As important as it is to stretch and release our external rotators, we often neglect to touch upon our internal rotators. Some of our main internal rotators of the hip region include the gluteus medius and gluteus minimus muscles. The movement of internal rotation of the hip is described as bringing the knee towards the midline of the body.

If you find this movement a challenge, you’re not alone. It is an area of hip mobility that most people need to improve on. Additionally, this action becomes more difficult to improve as we age due to the degeneration of our joints.

One of the most common conditions that limit mobility at the hip joint is a type of arthritis (a term referring to any type of disorder of the joints) called Osteoarthritis (OA). It occurs when the protective cartilage at the end of the our bones begins to wear down over time. When this happens, people begin to feel joint pain, stiffness and a loss of range of motion to the area. This issue affects the daily lives of many of the patients in our clinics and millions of people worldwide each year.

A study done by Cibulka and Threlkeld states that, “diminished hip range of motion is the most common component used to indicate the presence of hip joint osteoarthritis.” (2007). The study also mentions that, “In osteoarthritis of the hip, the first 2 motions that are diminished are usually hip internal rotation and hip flexion.” (2007). Having this information really stresses the importance of increasing hip mobility and even more specifically, internal rotation.

“World Arthritis Day” is a campaign on October 12th that aims to spread global awareness about getting early diagnosis and treatment for all types of arthritis. In honor of “World Arthritis Day”, here are three effective internal rotation stretches that can be done either as a warm up, prior to sports or exercise, or as a stand-alone stretching series as often as once a day.

Active “Windshield Wiper” Hip Movement
(Internal Rotation Stretch)

1. Start by lying on the ground on your back with both knees bent and feet on the ground.
2. With both hands behind your head and feet still planted on the ground, we are going to gently allow our knees to fall all the way to the left as far as we can go without causing pain, hold for 5 seconds.
3. Gently raise knees back upward to neutral again in an upright position.
4. Now gently allow knees to fall all the way to the right side as far as you can go without causing pain, hold for 5 seconds.
5. Repeat this process 10 times on each side, each time trying to get your knees completely flat to the ground.

Passive “Windshield Wiper” Hip Movement
(Internal Rotation Stretch)

1. Start by lying on the ground on your back with both knees bent and feet on the ground.
2. With both hands behind our head and feet still planted on the ground, gently allow your knees to fall all the way to the left as far as you can go without causing pain.
3. Place your left heel on top of your right knee and allow the weight of the left heel to press your right leg further into internal rotation passively.
4. Breathe and hold for 30-60 seconds.
5. Switch sides and repeat.

Glute Medius/External/Internal Rotator Release With Lacrosse Ball

1. Start by lying on the ground on your back with both knees bent, feet on the ground and arms by your side.
2. Lift your right foot off the ground and place it on the bent left knee so that the outer area of the right ankle is resting just above the left knee.
3. Place the ball under the right glute region
4. Anchoring into the ground with your arms and left foot, slowly rock your body back and forth as you begin to roll your right glute over the ball.
5. Switch sides and repeat.

BONUS: External Rotation Stretch
Add in this external rotator stretch as a complementary stretch to the above internal rotation stretches

1. Start by lying on the ground on your back with both knees bent, feet on the ground
2. Lift your right foot off the ground and place the ankle over the knee of the left leg
3. Reach forward with both arms and grab the left knee/shin region and begin to slowly pull left knee towards your chest
4. Slowly lower your torso to the ground and hold for 30-60 seconds. Switch sides and repeat.

Author: Jared Bir, RMT at Allan McGavin Sports Medicine

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Bibliography:
Cibulka, M. T., & Threlkeld, J. (2007, September). The Early Clinical Diagnosis of Osteoarthritis of the Hip. Retrieved September 28, 2018, from https://www.jospt.org/doi/pdf/10.2519/jospt.2004.1313