Hip pain can be a common issue for women over 40. Hip pain can come in many different forms from congenital issues that are showing up later in life, from overuse, or from back or lower extremity injuries that never fully healed correctly. Without proper correction, “compensations” with movement can develop and years later annoying hip pain or abnormal gait can become present.
To help reduce hip pain and re-educate proper muscle firing patterns and hip alignment, Pilates may be the answer. With an effective screen or evaluation, Pilates can make a powerful impact on regaining hip function. Platies is a great way to help re-educate the hip/pelvis/leg and create balance between tight or weak muscles that could be contributing to the hip pain.
Using Pilates Principles to better understand how to move the head of the femur (ball of hip joint) independently from the acetabulum (socket) and spine, can improve hip function and reestablish pain-free movement.
Pilates Exercise for Your Hip
To start, one of the simplest exercises that you can do from home is one that helps to train the core to help stabilize the spine for hip movements…
Set-up: Begin on your back in the hook-lying position (lying on back with knees bent and feet on floor). Hand on your “hip bones” (really the bones of your pelvis).
Action: As you exhale, float one leg up to 90/90 or “table top” position — 90 degree knee bend and 90 hip bend, inhale gently at the top, then exhale and set foot back down. It’s a slow movement. Try to alternate legs while keeping your pelvic bones still and your knee at 90 degrees throughout the exercise. You can exhale gently with each leg movement and then progress to exhaling only when the leg goes up or down – either way – just remember to breathe and keep your pelvis still in the neutral spine position. Complete 10 times, alternating legs (so 20 total).
Modification: If it is too painful to lift your foot off the ground, then slowly slide one heel away on your mat/carpet and slowly back in, continuing to focus on pelvic control and stability (“stillness”) while moving the “ball” in the hip joint. You can alternate legs as you go. Complete 10 times, alternating legs (so 20 total).
Cues: Having your hands on your “hips” give you cues to keep your bones still. Using your breath, think “pelvis still” as you are moving your legs. Think of your spine like a long straight pole with laser beams reaching out of thru the top of your head and the other reaching out thru your sit bones while you just moving your legs.
Note: Variation of small circles of hip keeping the pelvic bones still and circling the thigh bone around slowly in each direction. Have the image of a "pearly while clean cartilage bowl” for the socket as you circle the ball around. Complete x5 each direction.
It’s easy to compensate with tightening your butt or flattening your back into the mat, so work on finding a neutral spine (somewhere between arching your back and flattening your back) while alternating your legs. Work on keeping your butt loose – this can be very challenging, but very helpful to not over recruit those large muscles to stabilize.
Hope this helps! This exercise is a helpful foundation to then progress into other movement patterns on the mat or on the Pilates machines.
Courtesy of Heather Brummett, PT, DPT, CMPT, CSCS, PMA®-CPT founder of Pilatespal.com.
Balanced Physical Therapy, Pilates and Wellness Center