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Hip Alignment and Rebalancing Strategies by Scott Adams BHK

Gain insights into hip anatomy, assessment, rebalancing techniques, and corrective exercises to optimize hip alignment. Discover chronic muscle issues, corrective strategies, and movement differences for improved health and performance.

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Hip Alignment and Rebalancing Strategies by Scott Adams BHK

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  1. HIP ALIGNMENT AND REBALANCING STRATEGIES HIP ALIGNMENT AND RE-BALANCING STRATEGIES By: Scott Adams, BHK, MA, ATC, CES

  2. Scott Adams, BHK, MA, ATC, CES • Educational Background • University of Windsor - Bachelors of Human Kinetics (Kinesiology) • University of Nebraska Omaha - Masters in Athletic Training • Corrective Exercise Specialist • Survival Operating Systems – Level I

  3. Scott Adams, BHK, MA, ATC, CES • Career Path • LaSalle Physiotherapy and Rehabilitation Centers • St. Clair College • Accelerated Rehabilitation Centers • Windsor Spitfires Hockey Club (Ontario Hockey League) • Johnstown Chiefs (East Coast Hockey League) • Pittsburgh Penguins (National Hockey League)

  4. HIP ALIGNMENT AND RE-BALANCING STRATEGIES • Topics to Review • Review Hip Anatomy • Assessment of alignment • Un-Balancing of the Hips • Re-Balancing of the Hips Courtesy of www.stonetemplesanctuary.com

  5. ANATOMY REVIEW • Hip Joint • Multi-axial ball and socket synovial joint between the head of the femur and the acetabulum • Fibrous Capsule – capsule incomplete posteriorly • Ligaments – illiofemoral, pubofemoral, ischiofemoral • Intracapsular – ligament of the head of the femur (very weak) • Retinacula

  6. ANATOMY REVIEW Source: www.medical-illustrations.ca

  7. ANATOMY REVIEW

  8. ANATOMY REVIEW • Prime Movers of Flexion • TFL • Pectineus • Sartorius • Gracilis • Illopsoas Courtesy of ImageRepository.net

  9. ANATOMY REVIEW • Prime Movers of Extension • Gluteus Maximus • Hamstrings • Adductor Magnus (posterior region)

  10. ANATOMY REVIEW • Prime Movers of Adduction • Adductor Longus • Adductor Brevis • Adductor Magnus • Gracilis www.medmeshop.com

  11. ANATOMY REVIEW • Prime Movers of Abduction • Gluteus Medius • Gluteus Minimus http://files.myopera.com/sanshan/blog/piriformis.gif

  12. ANATOMY REVIEW • Prime Movers of Inward Rotation • Gluteus Minimus • Tensor Fascia Lata

  13. ANATOMY REVIEW www.aroundhawaii.com • Prime Movers of Outward Rotation • Gluteus Maximus • Piriformis • Obturator Externus • Obterator Internus • Superior Gemellus • Inferior Gemellus • Quadratus Femoris • Gluteus Medius

  14. ANATOMY REVIEW • Reference Points for Rotation • ASIS and PSIS • We are going to use these two reference points to determine the athletes current resting position

  15. ANATOMY REVIEW

  16. CHRONIC CONTRACTORS • Muscles that are constantly contracted • Constant state of fatigue • May be the primary site of a breakdown leading to chronic injury

  17. UNDERACTIVE MUSCLES • Muscles that are “lazy” • They don’t need to work because something is working for them • Compensation patterns formed • Leads to chronic injury

  18. CHEST MUSCLES • Pre and post treatment of releasing the chest muscles • Note: Hip position http://www.hellerworkstructuralintegration.com/assets/images/client_photos.jpg

  19. MOVEMENT DIFFERENCES

  20. MOVEMENT DIFFERENCES

  21. MOVEMENT DIFFERENCES

  22. ASSESSING HIP ORIENTATION • Athlete Supine • Hips and knees bent

  23. ASSESSING HIP ORIENTATION • Perform three bridges

  24. ASSESSING HIP ORIENTATION • Gently return the athlete to a supine position with the legs resting on the table

  25. ASSESSING HIP ORIENTATION • Landmark the ASIS • Compare left vs. right • Note variation in the height of each

  26. ASSESSING HIP ORIENTATION • Have the athlete move into a prone position • Landmark the PSIS • Compare left vs. right

  27. ASSESSING HIP ORIENTATION • Note leg lengths • Gives an insight if an up-shift has occurred • This will not show a true anatomical leg length

  28. ASSESSING HIP ORIENTATION • RESULTS • If ASIS and PSIS are even, the hips are in a balanced position

  29. ASSESSING HIP ORIENTATION • IF ASIS on one side is high, and PSIS on opposite side is high -> we have a rotation of the hips

  30. ASSESSING HIP ORIENTATION • If the ASIS and PSIS are elevated on the same side -> an up-shift has occurred

  31. ASSESSING HIP ORIENTATION • If the PSIS or ASIS on the same side are a different distance away from the midline -> an out-flair or in-flair has occurred

  32. CORRECTING HIP ORIENTATION • Rotation • Break arm method • Up-Shift • Distraction method • Flairs • Abduction contraction

  33. CORRECTING HIP ORIENTATION • Perform corrective strategy • Have patient remain supine, hips and knees bent as in starting position • Perform 3 reps of isometric contractions and different angles (adduction and abduction) • Perform 3 bridges • Return to original position and re-assess in supine

  34. CORRECTING HIP ORIENTATION • Focus on lengthening “chronic contractors” • Massage, myofascial stretching, etc • Awaken “underactive” muscles • Isolated muscle strengthening • Integrate into movements • Squats, lunges, rotational movements • Integrate into sport-specific movements

  35. CORRECTING HIP ORIENTATION • REMEMBER • The role fascia plays on chronic muscles -> the hip flexor may not be the true source of dysfunction -> look up and down the movement chain

  36. THANK YOU

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