9 Powerful Exercises For Hip Instability Treatment

Do your hips feel weak and unstable when you walk or stand? You are not alone! Approximately 10% of the general population have hip pain and this number is even higher in older populations. This post will cover hip instability treatment, specifically through the best 9 hip exercises with pictures to improve hip stability.

Hip Anatomy

The hip is a ball and socket joint created by the femoral head and the acetabulum of the pelvis. The acetabulum of the pelvis is the socket-shaped region of the pelvis. The hip plays an important role is both hip stability and functional movements in everyday life. The actions of the hip are:

• Flexion
• Extension
• Abduction
• Adduction
• Internal Rotation
• External Rotation

What Is Hip Stability?

Before we can cover hip instability treatment, we must first understand what exactly hip stability is. Hip stability is the ability of the hips to stabilize the pelvis. The hip capsule and the hip muscles play an important role in the stability of the hip and pelvis. The hip stabilizing muscles are:

• Gluteus Medius
  • This is the most important muscle involved in hip stability
• Gluteus Maximus
• Piriformis
• Deep core stabilizers

Hip Instability Symptoms

There are many symptoms that are associated with hip instability. As always it is important to see a medical provider for a full evaluation if you are experiencing hip instability symptoms.

Your doctor will be able to look at your medical history and any contributing factors such as excess lower body or upper body weight. The most common symptoms of hip instability are:

• Hip pain
• Groin Pain
• Clicking/grinding
• Loose hip that feels as if it will “give out”
• Hip gives out suddenly with sharp pain

Hip Instability Causes

There are many causes of hip instability. The most common causes of hip instability are:

• Hip Dysplasia
  • Congenital abnormalities of the hip joint such as in hip dysplasia are considered a atraumatic instability
  • This occurs when the hip socket is too shallow for the thigh bone or femoral head
  • This is most common in women
  • It can lead to excessive stress on the hip joint and eventually osteoarthritis and hip instability
• Labral Tear
  • The labrum is the cartilage of the hip joint. It is the rim of tissue the lines the hip joint.
  • The common causes of a labral tear are congenital abnormalities and repetitive stress over time, such as in runners
  • If you suspect a hip labral tear you can find 9 Simple Hip Labral Tear Symptoms Lower Back Pain Exercises here.
• Motor Vehicle Accidents
  • Motor vehicle accidents can cause traumatic injuries such as severe dislocation or large fractures.
• Posterior Impingement
  • This occurs when the femoral head of the thigh bone pinches the acetabulum of the pelvis.
• Simple Subluxation
  • A subluxation occurs when the hip is not fully in the socket. This typically leads to a partial displacement or full hip dislocation and overall hip instability.

Diagnosing Hip Instability

There are a few tests that are commonly used to diagnose hip instability. Typically hip instability is diagnosed with symptoms that you as the patient are experiencing, however these tests can determine the cause of your hip instability. It is best to see your doctor for a physical examination, however these hip instability tests are common tests that may be performed:

• Computed Tomography (CT scan)
  • A CT scan takes multiple X-ray images of the body at different angles and provides more information than plain x-rays.
  • A CT scan may be taken with the use of a contrast agent. This will allow the internal structures to be seen more clearly.
• Magnetic resonance Imaging (MRI)
  • A MRI arthrography can show the ligaments and cartilage of the joint that plan x-rays and CT scans cannot see.
  • An MRI may also show loose bodies in the joint.
• X-ray
  • An x-ray shows the body structures of the body. This includes fractures and any type of dislocation or subluxation of a joint.

Hip Instability Test

There are a couple of special tests known as hip instability tests which can test for hip instability in just a few minutes without any imaging. These can be performed by a physical therapist or doctor. The most common and effective hip instability tests are:

• Prone Instability Test
  • The patient will lies on their stomach on the examination table with their feet on the floor.
  • The examiner will apply pressure on the spinous processes of the spine while the patient is relaxed.
  • The patient then lifts one leg while the examiner applies the same pressure on the spinous processes of the spine
  • A positive test is when the patient notes pain when in the first relaxed position but no pain when lifting one leg up.
  • This includes a video of the test being performed.
• Abduction-Hyperextension External Rotation test (ABHEER Test)
  • The patient will start by lying on the unaffected side.
  • The examiner will then abduct the affected leg to 30-45 degrees, extend the leg back and externally rotate the hip while applying an anterior force on the greater trochanter. (In simpler terms, you will press forward on the back of the hip)
  • A positive test is anterior hip pain.
• Hyperextension External Rotation Test (HEER Test)
  • The patient will start by lying on their back with their legs hanging off of the table.
  • The patient will then bend or flex the unaffected hip.
  • While holding this position the examiner will hyperextend and externally rotate the opposite or affected leg.
  • A positive test is anterior hip pain.
• Dial Test
  • The patient will lie on their back to start.
  • The examiner will then internally rotate the hip, and then release the limb, allowing it to externally rotate.
  • A positive test is when the hip externally rotates more than 45 degrees and their is no definitive endpoint.

Hip Instability Treatment

There are 2 main ways to treat hip instability. The most common way to treat hip instability is through a non-operative treatment approach such as physical therapy. Conservative options are typically tried before any surgical options. If non-surgical options fail, then surgical management is the next option.

Hip Instability Physical Therapy

Physical therapy is the best conservative hip instability treatment. Physical therapy will focus on strengthening and stabilizing the muscles around the hip. It is best to see a licensed physical therapist who can perform an evaluation on you and develop the best plan of care for your specific diagnosis.

If your symptoms are severe and your hip is stiff, you may need to start with simple range of motion exercises prior to advancing to the following exercises. If you are treating your hip at home and have mild to moderate symptoms these are the best hip stability exercises for you!

Exercises For Hip Instability

These 9 exercises for hip instability can be performed at home with little to no equipment. These include 1. Hip Abduction 2. Hip Hinge 3. Bulgarian Split Squat 4. Hip Abduction Series 5. Clamshells 6. Side Planks 7. Side Steps 8. Donkey Kicks 9. Single Leg Stance.

1. Hip Abduction

• Lie on you side with your hips stacked on top of each other.
  • Keep your bottom leg bent and your top leg straight.
• Now lift your top leg up, making sure to not allow your hips to rotate or your leg to come forward as in the first picture
• You can also perform this exercise in standing position as seen in the second picture with a resistance band for added resistance.
• You can find The 29 Best Band Warm Up Exercises For Full Body Workout here.

2. Hip Hinge

• Start with your feet hip-width apart.
• Now keep your back upright and slowly hinge at your hips.
  • Keep your knees slightly bent throughout the exercise.
• Now slowly push your hips forward until you are back at the starting position
• This exercise can be performed with a barbell weight, resistance band or with no weight.
• Remember to keep your spine neutral throughout the movement, and avoid rounding your back or letting your knees collapse inward.

3. Bulgarian Split Squat

• This is quite possibly the best exercise for hip instability treatment.
• Stand facing away from a bench or step, with one foot resting on it.
  • Your other foot should be a few feet in front of the bench, with your knee slightly bent.
• Lower your body down by bending your front knee, while keeping your back leg resting on the bench behind you.
• Lower your body until your back knee almost touches the ground.
• Now push up through your front foot to raise your body back up to the starting position.

4. Hip Abduction Series

• Lie on your side in the same position as you started in for the hip abduction exercise.
• Now lift your top leg and perform 10 circles clockwise and 10 circles counterclockwise.
• Make sure that your hips remain stacked on top of each other for the entire exercise.
  • Your hips should not be rotating and moving back and forth.

5. Clamshells

• Start on your side with hips stacked on top of each other, your knees bent and a resistance band around your knees.
• Now keep your feet stacked on top of each other but lift your top knee.
  • Once at the top position, slowly bring your knee down in a controlled movement.
• If this is too difficult, or you have pain while lying on your side you can perform a modification of this exercise.
• Start lying on your back with your knees bent and the resistance band around your knees.
• Now slowly push both of your legs out to the side.

6. Side Plank

• The deep core muscles also play a major role in hip stability.
  • These muscles are often neglected.
• To perform this exercise you will start on your side with your elbow on the ground.
  • Now push up through your elbow and lift your hips off the ground so your body is in a straight line.
• Start by holding this for 15 seconds and slowly progress to holding for longer durations
• Be sure to not allow your hips to “sag down”

7. Side Steps

• Start in a mini squat position with a resistance band around your knees.
• Now keep the resistance in the band the entire time and start taking steps to the side.
• Be sure to keep the mini squat position the entire time throughout the exercise.

8. Donkey Kicks

• Start on your hands and knees with your hands directly below your shoulders and your knees directly below your hips.
  • Now keep your back leg bent and lift it up.
  • You will feel your glute muscles working.
• This exercise is great because the leg that is still on the ground is stabilizing your hip, while your other leg is strengthening your glutes as you lift it up.
• You can add a resistance band around your thighs for added resistance.

9. Single Leg Stance

• Start by standing near a sturdy surface such as a counter or parallel bar.
• Now lift one leg up and balance on one leg for 30 seconds.
  • Focus on activating your glute muscle as you are balancing.
• This exercise strengthens your gluteus medius which is the most important muscle in hip stability

Summary of Hip Instability Treatment

These 9 exercises are the best hip instability treatment to fix your hip pain and hip instability. If your hip instability is causing you back pain, you can find 7 Miraculous Exercises For Lower Back And Hamstring Pain here. As always if you have ongoing pain and instability, the best person to seek medical care from is your doctor.

These 9 special exercises will improve hip stability and strength. Most importantly this hip instability treatment will get you back to the activities that you love! You can find more hip exercises you can perform at home with just a resistance at 29 Best Band Warm Up Exercises For Full Body Workout.