Hip External Rotator: Release and Lengthening

This course describes hip external rotator release and lengthening, commonly referred to as hip external rotator foam rolling, hip external rotator release with ball, hip external rotator stretching, and hip external rotator mobility techniques. Although terms like tight muscle, muscle tightness, tight hips, tight piriformis, or tight hamstrings are commonly used, it may be more accurate to label these muscles as prone to over-activity (e.g. hypertonic, phasic). Performing hip external rotator release and lengthening techniques to increase mobility prior to activation, integration, and strengthening techniques may significantly enhance rehabilitation and performance programs. In practice, the release of the piriformis, biceps femoris, and posterior fibers of adductor magnus, mobilizing the hip joint, and integrating a figure 4 stretch (piriformis stretch), bicep femoris active stretch, and Captain Morgan stretch (posterior fibers of adductor magnus stretch), is likely to improve hip mobility and improve the effectiveness of exercises like gluteus medius clams, glute bridges, deadlift touchdowns, etc. Hip external rotator over-activity has been correlated with altered lower extremity alignment, lower crossed syndrome, pronation distortion syndrome, lower extremity dysfunction, sacroiliac joint dysfunction, an asymmetrical weight shift, knee bow out (knee varus or functional varus), and a posterior pelvic tilt ("butt wink"). Further, hip external rotator over-activity has been correlated with a loss of hip external rotator strength, loss of gluteus maximus and gluteus medius strength, low back pain, hip pain, knee pain, an increased risk of future low back, hip, and knee injury, and a loss of sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should consider adding these exercises to their repertoire to improve the outcomes of their integrated exercise programs and therapeutic (rehabilitation) interventions.

Release Techniques

• Piriformis Static Release
• Biceps Femoris Static Release
• Posterior Fibers of Adductor Magnus Static Release
• Posterior Fibers of Adductor Magnus Dynamic Release
• Biceps Femoris Vibration Release

Joint Mobilization Techniques

Following release techniques, but before lengthening techniques, it may be beneficial to perform Self-administered Joint Mobilization Techniques: Lower Body

• Hip Mobilization
• Open Books

Lengthening Techniques

• Posterior Fibers of Adductor Magnus Static Stretch
• Biceps Femoris Active Stretch

Caption: A release technique for the commonly overactive piriformis muscle