Hip Tightness: Difficulty internally or externally rotating hips

Muscle Groups Involved:

Hip Abductors: Tensor Facsia Latae, Gluteus Minimus, Glutues Medius

Hip External Rotators: Glutues Maximus, Piriformis,

• External rotators of the hip control deceleration of internal rotation of the femur during
the heel strike of the gait cycle.

Muscle Imbalances:

Tight: low back, hamstrings, illiotibial band, hip flexors, adductors, piriformis, psoas

Weak: Gluteus maximus, gluteus medius, gluteus minimus

Possible Indicators:

- Difficulty internally or externally rotating hips during step ups

- Forward leaning posture

- Increased forward lean when squatting, heels coming off ground

- Tightness in hamstrings, low back, hip flexors, etc

- Rotational movement of the knee when performing a single leg mini-squat (20 degrees)

- Shifting of trunk when performing a single leg mini-squat (20 degrees)

- Knees caving in when squatting

- Foot (lead leg) turning in when performing forward reaches

- Trail leg caving in (moving towards mid-line) when performing forward reaches

- Instability when performing forward reaches or lunges

- Instability when performing step up’s to single leg stabilization

- Foot turning inward during gait cycle

- Flat foot or lack of arch showing abnormal wear on shoes or calluses on feet
Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Quadraped Hip Mobility (Fire Hydrants) Over/Under Drills

Hurdle Exercises Reverse Lunge w/ Twist
Squat to Stand

Motor Control Exercises:

Scorpions Mini Band Side Steps

Mini Band Monster Walks Elevated Step Single Leg Reaches
Elevated Step Single Leg Squats Floor Bridges
SB Hip Bridges Quadraped (Birddog’s)
Single Leg Cone Reaches Reverse Hyperextensions
Bodyweight Squats (90 degree) 2x4 Squats
Split Squats MB Forward Reaches
Bulgarian Squats Box Step Up’s
Box Step Up’s w/ Single Leg Stabilization Box Step Up’s w/ External Rotation
Box Step Up’s w/ Internal Rotation Single Leg Squat variations

Strength Training Exercises

Squats Lunge (static, dynamic, walking, 6” box)
Bulgarian Squats Glute/Ham Raise
Box Step Up’s 1 Leg Romanian Deadlifts
Cable Pull Throughs

Static Stretching:

Kneeling Hip Flexor Stretches Bulgarian Hip Flexor Stretches

90/90 Seated Hip Flexor Stretches Seated Groin Stretch
Lateral Step w/ Forearm to Foot Stretch Standing Adductor Stretch
Lying Tensor Fascia Latae Stretch Standing Hamstring Stretch (foot raised)

Self Myofascial Release:

Foam Roller Stretch (Iliopsoas) Foam Roller Stretch (Hamstrings)

Foam Roller Stretch (IT Band) Foam Roller Stretch (Calves)
Foam Roller Stretch (Low Back)
Anterior Pelvic Tilt: “Hips Pushed Back”

Muscle Imbalances:

Tight: lumbar erectors, hamstrings, hip flexors, adductors, quadriceps, psoas

Weak: Gluteus maximus, gluteus medius, gluteus minimus, transverse abdominis, internal
obliques

Possible Indicators:

- Short depth on squat

- Gap between low back and floor when lying on their back (rounded arch)

- Increased forward lean when squatting, heels coming off ground

- Doorway test with heels and head against door, look for significant gap between low back
and doorway. Enough room to stick your entire arm through without touching.

- Low back sags when attempting to do planks

- Appearance of a “sway back” when standing

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Walking Toe Touches Walking Reaches

Squat to Stand Walking Knee To Chest Stretch
Walking Lunge w/ Overhead Reach Lateral Lunge
Drop Squat

Motor Control Exercises:

Scorpions Reverse Scorpions

Mini Band Monster Walks Elevated Step Single Leg Reaches
Elevated Step Single Leg Squats Floor Bridges
SB Hip Bridges Quadraped (Birddog’s)
Single Leg Cone Reaches Hyperextensions
Bodyweight Squats (90 degree) 2x4 Squats
Split Squats MB Forward Reaches
Bulgarian Squats Box Step Up’s
Box Step Up’s w/ Single Leg Stabilization Box Step Up’s w/ External Rotation
Box Step Up’s w/ Internal Rotation Single Leg Squat variations
Band Glute/Ham Kickbacks Mini Band Side Steps
Pelvic Tilts Pelvic Figure Eights On SB
Facing Wall Squats Supine Vertical Leg Raises

Strength Training Exercises

Squats Lunge (static, dynamic, walking, 6” box)
Bulgarian Squats Glute/Ham Raise
Box Step Up’s 1 Leg Romanian Deadlifts
Cable Pull Throughs Deadlifts

Static Stretching:

Kneeling Hip Flexor Stretches Bulgarian Hip Flexor Stretches

90/90 Seated Hip Flexor Stretches Seated Groin Stretch
Lateral Step w/ Forearm to Foot Stretch Standing Adductor Stretch
Standing Hamstring Stretch (foot raised) SB Psoas Stretch
Prone Butterfly Stretch Sumo Adductor Stretch
Supine V Legs Split Against Wall Stretch

Self Myofascial Release:

Foam Roller Stretch (Psoas) Foam Roller Stretch (Hamstrings)
Foam Roller Stretch (Hip Flexors) Foam Roller Stretch (Lumbar Erectors)
Foam Roller Stretch (Quadriceps) Foam Roller Stretch (Adductors)
Posterior Pelvic Tilt: “Hips Pushed Forward”

Muscle Imbalances:

Tight: hamstrings, glutes, lower abdominals

Weak: quadriceps, illiopsoas, lumbar erectors

Possible Indicators:

- “belt buckle up” from standing position (you could read everything perfectly)

- leaning back when walking

- history of repetitive hamstring pulls

- hips pushed way forward from a standing position

- clients complains of significant tightness in low back

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Walking Toe Touches Walking Reaches

Squat to Stand Walking Knee To Chest Stretch
Walking Lunge w/ Overhead Reach Lateral Lunge
Drop Squat

Motor Control Exercises:

Scorpions Reverse Scorpions

Mini Band Monster Walks Elevated Step Single Leg Reaches
Elevated Step Single Leg Squats Floor Bridges
SB Hip Bridges Quadraped (Birddog’s)
Single Leg Cone Reaches Hyperextensions
Bodyweight Squats (90 degree) 2x4 Squats
Split Squats MB Forward Reaches
Bulgarian Squats Box Step Up’s
Box Step Up’s w/ Single Leg Stabilization Box Step Up’s w/ External Rotation
Box Step Up’s w/ Internal Rotation Single Leg Squat variations
Band Glute/Ham Kickbacks Mini Band Side Steps
Pelvic Tilts Pelvic Figure Eights On SB
Facing Wall Squats Supine Vertical Leg Raises

Strength Training Exercises

Squats Lunge (static, dynamic, walking, 6” box)
Bulgarian Squats Glute/Ham Raise
Box Step Up’s 1 Leg Romanian Deadlifts
Cable Pull Throughs Deadlifts

Static Stretching:

90/90 Stretches for Glutes

Standing Hamstring Stretch (foot raised) Kneeling Abdominal Stretch w/ Reach

Self Myofascial Release:

Foam Roller Stretch (Psoas) Foam Roller Stretch (Hamstrings)
Foam Roller Stretch (Glutes)
Internal Rotation At Femur: “Feet Turning In, Knock Knees”

Muscle Imbalances:

Tight: lumbar erectors, hamstrings, hip flexors, illiotibial band, adductors, quadriceps, psoas

Weak: gluteus maximus, gluteus medius, gluteus minimus, transverse abdominis, internal
obliques

Possible Indicators:

- Feet turning in during gait

- Shoes showing excessive wear on inside area of the sole

- Calluses developing right underneath the big toe.

- History of knee pain (patella femoral syndrome, illiotibial band syndrome) “runner’s knee”

- Toes pointed in on lead foot with lateral lunges

- Tightness or pain in the hips when stretching

- Foot on lead leg turning in when doing forward reaches, trail leg drops inward towards
midline of the body.

- Look for “flat feet” with a lack of an arch being a primary culprit to patella femoral
syndrome. If found refer to a foot specialist for assistance with arch supports.

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Walking Toe Touches Walking Reaches

Squat to Stand Walking Knee To Chest Stretch
Walking Lunge w/ Overhead Reach Lateral Lunge
Drop Squat
Motor Control Exercises:

Scorpions Reverse Scorpions

Mini Band Monster Walks Elevated Step Single Leg Reaches
Elevated Step Single Leg Squats Floor Bridges
SB Hip Bridges Quadraped (Birddog’s)
Single Leg Cone Reaches Hyperextensions
Bodyweight Squats (90 degree) 2x4 Squats
Split Squats MB Forward Reaches
Bulgarian Squats Box Step Up’s
Box Step Up’s w/ Single Leg Stabilization Box Step Up’s w/ External Rotation
Box Step Up’s w/ Internal Rotation Single Leg Squat variations
Band Glute/Ham Kickbacks Mini Band Side Steps
Pelvic Tilts Pelvic Figure Eights On SB
Facing Wall Squats Supine Vertical Leg Raises
Squat w/ Band at Knees Single Leg Hop w/ Band Abduction
Resisted Walking w/ Band at Feet Glute Raise on Stability Ball
Frog Press Over Stability Ball Single Leg Hops

Strength Training Exercises

Squats Lunge (static, dynamic, walking, 6” box)
Bulgarian Squats Glute/Ham Raise
Box Step Up’s 1 Leg Romanian Deadlifts
Cable Pull Throughs Deadlifts

Static Stretching:

Kneeling Hip Flexor Stretches Bulgarian Hip Flexor Stretches

90/90 Seated Hip Flexor Stretches Seated Groin Stretch
Lateral Step w/ Forearm to Foot Stretch Standing Adductor Stretch
Standing Hamstring Stretch (foot raised) SB Psoas Stretch
Prone Butterfly Stretch Sumo Adductor Stretch
Supine V Legs Split Against Wall Stretch

Self Myofascial Release:

Foam Roller Stretch (Psoas) Foam Roller Stretch (Hamstrings)
Foam Roller Stretch (Hip Flexors) Foam Roller Stretch (Lumbar Erectors)
Foam Roller Stretch (Quadriceps) Foam Roller Stretch (Adductors)
Foam Roller Stretch (Illiotibial Band)
External Rotation At Femur: “Feet Turning Out, Knees Out”

Muscle Imbalances:

Tight: soleus, piriformis, biceps femoris

Weak: gluteus maximus, gluteus medius, adductors

Possible Indicators:

- Feet turning out when squatting or reaching

- Knees turning out when squatting

- Poor single leg balance

- Leaning forward when walking

- Falling forward when squatting (back bending over)

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Walking Toe Touches Walking Reaches

Squat to Stand Walking Knee To Chest Stretch
Walking Lunge w/ Overhead Reach Lateral Lunge
Drop Squat

Motor Control Exercises:

Scorpions Reverse Scorpions

Mini Band Monster Walks Elevated Step Single Leg Reaches
Elevated Step Single Leg Squats Floor Bridges
SB Hip Bridges Quadraped (Birddog’s)
Single Leg Cone Reaches Hyperextensions
Bodyweight Squats (90 degree) 2x4 Squats
Split Squats MB Forward Reaches
Bulgarian Squats Box Step Up’s
Box Step Up’s w/ Single Leg Stabilization Box Step Up’s w/ External Rotation
Box Step Up’s w/ Internal Rotation Single Leg Squat variations
Single Leg Balancing Balance w/ Reach
Single Leg Squat Cable Adduction
Band Internal Rotation (at toes) Squats w/ Soft Ball between Knees (squeeze)
Stability Ball Adductor Squeeze w/ Hip Bridge Lying Soft Ball Squeeze w/ Hip Bridge

Strength Training Exercises

Squats Lunge (static, dynamic, walking, 6” box)
Bulgarian Squats Glute/Ham Raise
Box Step Up’s 1 Leg Romanian Deadlifts
Cable Pull Throughs Deadlifts

Static Stretching:

Standing Hamstring Stretch (foot raised)

Self Myofascial Release:

Foam Roller Stretch (Hamstrings) Foam Roller Stretch (Piriformis)
Foam Roller Stretch (Illiotibial Band)
Internal Humeral Rotation: “Palms Facing Back, Shoulders Rounded”

Muscle Imbalances:

Tight: pectoralis major, pectoralis minor, anterior delts, serratus anterior, lats

Weak: mid traps, rhomboids, rear delts

Possible Indicators:

- Shoulders rounded forward with hands turned in, palms facing rear body.

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Motor Control Exercises:

Cuff Complex Y’s and T’s on Stability Ball
Band Pull Aparts Reverse Flys
Prone Straight Arm Rotation Prone Cobras
Scapular Push Ups

Strength Training Exercises

Static Stretching:
Doorway Chest Stretch Pec Stretch on Stability Ball

Self Myofascial Release:

Foam Roller Stretch (pec major/minor) Foam Roller Stretch (serratus anterior)
Foam Roller Stretch (lats)
Protracted Shoulder Girdle: “Shoulders Rounded Forward”

Muscle Imbalances:

Tight: pectoralis major, pectoralis minor, anterior delts, serratus anterior, lats

Weak: mid traps, rhomboids, rear delts

Possible Indicators:

- Shoulders rounded forward

- Shoulder pain and injury history to the shoulder girdle
- Inability to lay flat on your back and raise arms over head until flat on floor

Protocol for correction:

1. Dynamic Flexibility Exercises

2. Motor Control Exercises

3. Strength Training Exercises

4. Static Flexibilty/Self Myofascial Release

Dynamic Flexibility Exercises:

Motor Control Exercises:

Cuff Complex Y’s and T’s on Stability Ball
Band Pull Aparts Reverse Flys
Prone Straight Arm Rotation Prone Cobras
Scapular Push Ups

Strength Training Exercises

Static Stretching:
Doorway Chest Stretch Pec Stretch on Stability Ball

Self Myofascial Release:

Foam Roller Stretch (pec major/minor) Foam Roller Stretch (serratus anterior)
Foam Roller Stretch (lats)
Anterior Head Carriage: “Neck and Head Extended Forward”

Muscle Imbalances:

Tight: sternocleidomastoid, upper traps, levator scapulae

Weak: middle traps, long cervical extensors

Possible Indicators:

- Neck and head extended forward

- Very tight in neck and traps
- Inability to rotate head side to side with significant range of motion

Protocol for correction:

1. Corrective Exercises

2. Static Flexibilty

Corrective Exercises:
Static Wall Lean Neck Rotations

Static Stretching:
Neck Flexion (ear to shoulder) Levator Scapulae Stretch (chin to chest)