Bulletproofing Coaches - Hips

August 25, 2019

A common misconception is that coaches and personal trainers live their lives without any musculoskeletal issues. Free from niggles or injuries and blissful in their pain-free existence! Watching a coach demonstrate a deep squat or a perfectly executed scapula push up gives the impression that they move so well that injuries must be uncommon for them. This, however, is not the case and coaches, given the nature of their active work, can present with frequent issues that require attention.


From working closely alongside the coaches at FFS, it has given me plenty of exposure to such issues. The fourth coach I would like to discuss in a series of monthly blogs post will be Conor. See my previous articles on Sinead's Knee, Jamie's Hamstring, and Brian's Shoulder.



Assessing Conor's Hip Issue


Conor is a Personal Trainer, Tag Rugby enthusiast and along with Brian, oversees the creative direction and photography at FFS. Between coaching classes, training and playing rugby, his week tends to be filled with physical activity. I assessed Conor during a period of high volume of tag rugby and training.


He presented to me with :


  • Pain along the front and side of his hip.

  • Discomfort felt through the groin and lower back whilst running.

  • Felt gluteus muscles were constantly tight.



Assessing Hip Range of Motion (ROM)




Testing Anterior Hip Flexibility using the Thomas Test



Testing Lateral Hip/Gluteus Medius Strength




Main Findings


The main findings were the following:


  • Reduced hip internal rotation compared to the opposite hip.

  • Reduced Left side strength in hip extension and abduction.

  • Tenderness palpating the Piriformis, Gluteus Max/Med, Iliopsoas (Hip Flexor) muscles.



Exercise Programme






1. Gluteus Myofascial release with Lacrosse Ball


I felt Conor needed to include a lot more maintenance/accessory work into his weekly routine that included daily ball/foam rolling release work. 2 minutes each side spent massaging the lacrosse ball into the tight areas of the posterior hip







2. Psoas March


With the aid of a mini-band, we can target the Iliopsoas muscle here. It is also a great way of reinforcing co-contraction between the hip flexors and abdominals in controlling lumbopelvic position as the hip is moved from flexion to extension.








3. Clam Exercise


This exercise was given to help Conor work on his lateral hip strength deficit. This was one of the more pertinent areas to work on in the early stage of the rehabilitation process.






4. Side-Lying Hip Abduction


Similar to the Clam, the aim was to bring more structural integrity and strength to Gluteus Med/Min and TFL of his left hip.





Conor's Rehab Plan


It was important to discuss the volume of Conor’s training and potential aggravating factors. I asked him to cut down his time spent on the pitch by a minimum of 50% – and then grade back into his normal training routine depending on overall symptoms. I asked for strict compliance with warming up before training including dynamic hip stretching, foam rolling, and gluteus activation exercises using bands. As the symptoms started to improve and hip mobility matched that of the opposite hip, we added in progressive strengthening exercises like weighted step-ups and split squats.


Please note:

The above exercises were prescribed following a detailed assessment of Conor’s hip issue but can provide benefits to those as part of an active warm-up or training session. However, they are not the solution to all problems. If you think you have a problem with your hip, we advise you to see a Chartered Physiotherapist to get it checked out and given a tailored rehab programme for your specific issue.


Find Out More:


If you need advice, a physiotherapy assessment or feel your team/business could learn more about workplace ergonomics, contact Eric  at physio@ffs.ie or visit www.ffs.ie/physiotherapy.



About the Author:




Eric Cullinane is a Chartered Physiotherapist working with FFS Physiotherapy, a practice based on Leeson St Lower.


Chartered Physiotherapists have specialist knowledge in the field of work related injury management.


If you need advice, a physiotherapy assessment or feel your team/business could learn more about workplace ergonomics, contact Eric @ physio@ffs.ie or visit www.ffs.ie/physiotherapy.

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