Craig Liebenson: Restoring Hip Extension

 

Craig Liebenson discusses hip extension, delayed glute activation and shows some of the reactive techniques that have been developed to reset and restore this important movement.

Excerpted from Stuart McGill, Gray Cook & Craig Liebenson: Assessing Movement

Professor Janda, in a study with Joanne Bullock-Saxton, a physiotherapist from Australia, found a significant delay in the onset of muscle activation of the glutes during hip extension in people who had previously had an ankle sprain where the ligaments were compromised. This delayed activation was far away from the location of the original injury. It persisted afterward—it became programmed as a default.

On the top is the EMG of the control group, and on the bottom is that of the injured group. We’re seeing the hamstrings, glutes and erector spinae. In the control group, what we see is the glutes are fine, but in the injured group, we see this inhibition of the glutes—it’s hard to activate the glutes. Some of you might call it gluteal amnesia. This is a normal and expected response to an injury in the lower quarter.

Protectively, we expect the brain will try to immobilize this area and that will get programmed. It will become habituated. We know the ligaments are healed, but now suddenly the other knee is hurting or the sacroiliac is hurting.

When we take that history and retrace it, we find the glutes shut off and were never reset. People treated the ankle. They treated the site of symptoms instead of taking a step back and finding the painless dysfunction. With respect to the glutes and their main role, which is hip extension, we’ve developed a number of techniques.

Here’s Koichi Sato training one of our NFL athletes. We can promote hip extension in the frontal plane. When I’m doing something more ballistic and I’m landing, I’m trying to go as far or as high as I can—it’s hip extension.

Professor Janda talked about looking at gait. The most important thing in gait is the terminal phase where we have 10 degrees of hip hyperextension. If we’ve been sitting too long and don’t have 10 degrees of hip hyperextension, we still try to maintain upright posture and keep the eyes on the horizontal, so we tilt the pelvis too far and compress the spine a bit. Stability is lost. We don’t need this position when we don’t have load.

Hip extension is one of the most important movements and we can reactively get it in surprising ways—all will be felt right in the glutes.
• Through sagittal plane exercise using a strap that’s very popular at AEP and other gyms training hip extension
• Working in the rotational plane with the hip airplane—you’ll feel the glutes like nobody’s business.
• In a Voita position called the diagonal sit as done by a therapist getting beautiful hip extension out of kids with cerebral palsy

When we can challenge the body and progress people into positions that reactively get high-density contractions in the tissues that are inhibited or dormant we can see the residual adaptation we want.

As Laird Hamilton said, “Therefore, what we’ll expect is that which enhances performance will prevent injury.”


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