Why Hip Strengthening Is Essential For Female Athletes

By: Mo Skelton | March 6, 2013

Today’s female athletes have worked hard to narrow the gender gap. Setting records, making jaw-dropping plays and training at high intensity are just a few of the ways the ladies are proving they are just as aggressive, talented and successful as their male counterparts.

Performance gains aside, however, unfortunately, injury rates among female athletes are higher than males. (Concussions Are an Epidemic in Women's Sports Too) The largest factor is the difference in body structure. AlthoughACL injuries are the most widely discussed, hip pain is even more common among female athletes due to a higher likelihood of instability and muscle weakness in the hips. When jumping and landing, women are also more likely to cave their knees inward, a tendency known as knee valgus. This correlates with a number of other problems, from general hip pain to hip replacement surgery.

The hip is comprised of a ball and a large pelvic socket covered by a labral ring of cartilage to allow for mobility. Muscles surrounding the pelvis generally are larger and stronger, but more susceptible to stiffness. The Journal of the American Medical Association recently noted that hip replacement surgeries often fail in women due to size differences in the femur bone, hip socket and bone density.

The five injuries most commonly sustained by female athletes are hip hypermobility (pelvic torsion); labral tears; snapping hip syndrome and IT band syndrome; sports hernias; and muscle strains.

Hip Hypermobility (Pelvic Torsion)

Hypermobility refers to too much movement, associated with looseness of the ligaments connecting the bones. This can cause a shifting of the pelvis or even a rotational change, which can create leg length differences and then pain in the back, knee, foot and even the hip.

Labral Tears

The labrum is a ring of tissue around the hip socket that adds to the contact area and allows for more functional stability. Twisting, slipping or repetitive stress typically tears this tissue, causing deep pain and mimicking a hip flexor strain.

Snapping Hip Syndrome and IT or iliotibial band syndrome

These are two separate issues stemming from the same area of tissue. The IT band extends from the side of the hip near the muscle called the gluteus medius. With snapping hip, there is a notable "snapping" sound on the side of the hip when an athlete runs, jumps, climb stairs or walks fast. With IT band syndrome, the problem is at the far end of the tissue where it crosses the knee. Both conditions are common in runners. Snapping hip causes hip pain. IT band syndrome causes knee pain. The snapping is generally due to excess mobility, whereas IT band syndrome is due to tightness in the tissue at its insertion near the knee.

Sports Hernia

 A sports hernia is a muscle tear that typically occurs from a sudden twist under resistance, like during a tackle in football. The area most often injured is at the junction of the oblique muscles of the lower abdomen and the adductor (groin) muscles. The pain mimics that of a groin strain. The immediate cause is usually two muscles pulling in opposite directions at the same time.

Muscle Strains

The most common strains are in the hamstrings, often caused by eccentric contractions (lengthening while in action) produced when running. The purpose is to slow the leg down to land at the end of each stride prior to cycling to the next. The hip flexors are the next most commonly strained muscle group. These strains occur when an athlete propels her leg up during running. Sprinters with poor mechanics are at higher risk for hip flexor strains, especially when their leg travels too far behind their body before swinging forward. Finally, groin strains can be triggered during sudden changes of direction in sports such as soccer and basketball.

Common Themes

Q-angle

This is the angle from the hip to the knee. Since the female pelvis is naturally wider, this angle is larger in women, putting greater strain on the ACL and the hip musculature.

Natural hypermobility

At a certain point in the month, the female body produces higher amounts of relaxin, a hormone that naturally loosens ligaments and subjects the body to biomechanical stresses to the hip, as in pelvic torsion.

Muscle imbalances

Tightness typically affects the hips, glutes, iliopsoas and adductor muscles. They need to be stretched to improve mobility. Try bodyweight Lunges (forward and lateral) or Squat to Stands.

Hypermobile muscles

Generally the hamstrings, gluteus medius, IT bands and rotators in the hip.

Prevention

For any hip injury, performing appropriate exercises is critical. Below are some exercises female athletes can perform to prevent hip injury. To gain greater control of the hip rotators and prevent knee valgus:

• Squats
• Lunges
• Sumo Deadlifts
• Plyometrics

Strengthening exercises are essential for hypermobile muscles. Perform:

• Planks
• Reverse Hyperextensions
• Supermans
• Bridges with a barbell
• Clam shells with a theraband

Always seek expert advice as necessary.

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About the Expert

Mo Skelton - Mo Skelton is a physical therapist and a strength and conditioning specialist. He works with patients and athletes from all walks of life; serves as a strength coach for local teams in southern Oklahoma; and consults with small colleges to assess their sports medicine...