Sore lower back? Is your internal hip rotation limited?

I hear you asking what's hip internal rotation and how do I know if it's limited? 

Firstly hip internal rotation is when we rotate our femure (thigh bone) inwards towards our pelvis and our foot moves away from the body. A normal range is considered to be 40-45 degrees. 

Prone Hip internal rotation (about 40 degrees)  

Prone Hip internal rotation (about 40 degrees)  

Having poor Internal rotation is a curse  because it has been shown to be a  strong indicator to lower back pain, knee injury, hip impingement problems and it can hugely impare your sports performance. 

The people that are most in need for good hip internal rotation are sports people who require rotation in the transverse plane. So golfers, tennis players and kick boxers ext... 

Why does it cause my back to get sore? Your spine may compensate for the lack of rotation around the hip. Your spine tries to take up the slack, it could rotate, extend or even flex more. If these poor mechanics are repeated over and over or under high load you will probably get injured.  

Now what can you do if you have a stiff hip?  

First Its important to know why you can't turn your hip enough. Is it: 

  1. weakness of the hip internal rotator muscles?
  2. are the external rotators to tight?
  3. is your joint capsul restricted?

You will need to see a good sports therapist or physio to find this out but its probably a combimation of all 3.

I have described some of my most common sugestions for self help exercises below, if you suspect you are strugling with hip internal rotation I would start with active strengthening exercises, working the internal rotators (tensa facia late, some fibers of gluteus medius and minimus).

Next we'd need to do some hip mobilisation work. I have 2 mobilisation that I get most patients to do. The 'laying knee to knee mobilsation/stretch' and the 'band assisted hip internal rotation mobilisation' both are shown in the pictures below.  

Laying knee to knee stretch.  

Laying knee to knee stretch.  

Band assisted hip internal rotation mobilisation.  

Band assisted hip internal rotation mobilisation.  

We should now work on the soft tissue. I like to use a foam roller and a ball (tennis ball for beginers and lacrose ball for more advanced people). My favorite movements are shown below.  

Foam roller on external rotators of the hip. Slightly stretching the hip adds a little extra to this.  

Foam roller on external rotators of the hip. Slightly stretching the hip adds a little extra to this.  

Lacrose ball pressure on external rotators.  

Lacrose ball pressure on external rotators.  

Finaly I like to reinforce the movement quality so if your a golfer do some practice swings, a thai boxer throw some round house kick or a weightlifter could do some body weight squats. Each one should be concentrating on hip internal rotation and limit any compensatory movements. 

Please remember that this is just a general blog post and everyone will have slightly different needs. 

If you need some more advise or want to have a more detailed assesment of your hip visit www.movefreelysolutions.co.uk or call 0131 557 4404.