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Measuring Hip Internal Rotation

Written on November 23, 2009 at 11:07 am, by Eric Cressey

Q: Inspired by your articles on T-Nation, I’ve started to measure IR/ER/Total shoulder rotation deficits using a goniometer.  I did have another question, however: you mentioned in an article that Hip Internal Rotation Deficit (HIRD) is a serious problem among baseball pitchers and hitters due to the asymmetrical front leg blocking in both mechanics. I absolutely agree, and I use corrective exercises and stretches to help alleviate these problems. However, I lack a good way to test for this; do you have any suggestions?

A: We check hip internal rotation in the seated position.  Basically, you just have the individual sit up tall at the end of a table, and position the hips and knees at 90 degrees.  Then, without allowing the hip to hike, you internally rotate the femur. This is one of the many assessments on our new DVD set, Assess and Correct, and it’s featured on page 50 of the tag-along e-manual.  Check it out:

For more information on how to correct the problem – and assess for other issues like this, check out www.AssessandCorrect.com.

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23 Responses to “Measuring Hip Internal Rotation”

  1. Smitty Says:

    You cool!

    Great video.

  2. Kyle Boddy Says:

    Thanks for addressing my question, Eric!

  3. Andrew Barker Says:

    Just got the Assess and Correct DVD, very excited to see what you have to show in this. This is right up my line with my Master’s work… you are excellent at what you do.

  4. Matt B Says:

    Since when do you have a goatee? It must be No-shave november huh?….

  5. Carson Boddicker Says:

    EC,

    Great stuff, my friend.

    Craig’s Test is one of my favorites to use with my runners as many of them lose internal rotation ROM from excessive pronation. Furthermore, I like to use it to evaluate the position of the femoral head in anteversion/retroversion.

    Keep up the great work.

    Best,
    Carson Boddicker

  6. Kyle Says:

    EXCELLANT!!!

  7. Chris Brown Says:

    Great stuff EC, very informative as always!!

  8. Rick Kaselj Says:

    Great stuff.

    Rick Kaselj of ExercisesForInjuries.com

    .

  9. Derek Peruo Says:

    Do you warm up your athletes before assessing them? Or do you assess the athlete while still “cold?”

  10. Travis Says:

    This video is great! Very informative, interesting and applicable.

  11. Christian Says:

    Hey Eric,

    I’m a Podiatric student from Australia and we are currently learning hip mobility examination techniques, much the same way as instructed in your video.
    I exhibit very limited internal rotation (<10degrees) and do to the defined end point felt during the examination have been told that this is a bony deformity that cannot be resolved. i.e. i apparently haven’t de-rotated enough during development.
    I just wanted your opinion on this as I value it heavily. So what do you think, am I doomed or is it resolvable. Also have had an external impingment problem with my Left shoulder which has falerd during repetitive boxing movements. Could this be influenced by my poor roattions at hip?

  12. Eric Cressey Says:

    Christian, it certainly does happen (retroversion). If you have an IR deficit in prone as well as supine and seated, it (along with capsular changes) would be a candidate. I wouldn’t expect it to change.

    Everything influences everything else, so that poor hip rotation could cause you to compensate with scapular protraction and shoulder internal rotation. Of course, it could also lead to back, hip, etc. issues. It’s just a matter of where you happen to break down.

    Or, it might be completely unrelated.

  13. Eric Cressey Says:

    Derek, we usually assess cold just for standardization.

  14. Gene Says:

    Eric,

    I always assess the hip supine in axial extension, prone for craigs measurements, sitting; capsular & ligamentous changes and standing for weight bearing and lower chain involvement. Then I assess the hip with mobilization techniques.
    This certainly adds a time factor to your exam but gives you a good idea of the internal rotation physiological and accessory movements of the hip.

  15. Eric Cressey Says:

    Gene,

    Great additions. We talk about several of those techniques in our Assess and Correct DVD set – although I tried to keep this newsletter a bit more simplified for the masses. ;)

  16. Kasey Says:

    Hey Eric,

    When you talk about the lead leg for pitchers lacking IR, would the same thing apply to golfers? Would right handed golfers have a left HIRD and would that lead to the same movement pattern as a pitcher, where the left hip would open too soon on the downswing and the arm swing would lag behind, causing the “stuck” or “block” swing?

    Thanks!

  17. Andrew Says:

    Eric,
    I’ve pitched for several years and I definitely have HIRD on my lead leg. But my drive leg hip always seems to be an issue. Naturally it wants to remain in external rotation and I’m thinking this is compounding the issue of flying open too early. I’ve been working a stride stretch w/ rotation to open up the hip flexors as I have also tested myself positive for impingement on the rear hip. I’ve just recently started to try to strengthen internal rotators on the drive side. Even after working at this for awhile now and doubling up reps on that side for single leg squats to try to compensate for weakness on my drive leg I can still tell a considerable difference in lack of stability on my drive side accompanied by a general weakness compared to my landing leg. Any thoughts? Is this something you have ever come across before?

  18. Kelsie Koester Says:

    I am a PT student doing a research project over internal hip rotation, do you know of any good research article for reviewing.

  19. Eric Says:

    Great video Eric

  20. Conor Says:

    Cool video Eric…very informative. What implications would this have on hockey players and what type of corrective exercises would you recommend using with this population?

  21. Eric Cressey Says:

    Conor – very common issue among hockey players. I like kneeling glute mobs and lying knee-to-knee pull-ins/stretches. Good manual therapy on hip external rotators is key, too.

  22. Kjetil Says:

    When seated, the piriformis becomes an internal rotator. Which means that you have to check internal rotation when standing and external rotation when sitting, for the same assessment.

  23. Chance Cooley Says:

    Eric can you explain to me why a good degree of Hip IR is required to perform a deep squat? Also, could a lack of Hip IR lead to knee valgus? I’ve improved my ankle mobility, strengthened my VMo’s and glute meds, and I still experience knee valgus when I squat. I recently had my Hip IR measured, and it was well below 30 degrees. Could my lack of Hip IR be causing the knee valgus?

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