< Focus Physio Blog

Hips Don't Lie

Hips don't lie. Why our hips play such a pivotal role in general movement

< Focus Physio Blog

Hips Don't Lie

Hips don't lie. Why our hips play such a pivotal role in general movement

The hip hinge movement pattern is commonly seen in variations of deadlifts, rack pulls, kettlebell swings, kettlebell pulls, etc. It is a movement pattern where there is flexion and extension of the hip involving a posterior weight shift, usually with little to no movement in the knees. It is hip dominant– hence a hip hinge. The squat on the other hand should not involve a weight shift, as it goes directly down and up. Once again, it involves hip flexion and extension, but also knee flexion and ankle dorsiflexion, requiring a lot of mobility and control in those joints as well.

Regardless of how much weight or resistance you are using, these movement patterns stay largely the same, but distinct from each other. To get the most out of your training and prevent any injuries, it is best to keep these two movements separate – don’t squat your deadlifts and don’t deadlift your squats.

What’s better for your training? The squat or the hip hinge? It always goes back to the same answer that you may have heard many times: it depends on your goals and sports.

Does that mean if one movement is better than the other for my sport, does that mean I should just do that? No! The squat and the hip hinge are movement patterns that should be used day to day, regardless of your sport. You may not need to deadlift as a runner, but you need to pick stuff off the floor as a human being.

In our clinic, we assess your if you are safe to train for squats or hip hinge variations using the Functional Movement Systems (FMS). 7 movements are tested in the FMS, 2 of them assesses your risk in training the hip hinge and the squat: Active Straight Leg Raise (ASLR) and Overhead Deep Squat respectively. However, we not only assess if those movements are acceptable, but the FMS also gives us a guideline which movement to prioritise first.

Among the 7 different movements tested, the ASLR is the first movement that should be addressed if it is below the safe zone. The overhead deep squat, is the 7th and last movement to be “fixed”.

Why the huge disparity? The hip hinge is a more fundamental movement compared to a squat. To achieve a deep squat you would need a lot of hip flexion, knee flexion and ankle dorsiflexion and controlling any rotation as you squat; if there are any weights involved, you would also need to maintain extension of your upper half (trunk and spine) – that’s a lot of things.

Now if we look at hip hinge patterns (e.g. deadlift) you need much less hip and knee flexion with minimum to no dorsiflexion. The hip hinge requires a lot less mobility and a lot more control and stability in that weight shift.

So, what do we need before we learn to do the hip hinge? Following the FMS guidelines, ASLR needs to be at least 70 degrees of hip flexion, where the bony bumps (malleolus) of your moving leg’s ankle going past your knee joint that’s staying down in a vertical line. This first ensures that you have sufficient mobility and control to separate the legs (lifting one up while keeping the other one down) in a good supported position (lying down, supine). In addition, if you achieve that and are symmetrical on both sides, you can start learning or training the hip hinge.

There are many ways you can learn to hip hinge. The most difficult part of the hip hinge is controlling that backward weight shift. One way to learn how to do this is to stand facing away from a wall and take half a step forward. Then, keeping your lower leg (tibia) vertical, touch your bottom to the wall. This movement primarily involves your lower limbs. Once you can do this confidently, we need to make sure you can control your trunk during a hip hinge so we can add weight– particularly the back.

One way to do this is to have a dowel/stick touching your head, mid-back, and bottom – then hinge while keeping these three points touching the dowel/stick. This is when people may start squatting their hip hinge; the lower leg (tibia) should be as vertical as possible while the dowel/stick does NOT have to be vertical.

After they can do this, test them by doing the same movement without a stick. If they can do it without a stick, they can start doing some hip hinge movements with resistance (weights/bands/cables). Most often people use this pattern to practice pulling/lifting up, but another way to improve this pattern is to actually do the opposite: to pull down into the hinge using bands/cables– this is NOT an assisted hip hinge, you can still put a significant load and basically work the pattern backwards.

Hip hinge looks great so far? Good! Can I deadlift yet? Maybe.

Another criteria we like to see in the clinic before you deadlift from the ground is being able to touch your toes - you can bend your back while you touch your toes. Just another safety factor in the works of deadlifting. If you can’t touch your toes but able to do a hip hinge well, you can still safely do deadlift variations that requires less mobility: e.g. rack pulls, elevated deadlifts.

Right, so I can’t touch my toes, what do I do? It could be mobility restrictions which means you many need to do foam rolling/stretching/stick work for your hip flexors, quads, adductors, glutes, and/or hamstrings, but after you’ve done that we need to get control of the movement. One way we can do this is by doing something we call the toe touch progression. It is simple and easy all you need is something to raise your foot about an inch (book/plank of wood) and something to squeeze between your knees (ball/pillow/cushion).

First step: stand with your feet together with your toes raised by the board/book. Put your ball/cushion/pillow between your knees. Now squeeze that ball/cushion/pillow as your try and touch your toes. If you can’t reach squeeze harder, and if you still can’t reach, "cheat" – bend your knees and touch your toes. This is the most important part of this movement: always touch your toes, even if you have to cheat and bend your knees. Do this 10 times, always squeeze first before cheating. Once you’ve done your 10, stand with feet together with the heels raised this time and repeat the same movement 10 times– always squeeze first before bending your knees and touching your toes, but always touch your toes to complete the movement. After the second set of 10,repeat it again just standing with feet together on the floor. This should give you the necessary control to touch your toes in the next few weeks if not on that day itself, given that you have sufficient mobility in the first place.

Finally, if you can hip hinge and touch your toes, you can now learn how to deadlift from the floor! Your risk should now be minimum, but not zero. Your risk is never zero with any movement, even the absence of movement. However, ensuring these basic steps (Active Straight Leg Raise, Hip Hinge, Toe Touch)are met reduces that risk.

After that it is up to you and your fitness professional to modify and perfect your hip hinge/deadlift techniques according to your goals. Technique is vital at this point and not to be neglected, otherwise there would always be that one bad lift that can injure you. If you get stuck and can’t get any headway in any of the Active Straight Leg Raise, Hip Hinge, or Toe Touch; or you keep getting injured repeatedly, feel free to consult your fitness and/or medical professional!