So I have received inquiries about exercises I do/have done with Dan, the marathon runner who had hip issues, that I train.  I've been working on getting more videos taken.  If you haven't already done so, be sure to read the hip impingement blog from months back.   Here is a vid explaining some basic progressions I like to use to get the glute medius functioning better. Check it out.

One thing I want to point out.  As you saw in the video, he flexed his hip when he first did the side leg raise.  I then cued him into extension.  He could be extended better than what we finished with; he was fatigued since we did this after his entire workout.  When the hip flexes, that means that the tfl (abducts the hip just like the glute med, tends to become more dominant) is trying to do the work.  So always be sure that the hip is extended fully when raising the leg up.  The side leg raise is done against the wall first while actively pushing back into the wall with the heel to ensure that the glute is doing the work.  The side leg raise shown here is done after.

As I said, it is very important to do multi joint exercises to get the muscle working in a "real time" environment.  Single leg exercises Dan has done and progressed with include split squats, stepups, reverse lunges, forward lunges, and progression from dumbbells to barbells with each.  Bulgarian split squats and one leg squats would be the next that I would use.  Hip dominant exercises include one leg glute bridges, one leg rdl's, hip thrusts, band stomps and single leg reverse hypers.  These all get the glute max nice and strong as well, which he lacked. 

When we first started, his left glute med was much weaker than his right so extra sets were done for the left with the clam shells.  I also used a band to teach him to keep his knee straight during single leg movements. 

After a couple of phases with all unilateral movements, we added in some bilateral movements including plate squats, back squats, front squats, yoke bar squats, pull-throughs,  rdl's, sumo rdl's, good mornings and reverse hypers (in different phases obviously). 

On top of all of the glute work (his glute was not extending the hip like it was supposed to so the femur rubbed against the socket, hence the reason for so much glute work), his tfl, rectus femoris and psoas needed length (psoas actually needed some strength too).  So plenty of stretching and mobility work has been done for these muscles.  The hip flexor stretch I have previously shown has been a mainstay.  It should also be noted that specific abdominal muscles play a role in what goes on at the hip and pelvis as well.(  We will save that for another post. 

He now has hardly any hip pain or clicking and has actually begun to get into some light running drills without issues.  Doing what needs to be done in the weight room to help running performance and prevent injury is HUGE and hopefully more runners will begin to realize this.  In a future post (hopefully soon future), I will discuss some of the energy systems training Dan has done to maintain and build his endurance while simultaneously strengthening his hips and fixing his problems.  Stay tuned!!

I recently had a new client come to me who was diagnosed with femoral acetabular impingement.  What that basically means is that he has issues with the head of his femur rubbing against his hip socket.  He is a marathon runner and this problem has been affecting his performance.  Unfortunately, instead of finding out what exactly was going on that was contributing to his impingement, specialists that he saw went ahead and shaved some of the bone off.  While this may or may not have been necessary, if imbalances that he has are not fixed, his problems could come back. 

As soon as I found out about his issue, I immediately suspected that he had glute and hip flexor issues.  Thus, I checked his glute function and sure enough, it sucked.  Then, I checked his hip flexor length and pretty much all of his flexors were very stiff and even short, especially psoas and tfl.  This leads to the situation I've discussed previously,  anterior tilt of the pelvis.  The reason his femur is impinging is because of the fact that his glute is not pulling his hip into full extension because of the position he is in.  His hamstrings try to extend his hip but without the help of his glute, it cannot be extended fully and properly and impingement comes about. 

What are we going to do to make things better?  We are going to get some length in his hip flexors and get his glute firing on all cylinders.  This will allow his glute to effectively pull his hip into proper extension, improve his running economy, get rid of his pain and problems and set him back on the road to record times.  There are also some other things going on such as pelvic rotation and other issues up and down the kinetic chain such as ankle stiffness and shoulder imbalances. 

This condition CAN result from bony abnormalities and various pathologies and in these cases, surgery and physical therapy may be necessary.  In many cases, muscular imbalances can be the root of the problem and with some proper training, symptoms can be resolved nicely. 

If you drive a car that is out of alignment long enough, eventually something is going to break down and you are going to find yourself stuck in the middle of nowhere on the side of the road hoping that you don't get stuck hitchhiking with some loon.  You can think of the body and running the same way.  If you run long enough with your body out of alignment, eventually something is going to give and you won't be running very far anymore.  So if you must run, do yourself a favor and get your body a tuneup once in awhile.  It will save you lots of trouble down the road. 

You can read more about running issues here.

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As you may or may not know, I suffered a grade 2 strain in a couple of deep muscles on a spot in my lower back a little while back.  I backed off from most squatting and deadlifting movements for awhile and have recently been getting back into some lighter ones (Don't worry, I've found ways to train hard).  While it has been a pain recovering from this injury, it has forced me to take a step back and look at what weaknesses contributed to this problem.  A couple of them were in my hips.  My psoas and my glutes were both weaker than they should've been.  While my back has been healing, I have been doing exercises to bring up weak points and facilitate recovery.  Here are a couple of hip exercises that I've been doing a few times a week either as part of main workouts or as smaller extra workouts.  They have helped me and maybe they can help you.

Knee Raises-  The psoas major is a unique hip flexor that attaches to the femur and all of the lumbar verterbrae.  With its attachments to the vertebrae, it has some control with the low back.  If its too stiff, it can pull on it and bring it into hyperextension. If its too weak, the back will have less support and help from it, causing it to round easier.  The psoas is most active in hip flexion above 90 degrees.  Looking at this fact, guess where it might be of assistance.  In the bottom of the squat.  Where have I been weakest when squatting.  In the bottom.  A simple exercise like this can help a lot.  I usually do them for 3-5 sets of 12-20 reps.  I am using 20 lb ankle weights in the video but some people can start with just their leg weight and it will be plenty difficult.  Notice how I focus on the top half of the hip flexion to emphasize the psoas.

Kneeling Hip Extensions-I do these to strengthen my glutes with the added benefit of strengthening my low back without loading it much.  Abdominal stability also comes into play with these. I've talked about the importance of having strong glutes many times before so I won't get into it too much here.  I usually do these for 3-5 sets of 12 to 20 reps as well. 

While injuries suck for the most part, they do make you smarter.  I have brought up weak areas now with plenty of different exercises and my hips feel stronger and more stable than ever since I've started doing some regular lifts again.  If your squat, dead or anything else has stalled, or if you have an issue with pain or posture problems, maybe special exercises like this could be what you are missing. 

P.S.    I've been adding more videos to my youtube page so be sure to check them out!