Hip Stabilization Exercises

The hip is one of the largest, most dynamic joints in the body, designed to stabilize and mobilize the lower extremity. Hip stability means the musculature of each side of the hips works equally with every movement you take with muscles that aren’t too loose or too tight. Physical therapists can help you improve your hip strength and stability through targeted hip stabilization exercises. Mangiarelli Rehabilitation physical therapist Sarah demonstrates three hip stabilization exercises to strengthen the front, back, and side of the hip.

Anatomy of the Hip Musculature

The hip is one of the largest, most dynamic joints in the body, designed to stabilize and mobilize the lower extremity. The hip is a ball and socket joint with the end of the femur (thigh bone) as the ball component and the acetabulum, which is part of the pelvis, forming the socket.

The hip bones are surrounded by more than 20 stabilizer muscles that are broken down into the hip flexors, hip adductors, hip abductors, hip extensors, and internal rotator and external rotators. The most important hip muscles within these muscle groups are:

• Gluteal muscles include the buttocks and outer thigh, which rotate the hips internally and externally and draw the thigh bones inward (abduction)

• Hip adductors which are the inner thigh muscles that move the thigh bones outward (adduction)

• Iliopsoas muscles which are located within the pelvis and move the knee toward the chest (hip flexion)

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Why Hip Stabilization is Important

The hips are key to trunk and core stability and balance as the hips serve as the foundation for the core; this allows for the transfer of power from the lower extremity to the upper extremity. The hip musculature can generate large amounts of torque that is used for explosive athletic movements.

Hip stability means the musculature of each side of the hips works equally with every movement you take with muscles that aren’t too loose or too tight. An example of imbalanced hips is a runner who has a stronger left hip that compensates for the weak right hip by pulling up or dipping to help the weak side; this shifts the center of gravity and can lead to running injuries like hip pain, low back pain, runner’s knee, or shin splints.

Hip muscle conditioning and stabilization is important for athletes, runners, and weightlifters in order to perform at the highest level and avoid injury. Conditioning your hip muscles as you age is also essential; as you age, your hip bones and tendons can weaken and become more vulnerable to injury, fractures, and arthritis.

Hip strengthening and stability are important because:

• Weak hips lead to hip, knee, and low back pain and injuries

• Weak hips can contribute to poor posture that affects your running form

• Strong hips help support core and pelvic floor muscles

• Your hips keep the body centered and aligned

• Strong hips help in the transfer of power from the lower extremity to the upper extremity

• Weak hips can make it difficult to walk and perform daily tasks

Common causes of weak hips include tight hip flexors that restrict the hip’s range of motion and cause the gluteal muscles to stop firing, leading to compensations and hip weakness; overtraining and overuse in athletes; inadequate warm up; excessive sitting and too little exercise; age-related degeneration; and lack of mobility, cross training, or gluteal and hip strengthening. When you sit too long, a common issue for office desk workers, the gluteal muscles can become weak from underuse while the hip flexor muscles can become tight and overactive. Targeted strengthening is essential to address the tight hip flexors and weak gluteal muscles and restore hip musculature balance for stable, balanced hips. 

Physical Therapy: Hip Stabilization Exercises

Physical therapists can help you improve your hip strength and stability through targeted hip stabilization exercises. Strengthening the hip musculature helps to reduce strain on the bones of your hip and the low back muscles and ensures proper knee alignment, all of which reduces the risk of injury. Strong hip muscles not only increase the range of motion and overall mobility of the hip, but also allow ease of movement to walk, run, jump, squat, lift, climb, and change directions.

It's important to target muscles that facilitate full mobility in each plane of movement of the hip: the front, side, and back. This means strengthening the gluteus maximus and medius and piriformis (in the buttocks), the hamstrings (back of the thigh), hip adductors (inner thigh), and abductors and tensor fascia (outer thigh).

Mangiarelli Rehabilitation physical therapist Sarah demonstrates three hip stabilization exercises to strengthen the front, back, and side of the hip:

Research has shown that hip strengthening exercises are effective in addressing issues like low back pain and knee osteoarthritis. A 2020 study assessed the effect of a hip stretching and hip strengthening program on non-specific low back pain and found that both the hip stretching and hip strengthening program participants experienced improvements in low back pain intensity, disability level, balance ability, and quality of life compared to the control group. A 2023 study noted that individuals with low back pain who participated in a hip strengthening exercise program also had significant improvements in pain and disability. Another study assessed the effect of a six-week hip muscle strengthening and core stabilization program on pain, symptoms, and function of those with knee osteoarthritis compared to a control group. Researchers found that after the 6-week intervention, knee osteoarthritis patents had improvements in symptoms, physical performance, and muscle torque.

Are you experiencing hip instability or hip pain? Work with a physical therapist to strengthen and stabilize your hips and address any hip pain!