A few months ago I was playing with some movements that could bring out more hip internal rotation in order to get some more active mobility. I decided to try different starting positions to see what would happen when trying to get more internal rotation, and came up with the following list of pros and cons:
Standing in Square stance, feet turned towards each other
Pros – easy to do, easy to execute, Allows for progressions and regressions, unlimited exercises can be done.
Cons – Can also cause pelvic anterior tilt if hips are tight.
Kneeling, feet turned out
Pros – Great active stretch of external rotators, great stretch of rectus femoris
Cons – A tight rectus femoris can also cause anterior tilt, negating the effects of the stretch
Standing in Split stance
Pros – Easy to position, unlimited exercises
Cons – Difficult to balance.
Then I hit on the one that seems to work well:
half kneeling
Pros – Easy to perform, easy to balance, pelvic angle stays constant
Cons – pressure from kneeling on back knee.
Why it kicks ass
You can set this up anywhere, using a medicine ball, dumbell, kettlebell, small puppy, anything you want to use as resistance, and get some great mobility out of the movement. A key feature to remember is to keep the back toe from crossing back across your midline, which effectively puts your hip into external rotation and limits the amount of stretch you can get through internal rotation.
Why it’s important
From a general population point of view, internal rotation of the hip is one of the main movements lost over time, and has a high correlation to hip dysfunction, low back pain, and even knee pain and foot issues when limited. In closed chain stance, internal rotation is needed to control the rotation of the pelvis from anterior to posterior tilt and vice versa, which means a lack of rotational range of motion will impact pelvic mechanics, and therefore lumbar spine mechanics. A lack of internal range of motion also makes walking different as the foot is less likely to roll off the inside of the big toe during the propulsion phase of the gait cycle, and also increase the tension through the IT band, reducing knee range of motion for squats and such.
For an athletic population, and sport that requires rotation to any degree (throwing, skating, jumping, cutting, turning, twisting) will require some degree of external and internal range of motion. In hockey, groin pulls are acutely linked to decreased internal rotation during cross-over strides, and shoulder injuries in throwers can be linked to a reduced internal rotation in the contralateral leg, which makes it a pretty important movement direction to maintain.
Most people will need to work on internal rotation if they have less than 45 degrees in both sitting and prone positions. This was a great video by Eric Cressey about measuring hip internal rotation in both posiitons.
I give this exercise to any client who has a general reduction in hip internal rotation that s causing some sort of dysfunction in other movements they need to be skilled in. For instance, I have a client who is a marathon runner and who would envy the joint mobility of the Tin Man from the Wizard of Oz. For her, the need to have a lot of hip mobility is actually counter-productive as it destabilizes her hips and reduces the elastic potential of her run stride, effectively making her less efficient and makes her muscles work harder, so we use these only during tapers and recovery weeks. For my clients waiting for hip replacement surgery, we try to get at least one series of these in each workout because it’s one of the easiest for them to get into position for and to perform. For rotational sport athletes, it’s either this movement or a couple of other ones each day to keep the range of motion sharp.