T Nation

Hip Stability Question

I recently took up ballet, and have been working a lot on flexibility. My right hip started making a clunking noise when I extend my leg either forward or to the side like this (see vid). It’s like the femur doesn’t want to stay seated in the joint when I’m pointing my toe and extending with the leg rotated out. If I make a conscious effort to stretch not only out at the toe, but to push the leg back in at the hip, I can sometimes get the noise to stop.

Interestingly, I can do the splits with my right leg forward, but not when the right leg is going backward (left leg in front). There seems to be a big discrepancy in flexibility at the right hip. Now I’m a bit worried about working on stretching so much if I’m giving up some stability.

Also, I’m starting to feel like it’s coming out of socket even when I’m rowing on the rowing machine, when leaning back at the bottom of the slide.

Anybody with experience with this sort of thing?

I have hip issues similar to what you explain, although I do not do ballet.

Have you had any accidents or injuries in your past ? I know I have had plenty, which explain my dilemma.

I recall Veggie-Strong tell me that hips are usually unbalanced in most people. One leg is more flexible, while the other is more stiff. She might have a better explanation, I do believe she is a chiropractor if I am not mistaken.

Thanks Max. I do toe-in a little bit on the right side, although I’ve mostly corrected it now. Maybe it’s something I’ve had since a kid. No injuries or problems with it otherwise. If I went on a very long run, say 8 or 9 miles, that right hip would sometimes be sore. That’s it.

i think i had a similar issue but i’ll let you be the judge…

i worked hard on stretching the front of the hip and then it would feel like the head of the femur was jamming at the front of the pelvis socket for certain movements.

what sorted it out for me was activating / strengthening the stabilizers from the back. i’m not entirely sure which ones in particular… but there are some tiny stabilizers under glute max. also the medial glutes (round the side of the hip).

  • x band walks (with femur in slight external rotation)
  • (assisted) deep pistols / one legged squats
  • step ups (unweighted up to a high step working on pushing knee out with the front leg / slightly externally rotating the femur and pulling myself up with the glutes in the front leg).

anyway… what i mean to say is that strengthening stabilizer muscles that should be working to pull the head of the femur in the opposite direction from the place where it jams. does that make sense??

under glute max… these muscles help hold / pull the head of the femur into the pelvis.

My hips do that a lot too, even my lower back sometimes. I went to a PT and this is what she found wrong with me:

Knees hyperextend while standing normally (probably due to tight soleus)
Weak hamstrings compared to my quads
Ridiculously tight hammies/gastroc, left side is tighter
Weak hip abductors
Poor hip internal rotation

BTW I went to the PT for a completely different reason (shin splint thing), I didn’t even mention the hip cracking thing. But maybe this info can help you out if you have anything in common.

[quote]alexus wrote:
i think i had a similar issue but i’ll let you be the judge…

i worked hard on stretching the front of the hip and then it would feel like the head of the femur was jamming at the front of the pelvis socket for certain movements.

what sorted it out for me was activating / strengthening the stabilizers from the back. i’m not entirely sure which ones in particular… but there are some tiny stabilizers under glute max. also the medial glutes (round the side of the hip).

  • x band walks (with femur in slight external rotation)
  • (assisted) deep pistols / one legged squats
  • step ups (unweighted up to a high step working on pushing knee out with the front leg / slightly externally rotating the femur and pulling myself up with the glutes in the front leg).

anyway… what i mean to say is that strengthening stabilizer muscles that should be working to pull the head of the femur in the opposite direction from the place where it jams. does that make sense??[/quote]

This person is heading in the right direction.

Think about it this way, the hamstrings and glutes have similar function on the femur. They both help extend the hip.

The glutes, specifically glute max and posterior gluteus medius, are often weak and underactive. Because of this, they aren’t helping to extend the hip like the normally should. Thus, the hamstrings have to pick up the slack to make sure the femur still extends as much as you’re trying to.

But the hamstrings pull the femur from way down on the knee while the glutes pull the femur from up high and nice around the femoral head.

The glutes help keep the femur nice and snug in the socket AND extend the hip. The hamstrings only do the latter. Therefore, you get the “jamming” feeling where the femur is moving forward in the hip socket = pain.

STOP stretching the hip into extension. If you do, you HAVE to have your glutes firing to help prevent the head of the femur from traveling forward.

This is crappy:

This is better:

Then you need to strengthen the glutes. Specifcally max and posterior medius.

Alexus - Thanks for your thoughts, and for the link. Ballet has found muscles that I didn’t know I had. Seriously, the strength required is in some ways sooo different. I hope it’s a matter of developing strength in some of those smaller muscles, rather than that something is wrong with the joint.

Andy - Thanks, and I recommend ballet. :slight_smile: I know I have much stronger quads than hams. And ballet is ALL about external rotation and extension. Hopefully this is just a newbie thing that I’m going to grow into as I get stronger, but it’s really disconcerting and uncomfortable to have the leg not staying in the socket like it should. If the leg is up high enough, gravity will actually help keep it in the socket. Unfortunately, I’m a beginner so mine usually aren’t high enough for gravity to help much. :slight_smile:

BReddy - Thanks for the post. My iliopsoas stretch (I think that’s what it’s called - I do it with my rear leg flat, and also holding an ankle to stretch the quad) looks a lot more aggressive. I’ll look for a good picture. My teacher talked about how people who do ballet make a choice to stretch ligaments, which once stretched, will never go back. Then some of these people have more problems with arthritis or pain down the road. Not where I want to go. Also a little bit concerned that the clunking could cause some damage. Hummm…

This is more like what I do. No bounce, just slow and sustained until I feel it release. Then hold ankle of rear leg to stretch quad. Of course, I’m doing all kinds of barre work, and other stretches.

As for glutes, I’ll try Lex’s idea of banded X walks. Any other ideas? I already do hypers with a 45 lb plate, RDLs, hamcurls, walking lunges, etc…

Just for fun…

[quote]BReddy wrote:
Specifcally max and posterior medius. [/quote]

This person is heading in the right direction…

But I’d like to point out that my glute max was working just fine from glute bridges / hip thrusts. It was the stabilizers UNDER glute max that I needed to target (I guess their stabilization function is why they get to be called stabilizers). I needed single leg work in particular to get them to wake up. Step ups onto a very high step, as I said, with the femur in slight external rotation / knee pushed out. You will know all about it the next day if you get this right - and in my case I needed a bit of assistance at the time and could really feel things waking up. My experience anyway FWIW.

Yeah, stretching ligaments might not be a good idea…
But I’m a big fan of the ‘use the muscles - spare the joints’ idea. The idea being that if you get the muscle tension / working relationships right then you really do take a load off the joints.
There is meant to be a stability / mobility trade-off in the sense that the more mobile something becomes the weaker it becomes… But I do think that one can strengthen new ROM.

I’ve been working on external rotation of my femur because it helps me keep my hips in close to the barbell and it gives my knees somewhere to go so I can get the bar swinging back towards me off the floor for Oly Lifting. Basically it is my adopting a bit of a frog stance / style pull. Not as much of a turn out as ballet - but a bit of a turn out. And significantly (or hopefully significantly one day!!) loaded.

I vacilate between thinking that I have structural abnormality in the shape of the ball and socket joint that results in painful jamming at times / not smooth movement / movement restriction… And thinking that I simply have a lot of work to do on the resting tension of the surrounding muscles… Perhaps a little stretching of ligament… Perhaps some waking up of stabilizers…

The women in my fathers side of the family all have had hip replacements for painful rubbing… I’ve had a clicky crunchy right hip in particular since I was a kid…

But I’ve got better ROM than ever and it is comfortable and smooth. I really do believe that while my joint might not be optimal… The work I’ve done on waking up the stabilizers and, yeah, lots of stretching for better ROM has actually helped me.

Ballet is more extreme with the whole turn-out thing… But wouldn’t it be more of the same in a way?? Ligaments… Are about what?? If the muscles are holding the joint stable then so long as the muscles do that I don’t see a problem…

But yeah that psoas stretch… Gotta be careful…

One thing I’m playing with…

Does the psoas need to be lengthened for your better ROM…
Or…
Does it need to simply relax?
I did a lot of work trying to stretch the psoas trying to roll it to force it to relax…
But really I needed neurologically to allow it to relax…
How do you go with whatever yoga pose it is…
You lie on your stomach then bend back from your knees…
Then reach back with your arms and grab your feet…
then RELAX your psoas and ACTIVATE your glutes and push your legs back and your chest up
(get what I mean)
Can you relax your psoas to pull your leg back up off the floor / behind midline?
If so… Then, uh, do they really need more stretching??

also (sorry i am going on)…
i have this thing with my humerus where if i’m not careful when i hang from the pullup bar it will pull out of the socket a bit…
my femur kinda does that, too.

partly it is neurological. to think of actively sucking it into the socket hard. i think you can actively think of sucking the head of the femur into the socket when you do your leg rotation stuffs. i think it helps the stabilizers activate to do that.

May be of interest…

olifter wants you to go get a dynamic sonograph. Better do what they says or be prepared for a dozen pubmed links to abstracts proving that you can’t fix it anyway

Alexus - Thanks for all the input. I swear, with all your experience with rehab you should have been a PT. You are fantastic at this stuff. It’s one reason I loved following your log.

I don’t have any problem with it coming out of socket when I’m hanging from a pullup bar. You’d think with all the years off running that if I really had a joint problem it would have shown up, right? I’m thinking it’s a matter of strength in all the smaller muscles that keep the femur engaged. I’m noticing now that when I really focus on engaging the glute, it is minimal.

About the stretching, I need to have quite a lot of flexibility in both hips to be able to do all of the movements. I know which yoga pose you are talking about, where you lean back and hold your ankles. I couldn’t do it after my umbilical hernia repair, but I can now and I think it’s a good one for this.

Olifter - Thanks for the pubmed link. It doesn’t sound like what I have. I don’t think it’s a snapping tendon, and I don’t have any problem when rotating the hip from internal to an external rotation. I’m pretty sure the clunking feeling is the femur not fully engaged when I’m raising my leg.

[quote]Powerpuff wrote:
Alexus - Thanks for all the input. I swear, with all your experience with rehab you should have been a PT. You are fantastic at this stuff. It’s one reason I loved following your log.
[/quote]

aw. lmfao i’m doing a course as we speak!! don’t get properly to injury rehab stuff till next year, though… i have a lot to learn. especially about places i’ve never injured (shoulders are new to me, as are wrists and, well, most of the body really. i only really do ankles and hips lol).

my bet is that it simply is a matter of working on your activation. neural - as you said, if you consciously try and hold it into the socket then it does okay. i heard (just last week actually) that yeah one wants to be careful with stretching ligaments since they aren’t elastic and it is hard (next to impossible) to tighten them up again… but i don’t see any problem with uncommon flexibility / ROM SO LONG AS one strengthens the new ROM.

you logging anywhere?? i’d love to read about your ballet journey…

Lex, glad to hear you are taking some courses. You’ll be a natural. I hope you enjoy it.

No, not logging but still lifting and working more on physique goals right now. I thought I’d take ballet to help me with ROM and as a balance for my lifting, but now ballet has really become my focus. OLY is the ballet of the lifting world by the way!

About activation, I think that’s a big part of it. When I can really slow down like in this video of developpes, I can focus on activation (contract the glute) and I can get it to stop at most angles. Note: My leg isn’t nearly that high yet!

Interesting and unrelated, there are a couple of men in my class and they are actually very good. No, my gaydar wasn’t going off. :slight_smile: Turns out they take ballet as an accessory to their martial arts training. And there is an older gentleman who plays piano for our class who started taking ballet when he was 49 and has taken classes for 12 years! That’s my plan. I may actually be pretty good in about a decade!