I am fortunate to work with some of the best minds in sports.  Of those brilliant minds is none other than Dr. Stephen Osterer…
I’ll let the Doc take it from here.

Enjoy!

——-

 

 

 

A while back I posted this video of myself going through some lower half movement exercises.

After doing so, I received a number of good questions and comments.

• Are you trying to create positive disconnection in the lower half?
• Is that how you gain mobility?
• Does this movement transfer to the mound?
• What is the purpose of this drill?

The point of this article is to:

1. Shed some light on what hip rotation means to me…
2. The rationale for why I train it…
3. And to provide practical applications for athletes, coaches and therapists.

 

What is Hip Rotation, Really?

 

When most coaches talk about “the hips” — particularly “hip” rotation…

they are actually referring to the pelvis.Differentiating hip rotation from pelvic rotation may seem like a matter of semantics (okay, who cares?), but I promise you this is an important distinction. Hip rotation and pelvic rotation are in fact very different, and, as you will see, insufficient hip rotation can become a significant detractor to efficient pelvic kinematics.

The femoroacetabular joint (the “hip” joint) is a “ball-and-socket” articulation composed of two bony surfaces:

(1) The femoral head (the “ball”), and
(2) the acetabulum (the “socket”; see picture below).

As with any articulation, relative motion between the composite parts is an indication of joint health.

That is, a healthy hip is one in which the femoral head (the “ball”) moves well through an appropriate range of motion relative to the acetabulum (the “socket”), and vice versa.

Let me state that in terms much easier to understand.

Each component of an articulation can move relative to the other.

• The femur can internally and externally rotate on the pelvis.
• The pelvis can internally and externally rotate on the femur.

So Why Train Femoroacetabular Joint Rotation?

My goal here is to offer up some new concepts…

Potentially connect some dots between the clinical, rehabilitative and performance worlds. This will not be the ‘definitive guide to training articulations’.

The rationale for training hip rotation runs much deeper than “dude look at Chapman”.Having said that, that is a really good place to start.

It’s no secret that hip rotation plays an integral role in the pitching motion (hitting as well, but this isn’t a hitting post).

Thank you to Rob Friedman (@pitchingninja) for supplying the goods! 

When an articulation expresses independent motion we term that ‘dissociation’.

Here’s an example of poor dissociation of the femoracetabular articulation on the table.

Notice that as I move this players femur relative to his acetabulum, the opposite side acetabulum moves as well.

That is, this player’s femur is intimately coupled to his acetabulum and cannot express independent motion!

Here’s an example of poor dissociation of the femoroacetabular articulation on the mound.

You can see that this player’s pelvis and femur are more tightly joined or married to each other in motion than Aroldis Chapman’s.

There is very little dissociation between the two.

• The femur cannot move freely relative to the pelvis.
• The femur cannot articulate freely relative to the pelvis.
• The articulation cannot articulation motion.

The ‘hip’ is no longer a ‘hip’.Intuitively this should invoke some problematic feelings.

Clearly not having a hip results in less than optimal biomechanics, but what does it mean for injury and long term health?

Injury prevention resides in the ability of the athlete to withstand the demands of competition — what is referred to as
capacity.

As such, the injury prevention equation is characterized by the intricate balance between capacity and demand.

When the demand placed on the athlete is much greater than his or her capacity, the risk of injury goes up substantially.

A perfect example of this is the young professional pitcher who doubles his innings pitched in his first year with the Big Club and
lands himself on the disabled list.

There are many ways in which we can define capacity; endless subcomponents of the word can be categorized. At the BPG, our definition we try to keep it concise and it includes:

• • Tissue capacity
  • Psychological capacity
  • Physiological work capacity…
  • And – Movement capacity

Obviously there is overlap between these categories (humans are complex systems, so why wouldn’t there be?) and your definition
certainly doesn’t need to be the same as ours. However, it is critically important to take into consideration all of these components when preparing your athletes for the upcoming system.

For example, a commonplace method to combating the Tommy John epidemic has been to improve the capacity of the forearm flexors. It’s been shown in the literature that these guys are force shielding stress from the UCL in the throwing motion.

Logically it would make sense that improve our chances of withstanding TJ surgery, we should strengthen the forearm flexors…right?

Not so fast.

Improving tissue capacity without addressing the other subcomponents may not be adequately preparing our
systems overall capacity.

Maybe the players underlying issue is a movement capacity problem?

Maybe it’s psychological capacity?

We must be able to account for these components when assessing, treating and training our athletes.Our goal in training hip rotation, therefore, is to add money to the capacity piggy bank.Specifically, we are improving movement and end range tissue capacity.

Movement capacity is, very simply, the ability to perform and better tolerate a wide range of movements.

Here, we are referring not only to the ability to passively access a large amount of articular range of motion (i.e. passive range of motion), but also the ability to actively control it.

The more controllable range that we own, the more potential solutions that we have in solving the particular movement task.

The more articular options in our disposal, the greater the ability that system has to offset load at any one particular joint, and, instead, distribute it more evenly throughout all of the involved biomechanical degrees of freedom.

Moreover, having more articular options affords pitching coaches the ability to shape efficient mechanics.

Poor mobility can be a thought of an organismic constraint to movement.The initiation, control and cessation of movement is…

Reliant on the brain’s interpretation of the sensory information provided to it.One of the primary (if not the primary) source of this info comes from the joint capsule.

Dr. Michael Chivers talked about this idea in a great post on mechanoreception for BPG.

The two main points that he was trying to make were;

1. When movement is initiated, there is a burst of mechanoreceptor activity from the articulation.

2. With limited range of motion, we have limited sensory feedback.

Our nervous system, therefore, does not get a full picture of the movement task that we are asking it to process.

A mismatch of input and required output may ensue, leading to motor error and reduced motor variability (the ability to adapt).

So when we talk about improving movement capacity we are synchronously talking about improving afferent sensory information.

Not only are we providing the nervous system with better hardware, in the form of moveable articulations, but we are improving the software, in the form of better sensory information.

Improving Mobility

Mobility work is much harder to improve than people think.

It requires effort.

 

Our bodies will only adapt and respond to meaningful and consistent inputs.

 

That means that 5 minutes of static stretching prior to lifting, foam rolling, or in a cool down, may not be enough of a stimulus to force adaptation.

Mobility is the ability to control an articulations range of motion = flexibility + strength.

What I typically see in practice is players misunderstanding this concept.

• • 1. It is not the same thing as a band mobilization or stretching end range passively.
    2. It is not opening up a short term window of opportunity with quick fixes or reflexive changes in tone.

Mobility needs to be thought as training.

• • • It deserves respect.
    • It requires intent.
    • It is not a walk in the park.

 

When to Use These Exercises?

 

Training for mobility, the way in which I train it at least, is usually a very neurologically demanding process. This requires
it to be prioritized on a training day, not as a fluff-filler between exercises or as part of a warmup.

It is a workout in of itself.

I program these exercises early in the off-season as their own lifting days. They should not be placed at the end of the workout when your nervous system is drained.

A Word of Caution

This is not considered medical advice nor is it a foolproof system to prevent injury. This is simply ways to improve
articular health, control & ultimately improve your movement capacity.

Some Moves to Try Out

 

3 Go-To’s I use to assess and address femoroacetabular issues in order of when to use them.

 

These are absolutely not the end-all be all of mobility training, so please do not take them as that. They are, however, a fantastic starting point to create more robust and resilient articulations.

*These movements and concepts come from

Functional Range Conditioning(FRC) so if you are truly dedicated to this stuff I highly recommend attending a course or seeking out a qualified practitioner.

CARs (“Controlled Articular Rotations”)

“Active rotational movements at the outer limits of articular motion.”

CARs provide valuable insight into the amount and quality of articular control, they act as a warm-up and provide the
brain with afferent sensory information at end range.

Much has been written on the subject of CARs, so if you want to learn more then check out Todd Bumgardner’s

Here’s a video of me performing a standing version of hips CARs.

You can perform them just as well in side-lying or in
quadruped.

• • 1. Bring maximum awareness and attention to controlling the outer limits of motion.
    2. It should feel like you are at war with your nervous system.Proceed through each direction of rotation three times increasing the amount of tension with each successive rep.

Take note of the amount of range, the fluidity or smoothness of it, and any pain.

As this becomes a daily routine you will begin to take note of change, good or bad, that will provide valuable insight into
the evolution of your ‘movement capacity.’

90/90 PAILs & RAILs

• • 1. 1. • Progressive
          • Regressive

Angular Isometric Loading”)

Mouthful of words aside, this FRC staple is my go-to starting point for improving range of motion.

The move is directed at the hip capsule and when done properly will heed tremendous changes in a relatively short period of time (a few weeks). As with CARs, there is some great info already out there on the exercise, so I will let Maria Mountain do the honors here.

Some other points to consider.

1. Maximal attention and focus is absolutely necessary.
2. Cut the pump-up music and try something low key.

Maximal tension &force = more motor recruitment = better results. 

Think of moving the pelvis relative to the femur.

The exercise that started it all off. Hopefully, now, the rationale behind this movement is clear.

It is Not used to create more range!! 

• • 1. 1. 1. Prior to beginning the movement take a deep diaphragmatic breath and build up tension in your entire lower half.
          2. Maintain contact of the trail leg with the ground for as long as you can while transitioning.
          3. If you need to place a pad underneath your knee then do so.

Major Takeaways

Let’s circle back now and look at the questions I posed at the onset of this post.

Are you trying to create positive connection in the lower half?

Not in the sense that most people think. We want the femoroacetabular articulation to be able to express movement independent of the rest of the body – what is termed dissociation.

Is that how you gain mobility?

No.

Mobility – control of an articulations range of motion – will be greatly improved with consistent strength work at end ranges.

We need to convince the nervous system to allow us more range and that usually requires more work than what people expect.

Does this movement transfer to the mound?

I don’t know. I’m not your pitching coach.

Transfer to the mound will be dictated by them and the specific goals of your training.

What, then, is the purpose of this drill?

To improve CAPACITY (and therefore resilience) by way of increasing sensory information required for…

• • 1. 1. • Movement…
          • Articular independence to create mechanical efficiency…
          • Improving strength at end range…
          • And creating the opportunity for biomechanical changes.

I hope that this post sparked some interest and curiosity in relation to the word mobility and movement capacity. If you
have any questions, comments or concerns, do not hesitate to let me know!

Dr. Stephen Osterer

Dr. Stephen Osterer holds a Bachelor of Science from Cornell University. While pitching for the Big Red baseball team he developed a strong passion for manual therapy, rehabilitation and sports performance.

The concept of combining these led him to the Canadian Memorial Chiropractic College (CMCC) where he completed a Doctorate of Chiropractic graduating Cum Laude with clinical honours.

Dr. Osterer has worked with athletes ranging from the amateur to professional levels aiding them progress along the therapy to performance spectrum. He is currently an assistant instructor for the Functional Range Release course

If you’d like to connect with him you can drop him an email at drstephenosterer@gmail.com…

Or you can follow him on twitter at: @drsosterer