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Knowing hip internal rotator release and lengthening techniques can reduce hip pain, knee pain, etc. and improve fitness performance.

Hip Internal Rotator: Release and Lengthening

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

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Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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This course describes hip internal rotator release and lengthening, commonly referred to as hip internal rotator foam rolling, hip internal rotator release with ball, hip internal rotator stretching, and hip internal rotator mobility techniques. Although terms like muscle tightness, tight hips, tight hip internal rotators, tensor fascia lata (TFL) tightness, a tight psoas muscle, etc., are commonly used, it may be more accurate to label these muscles as prone to over-activity (e.g. hypertonic, phasic). Performing hip internal 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 tensor fascia latae (TFL), gluteus minimus, and adductors (including pectineus, adductor longus, adductor brevis, adductor magnus, and gracilis), mobilizing the hip joint and sacroiliac joint, and integrating a kneeling hip flexor stretch (TFL, adductor, and gluteus minimus stretch), and standing adductor stretch, is likely to improve hip mobility and improve the effectiveness of exercises like gluteus medius clams, glute bridges, deadlift touchdowns, terminal knee extensions (TKE’s), etc. Hip internal rotator over-activity has been correlated with altered lower extremity alignment, lower crossed syndrome, pronation distortion syndrome, knee bow in (knee valgus or functional valgus), an asymmetrical weight shift, loss of hip internal rotator strength, and loss of gluteus maximus and gluteus medius strength. Further, hip internal rotator over-activity has been correlated with groin pain, hip pain, knee pain, increased risk of future 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.

Following release techniques, but before lengthening techniques, it may be beneficial to perform 

Self-administered Joint mobilization Techniques: Lower Body

Dr. Brent Brookbush demonstrating a TFL release

Course Description: Hip Internal Rotator Release and Lengthening

Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

, Sacroiliac Joint Dysfunction (LSD) and 

For a complete review of origin, insertion, innervation, action, integrated function, 

, motor behavior, subsystem involvement, and trigger points, please check out the Functional Anatomy & Human Movement Science of the:

Cadaver dissection of the tensor fascia latae muscle

Note on Integrated Functional Anatomy of Tight Hip Internal Rotators

An image of knee bow in during a gait assessment

 Signs of Over-activity and Adaptive Shortening

Optimizing Motion to Prevent Hip and Knee Pain

Introduction to Hip Internal Rotator Release & Lengthening

Several texts have noted the propensity of the muscles addressed in this article to become over-active and short (1-6). Further, many of these texts recommend techniques similar to those described in this article. Recently, more research has been done to investigate the relative activity of muscles as it relates to movement impairment, and although the research is scarce, there is a growing body of evidence correlating an increase in hip internal rotation and a decrease in hip abductor/external rotator strength, with low back, sacroiliac joint, hip, knee and ankle dysfunction (14 - 25). Note, studies correlating a decrease in hip external rotator/abductor strength with increased or excessive hip internal rotation may be evidence of altered reciprocal inhibition of functional antagonists, and over-activity of hip internal rotators. More research is needed that assesses the muscular activity of both internal and external rotators such as the Mauntel et al., Padua et al., and Bell et al. studies (20-22)

Although studies specific to hip internal rotator release and a decrease in hip internal rotation/functional valgus are scarce, the study by Bell et al. included many of the techniques below, noting a decrease in functional knee valgus post-intervention (22). Further, 3 studies have used "quadriceps rolling" as a means for examining the effects of self-administered release on post-workout muscle soreness and recovery between intense bouts of exercise (6-8). The studies showed participants perceived a decrease in muscle soreness and better performance and recovery in subsequent bouts of intense exercise when foam rolling was done immediately after training. Two studies have shown an increase in range of motion (

 and calf) without a decrease in force production post self-administered release (9-10), and several studies have shown release and stretching (

 and calf) is more effective for increasing ROM than either technique alone (11-13).

Dr. Brent Brookbush demonstrating release of the vastus lateralis

Research Corner: Hip Internal Rotator Release

Tensor Fascia Latae (TFL) Release: Static Only

Vastus Lateralis Release: Static --> Dynamic

Kneeling Hip Flexor Stretch: Static --> Active --> Dynamic

Adductor Stretch: Static --> Active --> Dynamic

Manual Stretch for TFL (Gluteus Minimus): Thomas Test Stretch for Hip Flexors

Manual Stretch for the Anterior Adductors

The muscle of the hip, which include the internal rotators such as the adductors, TFL, and gluteus minimus

Techniques & Progressions for Hip Internal Rotator Release and Stretching

Tensor Fasciae Latae (TFL) Self-administered Static Release

Tensor Fascia Latae

Gluteus Minimus Self-administered Static Release

Gluteus Minimus

Vastus Lateralis Self-administered Static Release

Vastus Lateralis Self-administered Dynamic Release

Anterior Adductors Self-administred Static Release

Vastus Lateralis

Static Hip Flexor Stretch

Active Hip Flexor Stretch

Dynamic Hip Flexor Stretch (Upright Lunge Series)

Stretching Technqiues

Anterior Adductor Static Stretch

Anterior Adductor Active Stretch

Anterior Adductor Dynamic Stretch (Side-stepping)

Anterior Adductors

Lower Leg Dynamic Stretching Series (Dynamic Anterior Adductor Stretch Included):

The sample circuit includes dynamic stretches for commonly over-active muscles in those exhibiting 

. This includes the dynamic stretch for the anterior adductors discussed above.

Lower Leg Dynamic Stretching Series

Manual Techniques

Manual Hip Flexor Stretch/Thomas Test Position (Pectineus and Adductor Stretch)

Hip Flexors

Manual Anterior Adductor Stretch

Perform each technique with accuracy (ex. hold until release for static techniques, 10-15 repetitions for active techniques at a 2:2:2 count, etc.). Progress the flexibility routine as trigger points are reduced, techniques are mastered, and optimal flexibility is attained (generally over the course of weeks). This can be accomplished by adding additional release techniques, and/or replacing static stretches with active and eventually dynamic stretches.

Activate and Integrate Under-active Structures specifically - 

Sample Mobility Program and Progressions

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

Diagnoses and Treatment of Movement Impairment Syndromes,

Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., and Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. Journal of Strength and Conditioning Research. 28(1). 61–68

Pearcy, G.E.P., Bradbury-Squires, D.J., Kawamoto, J., Drinkwater, E.J., Behm, D.G., Button, D.C. (2015) Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of Athletic Training. 50(1): 5-13

Macdonald, G.Z., Button, D.C., Drinkwater, E.J., Behm, D.G. (2014) Foam rolling as a recovery tool after an intense bout of physical activity. 

Sullivan, K.M., Silvey, D.B.J., Button, D.C., Behm, D.G. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. 

International Journal of Sports Physical Therapy

Halperin, I., Aboodarda, S.J., Button, D.C., Andersen, L.L., Behm, D.G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. 

The International Journal of Sports Physical Therapy. 9(1):

Mohr, A. R., Long, B. C., & Goad, C. L. (forthcoming 2014). Foam Rolling and Static Stretching on Passive Hip Flexion Range of Motion. 

Skarabot, J., Beardsley, B., Stim, I. (2015). Comparing the effects of self-myofascial release with static stretching on ankle range of motion in adolescent athletes. 

International Journal of Sports Phyiscal Therapy.

Renan-Ordine, R., Alburquerque-Sedin, F., De Souza, E.P.R., Cleland, J.A., Fernandez-De-La-Penas, C. (2011) Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: A randomized controlled trial. Journal of Orthopaedic & Sports Medicine

Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. 

Ramskov, D., Barton, C., Nielsen, R. O., & Rasmussen, S. (2015). High Eccentric Hip Abduction Strength Reduces the Risk of Developing Patellofemoral Pain Among Novice Runners Initiating a Self-Structured Running Program: A 1-Year Observational Study. 

journal of orthopaedic & sports physical therapy

Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. 

Smith, J. A., Popovich, J. M., & Kulig, K. (2014). The influence of hip strength on lower limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women. 

Journal of Orthopaedic & Sports Physical Therapy

Ireland, ML., Wilson, JD., Ballantyne, BT., Davis, IM. (2003). Hip Strength in Females With and Without Patellofemoral Pain. J Orthop Sports Phys Ther 2003. 33: 671-676

Souza, T. R., Pinto, R. Z., Trede, R. G., Kirkwood, R. N., & Fonseca, S. T. (2010). Temporal couplings between rearfoot–shank complex and hip joint during walking. 

Franettovich, S. M., Honeywill, C. O. N. O. R., Wyndow, N., Crossley, K. M., & Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. 

Medicine and science in sports and exercise

Mauntel, T., Begalle, R., Cram, T., Frank, B., Hirth, C., Blackburn, T., & Padua, D. (2013). The effects of lower extremity muscle activation and passive range of motion on single leg squat performance. 

Journal Of Strength And Conditioning Research / National Strength & Conditioning Association

Bell, D. R., Oates, D. C., Clark, M. A., & Padua, D. A. (2013). Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. 

Ellison, JB., Rose, S., Sahrmann, S. (1990). Patterns of Hip Rotation Range of Motion: A Comparison Between Healthy Subjects and Patients with Low Back Pain. Phys Ther 1990. 70: 537-541.

Cooper, N., Scavo, K., Strickland, K., Tipayamongkol, N., Nicholson, J., Bewyer, D., Sluka, K. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. J Euro Spine. 26 May 2015

Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600

Bibliography

Questions, comments, and criticisms are welcomed and encouraged

Hip Internal Rotator: Release and Lengthening

Related Courses:

Course Description: Hip Internal Rotator Release and Lengthening

Introduction to Hip Internal Rotator Release & Lengthening
3 Sub Sections

Research Corner: Hip Internal Rotator Release

Techniques & Progressions for Hip Internal Rotator Release and Stretching

Tensor Fascia Latae
1 Sub Section

Gluteus Minimus
1 Sub Section

Vastus Lateralis
3 Sub Sections

Stretching Technqiues
3 Sub Sections

Anterior Adductors
3 Sub Sections

Lower Leg Dynamic Stretching Series

Manual Techniques

Hip Flexors
1 Sub Section

Anterior Adductors
1 Sub Section

Sample Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Hip Internal Rotator: Release and Lengthening

Related Courses:

Course Description: Hip Internal Rotator Release and Lengthening

Introduction to Hip Internal Rotator Release & Lengthening3 Sub Sections

Research Corner: Hip Internal Rotator Release

Techniques & Progressions for Hip Internal Rotator Release and Stretching

Tensor Fascia Latae1 Sub Section

Gluteus Minimus1 Sub Section

Vastus Lateralis3 Sub Sections

Stretching Technqiues3 Sub Sections

Anterior Adductors3 Sub Sections

Lower Leg Dynamic Stretching Series

Manual Techniques

Hip Flexors1 Sub Section

Anterior Adductors1 Sub Section

Sample Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Introduction to Hip Internal Rotator Release & Lengthening
3 Sub Sections

Tensor Fascia Latae
1 Sub Section

Gluteus Minimus
1 Sub Section

Vastus Lateralis
3 Sub Sections

Stretching Technqiues
3 Sub Sections

Anterior Adductors
3 Sub Sections

Hip Flexors
1 Sub Section

Anterior Adductors
1 Sub Section