Establishing Your Drive Train: Screening and Correcting the Hip Hinge
Everyone has the same basic movement patterns – we habitually pick objects up off the floor, squat, sit up, and perform countless other patterns. These patterns are manifested in many different ways from daily activity to specific training, such as deadlifting heavy loads to build strength. We all have the same basic biomechanics and while there is a correct way to pick things up, many people fail to do so. Physical therapy clinics are busy with everyone from older adults to high school athletes who have injured their backs due to improper form, muscular imbalances, and deficient movement patterns. According to the American Chiropractic Association 70 to 85 percent of all people have had back pain in their life.1 Even scarier, back pain is the most frequent cause of general physical limitation for people younger than 45.1
What Is a Hip Hinge and Why Is It So Important?
A hip hinge is movement (flexion and extension) through the hip joint, keeping a neutral spine and the knees slightly flexed. Last week we looked at the deep squat movement. The deep squat has a relatively even ratio of knee and hip movement, as opposed to the hip hinge, which is very hip dominant. This positioning and movement pattern allows for safe movement in a variety of situations and provides the ability to effectively move large loads. Our posterior chain has incredible power if we harness it correctly and move efficiently.
Left photo: Standing with good posture. Right photo: Keeping spinal alignment and vertical shins.
A commonly seen trend is quad dominant, imbalanced athletes with glute inhibition who run and lift with suboptimal technique.2 The pelvic girdle is balanced primarily between the hip flexors, abdominals, erector spinae (lower back muscles), and gluteal muscles. Many Americans spend an increasing amount of time sitting, leading to tight hip flexors, triggering reciprocal inhibition, and ultimately gluteal amnesia, robbing us of strength. Reciprocal inhibition in simple terms means, if one muscle is active the opposing muscle relaxes to get out of the way. A simple example of this is to extend your arm, contract your triceps as tight as possible and try to do a bicep curl without letting go of your triceps tension. This motion is physically impossible. The same issue arises with tight hip flexors that create inappropriate tension, not allowing full hip extension or glute activation.
Hip Hinge Screen
For these screens you will need a PVC pipe, broomstick, or any similar, lightweight rod to appropriately substitute safely.
Screen #1: Perform a hip hinge with a PVC pipe against your back to full flexion and extend back to standing. The PVC pipe must touch your tailbone (coccyx), hand in lower back, PVC touches upper back, hand behind neck, and PVC touches head throughout the entire movement. Any loss of contact will constitute failure of the test.
Screen #2: While standing, bend to touch your toes while keeping knees locked. If you are unable to maintain a locked knee position, continue work on the mobility exercises. Ensure proper posterior (backwards) weight shifting during a forward bend by using the hip hinge wall drill listed below under Re-Patterning of Movement.
Screen #3: Perform a single leg hip hinge. Place PVC pipe on your back, maintaining the same contact points as before, the tailbone, upper back, and head. From standing, perform a single leg hip hinge (shown below), ensuring hip symmetry and alignment with the foot. Use a mirror to watch for proper alignment. From the front view make sure no twisting occurs and the leg traveling backward is directly under your hip, while keeping your grounded foot in alignment. From the side view maintain alignment with level hips and the leg in line with the core. Use a mirror to check your form, or better yet partner up with a friend and screen each other.
If the single leg deadlift pattern is failed, first go through this corrective pattern sequence with both legs until you are successful with re-patterning (screen #1). When successful, you may restart the sequence, shifting the exercises to single leg versions. Perform these excises on both legs and aim for symmetrical mobility, coordination, and strength.