Hip Hinging: Rehab to Performance

Do you ever feel like your hips are tight and your legs just don’t seem to want to work? I can speak from experience and say that this happened quite a bit to me in my playing days. It was always conveniently the worst on days that we’d test the 60-yard dash. The problem with having this much tension and decreased range-of-motion in your hips is that your brain is a master compensator and you’re going to make up for that lost range-of-motion somewhere. Typically, that somewhere is your low back or your knees.

Now I’m not stating that tension and stiffness can’t be used in your favor, but more in the sense that this movement compensation isn’t allowing you to perform to your best, and potentially leading to future injury.

Let’s break down the movements of the hip hinge and what muscles are involved in this process. The task should focus on movement primarily from the ball-and-socket joint which is the actual hip joint. Some people like to call their Sacroiliac joint their hip joint, which it is not. In this action, the butt shoots back while the lumbar spine and pelvis stay relatively neutral through the process.

You’ll want to see the shin angle stay relatively vertical as well, which is good cue or measure to judge if you’re hinging or not. You want to limit the amount of quadriceps activation by focusing on not allowing the knees to bend much past 50-60 degrees or so and keeping them behind the toes. The more you do of both of those movements the more the quad takes over and the glute is more of a secondary mover. The movement should be slow and controlled, not choppy. A rigid hip hinge indicates some muscle balance compensations (i.e. overuse or weakness). A good hip hinge is smooth while loading into the glutes, which is then shortly followed by exploding from the glutes.

So now let’s investigate the lumbo-pelvic complex and what muscles are being used to control this motion. A common mistake when hinging back is that we overarch or hyperextend the lumbar spine. This is due to 1 of 2 things:

1. The iliopsoas (hip flexor) is short and restrictive which pulls the lumbar spine anterior as you roll through the motion.

2. The lumbar erector spinae muscle group (Spinalis, Longissimus, and Iliocostalis) are short/hypertonic and being overused.

Coming up from the loaded hinge position you should see/feel the hamstring synergize along with the extension coming from the gluteus maximus. Too many people mislabel the hamstring solely by its action of knee flexion, but if you create a closed and stable base of support the muscle action reverses from its origin/insertion making the hamstring a pelvic uprighter/posterior tilter (I might have made uprighter up). In other words, it must control the descent into the hinge and then be able to fire appropriately to extend the hip back to neutral.

Let’s discuss some of the underrated muscles involved in the hip hinge, the hip abductors. These muscles, gluteus medius and gluteus minimus (there are more but these will be our focus), stabilize and centrate the hip into the ball-and-socket joint through movement. A lack of good muscle activation from these will result in wonky movement of the hip as well as other issues down the chain at the knee and ankle.

(Photo Credit: Clinically Oriented Anatomy, 6th ed., Moore, Dalley, and Agur)

Now that you have a general breakdown of the muscles and actions involved in the hip hinge, let’s talk about the consequences of not having a good hip hinge and good hip stability. In baseball there is some level of flexing and rotating the spine during pretty much every throw, groundball or swing. This is the mechanism we typically see that can cause disc herniations. If you take this slow-progressing aggravation of the disc into the weight room and start losing form due to poor hip hinging/stabilization, then you’re asking for a recipe for disaster. I’m not saying you can’t flex your spine (don’t burn me at the stake), it’s just that the more you repeat these motions without adequate stabilization or movement the greater your risk to break down.

There is also quite a bit of lumbar extension (bending backwards) during the throw and swing as well which over time can irritate the pars interarticularis of the lumbar vertebrae which lead to stress fractures (spondylolysis) as well as many other various injuries. Having too much hyperextension at the lumbar spine and hypertension of the lumbar erecter spinae during the hip hinge is a good indication that this could be at risk during baseball activities if things get flared up.

I’m going to take things clinical now and run you through how I treat baseball players with low back issues and then how I work the hip hinge into rehab and training. I’ve been given the permission from the athlete to demonstrate and discuss his case. He’s a D-1 pitcher that came in with excruciating low back pain. He had pain with all lumbar ranges-of-motion, wasn’t responding to spinal manipulation, manual therapy, McKenzie direction therapy, or spinal decompression. The only thing that initially brought relief was the class 4 laser (photobiomodulation) which reduced inflammation enough for him to start having some decreased painful range-of-motion (not pain free though).

He was sent for an MRI which revealed a hefty lumbar disc herniation as well as spinal stenosis. A real doozy! He was unable to bend over, squat, or hinge without stabbing pain in his back and shooting pain down his leg. Once the inflammation started dying down, we were able to start making progress on getting him back on the mound. He started progressing well by using the techniques above that previously weren’t working.

Once he was through that initial inflammatory phase, we started working on re-building strength and function. Building the muscles around the hip is the first step as well as gaining a baseline level of activation and understanding of intra-abdominal pressure and diaphragmatic breathing. I’m not going to get deep into IAP too much on this post, but if you want to learn more about that and how we use it in rehab and performance check out our post at https://elitebaseballperformance.com/the-dynamic-neuromuscular-stabilization-approach-to-arm-care/. That IAP stabilizes the spine and works synergistically with the pelvis by creating the tension in the hip and not over-leveraging the low back. We use a device called the Core 360 belt to help use cue proper diaphragm activation during the rehab and training process.

The standard technique we go to re-establish hip strength and joint centration is Dynamic Neuromuscular Stabilization or DNS. You can learn more about DNS also from the article listed above. Many of the exercises are closed chained exercises that require a stabilized base of support with the intention of reversing the muscle action between the origin and the insertion, essentially flipping them. As the athlete gets stronger, we start utilizing various lifts and movements that require a controlled hip hinge to reengage those patterns.

Click on the picture to direct you to some of the hip hinge integrative training we did with him.

The hinge is an important movement for stability, mobility, power, and performance. The best athletes in the world are some of the best at the ability to hinge and activate their posterior chain. It’s one of the main power generators in both the throw and the swing. It must be trained. It must be strong. It must efficient. The key is to find a manual therapist and strength coach that fully understands the intricacies of the hip hinge in their process.

So that's a little bit on the rehab and return to play side of things. To give a better perspective on the strength training and performance side of things I had to bring in an expert... Senior Asst Director of Strength and Conditioning at Texas Christian University, Zach Dechant. Zach recently wrote a book, Movement Over Maxes, which has been a big hit in baseball and the strength training industry. Let's hear from Zach...

Tyler White

Gestalt Performance

World Pitching Congress

Zach Dechant

The RDL, or Romanian deadlift, is the exercise choice for training the hip hinge pattern. The RDL is a huge compound movement that essentially develops the posterior chain from the head to the ankles. It has huge bang for your buck. There is no comparison when looking at other movements such as the leg curl. The hamstring spans two joints at the knee and hip, which means it’s important for hip motion as well as knee motion. Performing a leg curl is training the isolation of the hamstrings. It leaves out the all-important glutes and trains a motion that is seldom a factor in sport performance. The real meat and potatoes of the posterior chain is hip extension. This is where speed, power, and strength originate. The following details the optimal position of the hip hinge.

Baseball athlete hip hinging during a deadlift
Hip Hinge

Optimal Position

1. Feet hip-width

  • Imagine testing a vertical jump. We wouldn’t jump from a wide base.

2. Knees should be slightly bent

  • Knee angle doesn’t change with the RDL. It remains fairly constant throughout the movement.

  • Knees bending means the athlete is substituting sinking the hips down instead of back.

  • Shin angle should remain fairly vertical.

  • If the shins are moving forward, the athlete isn’t shifting posteriorly. Again, he is sinking down.

3. Neutral spine and pelvis

  • Flexing the spine is a power leak and a giant injury risk, especially when loaded with weight. The same can be said of hyperextending the spine. The spine should stay locked and neutral.

4. Push hips back

  • Focus on shifting weight posteriorly and pushing the hips back.

  • The bar should travel just below knees or until limited by hamstring stretch earlier.

5. Scapular retraction/Lat tightness

  • The lats assist in lumbar stability. Teaching athletes to pull the bar back into the body will not only stabilize the spine, but keep shear forces under control.

  • Bar stays close to the body throughout.

6. Neutral head position

  • Head and spine always aligned.

Grooved Regressions for Youth Athletes

With youth athletes feedback is often necessary in teaching the positions of an optimal hip hinge. Grooved regressions assist the athlete into positions. The use of PVC pipes, bands, and/or foam rollers can provide tactile feedback. That feedback helps the athlete to feel positions creating greater body awareness.

1. PVC on Spine

  • Coaches can have athletes place a PVC down the spine. They must maintain three points of contact throughout the entire movement, on the head, mid back, and pelvis.

  • Any separation from the PVC means an athlete is breaking a flat spine.

  • This is a great movement for immediate athlete feedback.


2. Wall Drill / Foam Roller

  • Have the athlete stand 3-6 inches from a wall or use a 3-foot long foam roller standing on its end placed behind the athlete at that distance.

  • Athletes use the external cue of reaching back to touch the wall or foam roller. With the proper pattern of posterior weight shift, they should have no problem.

  • Without a posterior shift, athletes are just bending over at the waist and will not reach the obstacle behind.


3. Corner RDL

  • Barbell is placed into a corner or against an object.

  • Hold barbell end with both hands.

  • Feet directly under the end of the barbell.

  • The path of the barbell takes athletes back into a posterior shift.


4. Band-Assisted

  • Using bands attached above can assist an athlete who demonstrates trouble shifting their hips back.

  • The athlete will hold the band in the hand or hands and shift posteriorly.

  • The bands also assist in the countermovement of the hip hinge.

  • Straps attached high can be used in this progression as well.


Bodyweight Progressions

The bodyweight movements are simply a progression to the grooved movements. They are built around controlling an athlete’s own body weight as well as well as a light load. While the grooved patterns assist the athlete into position, the bodyweight movements require the athlete to control their body into the correct position. These are the next step in the progression of learning the movement.

1. Unloaded PVC RDL

  • Movement patterning with a PVC pipe

  • Emphasize the bar staying close to the body throughout.


2. Band-Resisted PVC

  • Attach bands from rack to a PVC pipe.

  • The athlete will be forced to hold the PVC tight to the body throughout the movement.

  • The band provides resistance and athletes must tighten the back to keep the PVC close to the body throughout.


3. Plate / DB / KB Loaded

  • Advancing to holding weight

  • An initial progression for athletes progressing to heavier weights.


RDL and Single-Leg RDL

The progressions listed above give athletes and coaches many options to building an optimal RDL position. Athletes must learn the ability to separate the hips from the spine. It is a fundamental position of all sports. Once this position is understood the loaded barbell RDL and its variations can now be loaded for athletic development.

Single-Leg RDL

Many athletes struggle with the unilateral nature of the SL RDL. Being able to connect the back leg with the torso is a troublesome area for many. The motor control of the movement becomes quite a struggle. The most common breakdown in the SL RDL is the back leg and torso not moving in concert.

The back leg in the SL RDL should be controlled by the glute. Locking the glute in prior to movement helps to create a single unit from shoulder to ankle. From that position athletes simply pivot on the opposite hip for the SL RDL.

Optimal Position

1. Stand on one leg

  • Dig the big toe into the ground to create a shortened arch

2. Activate backside glute

  • Without moving cue athletes to activate and lock in the backside glute for the swing leg

  • This creates tightness and keeps the athlete's legs locked with their bodies.

3. Cue athletes to raise the heel, not bend over

  • Focus on raising the swinging leg heel instead of bending over.

  • This helps to keep the leg and torso in line.

  • Raising the heel will naturally lower the torso

4. Square hips

  • One common flaw is hips that hike up or rotate

  • Cue athletes to sink into the down leg hip to stay flat through the pelvis

5. Neutral head position

  • Head and spine always aligned.

Single-Leg RDL w/ Foam Roller

Blocking a foam roller into the foot helps as a grooved regression for athletes to feel that locked in position of the body and leg moving in synchronization.


DB Single Arm / Single-Leg RDL

The second step in the progression is to add light load into the movement with a single arm DB hold. I prefer the single-arm hold in that it allows athletes more freedom to balance with the opposite arm.


Barbell Single-Leg RDL

The third and final step in the progression is to move to the barbell single leg RDL pattern. The barbell allows for the greatest load and requires, in my opinion, the highest degree of stabilization. Having