Hip Shifts and Rotations: Causes, Assessments and Corrections

Nick Rosencutter CSCS, NSCA-CPT, LMT

About Me Owner Rosencutter Ultra Fitness & Performance LLC Physical preparation coach, manual therapist, writer,

powerlifter, martial artist Degree in Exercise & Sports Science/Strength & Conditioning

from UW-La Crosse Diploma of Massage Therapy from Lakeside Full Body Active Release Techniques (ART) Provider Head of Strength & Conditioning at Greendale High School Consultant for ASE Speed Skating Corporate ART Provider Contributor to various continuing education products

Influences on this presentation

Postural Restoration Institute (PRI) Selective Functional Movement Assessment

(SFMA) Neurokinetic Therapy (NKT) Active Release Techniques (ART) Multiple sources and in the trenches

experiences

Goals for Today

*Identify common patterns to look for in clients and potential causes/reasons behind them

*Learn key assessments to determine the appropriate plan of action

*Learn exercises to help improve/control the imbalanced pattern that is found

Shifts and Rotations

What are they? Witness during movement and/or resting posture

− For today, we will observe squatting/deadlifting and standing postures

Different athletic activities, daily activities, etc. will produce various compensations

“Although these three motions of the pelvis may occur individually, they are most dynamically depicted during gait, when they should occur in a magnificently coordinated manner that results in a fluid pattern of movement, not only of the pelvis but also involving many of the joints that lie above and below the pelvis. Interruption of this vibrant kinetic cycle can be produced by a number of dysfunctional patterns, including tight or weak hip musculature, inappropriate firing sequences of muscles, joint dysfunction or pathology as well as dysfunctions within other regions of the body, particularly the foot.” (Clinical Application of Neuromuscular Techniques, Vol 2, P. 397)

Common Observations Right shift and right rotation (pelvic) are most common

− Why? − Effects on or from the chain above and below? − When should we intervene?

“The human body is not symmetrical. The neurological, respiratory,

circulatory, muscular and vision systems are not the same on the left side of the body as they are on the right, and vice versa. They have different responsibilities, function, position and demands on them. This system asymmetry is a good thing and an amazing design. The human body is balanced through the integration of system imbalances.”

− Ron Hruska, Myokinematic Restoration

Potential Causes? Natural asymmetrical design of our body predisposes us to like going right

Neurological patterning issue

Asymmetrical muscle weakness/imbalance

− Muscle length − Reciprocal inhibition − Trigger Points − Injury

Asymmetrical muscle stiffness or shortness (viscoelastic/connective tissue change)

Neuroreflexive factor (Sympathetic fight or flight response)

Technique problem

Others?

All Comes Back to the Nervous System

“The neurological approach to muscle imbalance recognizes that muscles are predisposed to become imbalanced because of their role in motor function. The neural control unit may alter the muscle recruitment strategy to stabilize joints temporarily in dysfunction. This change in recruitment alters muscle balance, movement patterns, and ultimately the motor program.”

− (Assessment and Treatment of Muscle Imbalance, P. 8)

The Pull of the Diaphragm

Pull of the Diaphragm “The respiratory system is an asymmetrical system with

asymmetrical form and asymmetrical function. Development of our asymmetrical systems, including the respiratory system, is well documented. Besides the obvious impact on respiratory function, the diaphragm muscle is uniquely positioned to directly influence every aspect of your postural skeletal and muscular core, and influences the position and function of all other body systems.”

− (PRI Integration for Fitness and Movement, P.1)

Muscle Imbalance Approaches (Assessment and Treatment of Muscle Imbalance- The Janda Approach, P. 10)

Different Compensations

Assessments

Hip Rotation Adduction Drop Test/Obers Test Thomas Test Breathing Mechanics

*Diaphragm plays a HUGE role Hip and Trunk Functional Muscle Testing

− Glute max, Glute med, Adductors, Obliques are some big players to look at

Corrections For unilateral strength imbalance

− Focus on single leg and offset exercises for 2 to 3 programs For neurological patterning or technique issue

− Cue them to find proper position/movement − Fix Set up − Physical cuing examples

For asymmetrical muscle imbalance

− Release overactive or stiff muscle − Activate and/or strengthen weak or inactive muscle − Common example: Release right adductors and left post glute

med/deep rotators − Activate/strengthen right glute max, right post glute med, left

adductors

Corrections

Fix breathing mechanics and everything else will fall into place much easier

Diaphragm influence *Thorax and rib motion helps drive pelvic/hip

motion and vice versa *If right ribs are stuck in IR, then rib rotation will

not occur optimally with movement, which will cause hips to compensate

Example Program for a Right Shift Client

Warmup: Release/foam roll right adductors, left deep rotators, 90/90 breathing w/ left shift and right reach (reposition pelvis and get diaphragm on board), Left sidelying pullback clam (activate left adductors and right glute with proper pelvic position), Right adductor mobe, Thoracic Rotation w/ left groiner hold

Offset split squat or reverse lunge 3x8-10 One leg rdl 3x8-10 Split Stance landmine press 3x8-10 Split stance cable row 3x8-10 Offset carry 2x40yds Pullback clam w/ breath 2x4 breaths 4 point breathing w/ hip shift 3x8-10 breaths/reaches

Progress to

Bilateral squat and deadlift variations − Use band or hands to provide external cuing

if needed − CNS needs to learn how to squat w/ newly

available movement and muscle activation − More rotational/transverse plane

progressions

So When Should You Jump In?

It depends Are they in pain? Does the pattern help them with performance? Does their shift/rotation seem like it will lead to

injury? Do enough to keep them healthy. Don't hurt

performance

Hands On Notes

Sources Chaitow, Leon, and Judith DeLany. Clinical Application of Neuromuscular

Techniques. Vol. 2. Edinburgh: Churchill Livingstone, 2011. Print.

Hruska, Ron. Myokinematic Restoration

Page, Phillip, Clare C. Frank, and Robert Lardner. Assessment and Treatment of Muscle Imbalance: The Janda Approach. Champaign, IL: Human Kinetics, 2010. Print.

Sahrmann, Shirley. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby, 2002. Print.

Contact

nick@rosencutterultrafitness.com Www.rosencutterultrafitness.com Www.nickrosencutter.com