We’re excited to share our first three-part series on the blog! There are so many seemingly simple, yet quite complex, our amazing bodies can do. Our team will dive into repetitive motions that you’re doing on the daily to share the why and the how so you can move in a biomechanically sound manner and strengthen your body.
Our first series, the Anatomy of the Squat, is courtesy of Bram van Bommel, our resident Registered Massage Therapist. Check out his third and final post in this squat series on the blog!
Part 3 – Fixing Hip Restriction
So what is causing this restriction in the hips and preventing a proper squat? Everyone is different and needs a thorough assessment from a health care practitioner, but I will refer to what is happening for the “most common person” and this has two or three causes.
The hip, as previously mentioned, is a ball and socket joint. This type of joint can be further categorized by as a synovial joint. Synovial joints in nature have what we call a capsule. The capsule is what keeps synovial joints including the hip moving smoothly.
This whole process is called the Cumulative Injury Cycle (as shown with the picture above).
Over time, when the hip is overused the muscles become short, weak and tight. From there, it begins to form a friction pressure between the muscles and surrounding tissues, which causes a decrease in circulation. This results in a lack of oxygen to the surrounding area, which leads to scar tissue or adhesions formation within the capsule and surrounding tissues.
What can we do?
As therapists, we assess and treat this effectively by decreasing the scar tissue and then maintaining this by treating the tight muscles effectively stopping the cycle from continuing.
The hip capsule alone is not the only dysfunction. When there are restrictions in the hip capsule, there is limited movement in the hip. The restrictions in the capsule limit flexion the most, and then abduction and then internal rotation creating what we call a “capsular pattern”. With these adhesions in the capsule limiting the range of motion we can assume there is tightness in the muscles and ligaments in the surrounding tissues.
As previously mentioned, when the hip is going into flexion, the head of the femur must glide posteriorly to get a full range of motion in the hip itself. The head of the femur has two attachment points: the greater and lesser trochanter. The Piriformis, Gluteus Medius, Gemelli and Obturator muscles all attach to these points and when tight, these muscles won’t allow the head of the femur to glide posteriorly in the acetabulum of the pelvis. This is, if you remember from above, essential in the squat movement.
Therefore, if you only treat the hip capsule the issue won’t be resolved and if you don’t treat the muscles you’ll have the same issues. An effective treatment plan then, must treat both the hip capsule and the muscles previously mentioned. I have done this effectively and collaboratively with Chiropractors using IFC (interferential current), joint mobilizations and soft tissue release.
So check out your squat and then book and appointment to come and show me!
About Bram van Bommel
Optimal athletic performance drives Registered Massage Therapist Bram van Bommel to work with athletes of all levels to recognize their strengths and weaknesses to pursue programs that proactively prevent sports-related injuries.