re at the end of the range of motion you can control, pause, then bend your knees slightly and activate hip internal rotation and external rotation as you pivot on the heels and balls of the feet to move back towards the starting position.
7) Perform two to three reps of this exercise, two to three times a week. Increase your reps weekly as your endurance and control improves
Looking Along the Chain
It’s natural to think that if your knee hurts, there must be something wrong with your knee. But the issue is usually more complex, and misunderstanding this can lead to frustration when trying to rehab a painful area.
The body is an interrelated kinetic chain and often the root cause of pain is dysfunction or improper movement patterns at a totally different area, up or down the chain.
Say you’re a soccer player and need to pivot on the field, but your hip rotation is lacking. You’ll probably end up putting excess rotation force through your knees – the next joint down the chain and one that’s not designed to manage much rotation. This can unfortunately (as many soccer players can attest) lead to painful meniscus and ACL injuries.
What Does the Science Say?
Recent research supports this idea of the kinetic chain – especially when it comes to hip strength and mobility.
One 2023 study measured hip rotation strength following ACL repair. The study found that increased hip external and internal rotation strength at one year post-op was associated with better function and decreased pain five years down the line [1].
This tells us that even if you have surgery to repair a torn ACL, if you don’t also strengthen your hip rotators, you’re going to end up with impaired function and increased knee pain. In other words, you’ve got to address the root cause or even surgery won’t save you.
Another 2023 study found that people with chronic low back pain tend to have generalized hip weakness [2]. This is exactly why our Low Back Pain Solution has so much focus on hip strengthening, not just the back itself or even the core!
You’ve got to look above and below the painful area and take the full body into account when it comes to addressing pain. This idea is central to our approach at Precision Movement and why our programs are so effective.
So how do you get started and determine if weak, limited hip rotation is holding you back or if your issues are stemming from a cause higher up or down the chain?
For one, try this hip mobility and strength exercise, because everyone could benefit. And then answer our simple questionnaire to figure out where to start and which of our powerful programs is best for you.
