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The Hip

The Hip as an Interface for the leg and Core

The hip interfaces the core and the lower leg. Many muscles of the hip originate at the core and attach to the thigh. As such, the hip is pivotal in generating both stability and power and has large implications up and down the kinetic chain. Where runner’s hit the ground is largely dependent on where the hip muscles approximate the lower leg. Runners will often complain of issues local to the hip as well as issues farther down the leg that can often be traced back to the hip and its role to the core. Running related injuries local to the hip include hip flexor tendinitis, gluteal tendinopathy, and labral tears.

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Gluteals

Gluteus maximus, medius and minimus all originate on the top of the femur and span various lengths along the back aspect of the pelvis. The glutes and deep lateral rotators work in all three planes of motion to both stabilize the hip as well as generate power at the hip. In running, glute medius and minimus work to stabilize the pelvis in the frontal plane. When these muscles are injured or not working correctly runners will demonstrate a hip drop while running that is easily visualized with gait analysis.

Deep Lateral Rotators

The deep lateral rotators are a group of six muscles that primarily move the hip in the transverse plane. These muscles include the superior gemellus, inferior gemellus, obturator externus, obturator internus, quadratus femoris, and the piriformis. While these muscles do move the hip, compared to the gluteals, they are very small muscles with not a great ability to generate power. These muscles function better as stabilizers of the hip- keeping the ball of the femur centered in the socket of the pelvis. Thus, when these muscles lose function runners develop instability issues within both the hip joint and the closely approximated pelvic floor. 

Hip Flexors:

The hip flexors are a group of muscles located in the front of the hip that work together to flex the hip, bringing the thigh closer to the torso. The main hip flexor muscles include the iliopsoas, rectus femoris, and sartorius muscles. In running, the hip flexors play a crucial role in propelling the body forward by pulling the thigh towards the torso during the swing phase of the stride and stabilizing the hip during the stance phase. Runners often complain of pain and tension along the front of the hips that is frequently attributed to hip flexor irritation. It is important to note that while the symptoms are located over the hip flexors, often this pain can come from within the hip joint itself or even be referred from the lower back. 

Adductors

The hip adductors are a group of muscles located on the inner thigh that work together to adduct or bring the thigh towards the midline of the body. The primary hip adductor muscles include the adductor magnus, adductor longus, adductor brevis, and gracilis.

In running, the hip adductors play a crucial role in stabilizing the pelvis and maintaining proper alignment of the leg during the stance phase of the running gait. Common running related injuries related to the adductors include groin strains and pelvic floor dysfunction.