Mobility training – avoid hip / posterior chain injuries
Injuries and rugby often go hand in hand. After all, rugby is a dynamic, high-impact sport. A large percentage of ruggers play injured and the pressure of a long, competitive season means injuries are sometimes ignored until the off-season.
While injuries in rugby can happen to any part of the body, hip injuries are on the increase. Past studies listed hip injuries as relatively rare – the 16th most-common rugby-related injury. A more recent 2014 report (ref 1) revealed that hip injuries have now moved up to the fourth most common rugby injury.
The hip is a ball and socket joint which means it’s naturally very mobile and capable of a wide range of motion. However, that mobility comes at a cost – instability. The more inherently unstable a joint is, the more prone it is to injury. That’s why shoulders, the other ball and socket joint, is also a common site of injury in rugby.
Why are hip injuries becoming more common?
When hip injuries were less common, most people were much less sedentary. They spent less time sitting, more time moving, and were likely to have active occupations. Even top-flight ruggers had “real jobs” to support themselves and, being big and strong, these were often in things like farming and the building trade.
This increased level of activity meant that pre-professional-era rugby players often had better hip joint mobility, flexibility, and stability than many modern players simply because they sat less and moved more. Movement helps keep your joints healthy, partly because muscles are less likely to tighten up with disuse, and partly because movement increases synovial fluid production, the substance that lubricates and nourishes your joints.
The current batch of ruggers is more likely to make a living sat behind a desk. Sitting for long periods of time can have an adverse effect on hip strength and mobility. This leads to problems not only on the pitch, but in the gym too.
Unlike muscles, the structures that make up your joints have no blood supply and repair themselves very slowly. That’s why joint injuries take so long to heal, and why prevention is such an important consideration.
Lack of hip mobility, stability, and strength can adversely affect performance in the squat, deadlift, and lunge, as well as affecting running, jumping, and sprinting mechanics. Poor movement quality can mean stress that should be borne by muscles ends up on the joints, and those joints are exposed to very significant and potentially injurious loads.
A lot of players dive head-first into intense strength and conditioning programs but lack the joint mobility and stability to perform their chosen exercises properly. They focus too much on the weight on the bar and not enough on learning proper technique. This is often compounded by the competitive atmosphere of a group training session and is a recipe for injury.
In many cases, ruggers would benefit from taking a step back from their regular workouts and doing some targeted pre-hab training to make sure their bodies are up to the demand more intense strength and conditioning work. Time spent pre-habbing can save on time rehabbing!
In summary, the stresses on rugger’s hips has increased but too much sitting means many player’s hips cannot cope with these greater demands.
How do you avoid becoming one of the ever-increasing number of hip injury sufferers? The answer is to address the triumvirate of mobility, stability, and strength. It’s no good working on just one of these elements – they are co-dependent. Mobility without strength and stability, or stability without mobility will not reduce your risk of injury and may compound the problem. Instead, all three elements require your attention.
Tight muscles will affect your mobility. Long periods of sitting means that the muscles that surround your hips are kept in a shortened position. Over time, this robs them of their flexibility. As your muscles tighten, your hip will lose mobility and will not move as freely as it should. This increases your risk of a host of different hip injuries, from strained muscles to arthritis. Here are some simple self-assessments you can do to establish if you have tight hips.
Restoring mobility requires stretching and not just the few minutes of quadriceps and hamstringing stretching that most ruggers do begrudgingly before or after training. Long periods of sitting have caused long-term muscle tightness. Fixing this will take a concerted effort. Luckily, you can improve your flexibility while watching TV.
Because of the large number of muscles that affect the hip joint, you’ll need to stretch your hips from several different angles. You’ll need to include stretches for the anterior and posterior hip, medial and lateral hip, as well as the hip rotators.
Here is a simple five-exercise hip mobility routine that will restore mobility throughout your hips. Some of the exercises are a little on the advanced side but, even if you have the hips of an 80-year old, you should still be able to do them, albeit with a reduced range of motion. Do this sequence of movements at least once a day, every day, gradually increasing your range of movement as your hips loosen up.
While your hips need to be mobile, you still need to be able to control them. For example, if your hips roll in or out during squats, lunges, or sprints, you are much more likely to suffer an injury.
Stability comes from the muscles deep within the joint which is why these muscles are often referred to as stabilizers. Like hip mobility, developing hip mobility requires a multi-directional approach. Stability exercises often involve relatively small ranges of motion, and some are entirely isometric or static.
Exercises that will increase hip stability include:
- Side lying clams
- Side steps with a resistance band around your knees
- Squats with a resistance band around your knees
- Knee squeezes
- Supine hip thrusts
- Hip flexion with band
When it comes to lower body strength training, most rugger’s go-to exercises are squats, deadlifts, and leg presses. These are great exercises, but they only really work your hips in one direction. To develop all-round hip strength, you need to work your hips from more than just one angle. After all, your hips can work through a wide range of motion, so they needs to be strong through a wide range of motion too.
Once you have developed adequate hip mobility and stability, include 1-2 of these exercises in your lower body training program:
- Lateral step-ups
- Lateral lunges
- Crossover lunges
- Reverse lunges
- Bulgarian split squats
- Single leg Romanian deadlifts
Your hips are a crucial joint. Whatever your playing position, you can be sure that your hips play an important role in your performance. Reduce your risk of injury by taking care of your hips.
(1) To identify intrinsic risk factors for groin/hip injuries among academy level rugby union players: A prospective cohort study – https://bjsm.bmj.com/content/48/7/655.2