GTP TV: Ep 7 – All About Your Hips

Hey gang. It’s Maria here from GoalieTrainingPro.com. This is episode number 7 of Goalie Training Pro TV! Today we’re talking about all things hips. I’m really gonna talk a lot about the pelvis.

 


This is another post that is pretty visual so if you are able to then you can watch it here! >>
https://youtu.be/vdA6yQqJzUo

Okay, so like I said, we’re gonna talk about the most important joint in a goalie’s body, without doubt, because if there’s a dysfunction at the hip, even if you’re not getting hip pain, it’s gonna lead to injury or compensations and eventual injury at your knee, your ankle, your back, anywhere sort of above and below the chain.

And you know, I’m talking about injury, not sort of well, sometimes it’s sore. And sometimes it’s stiff. What you do to your hips is unbelievable. It’s like a baseball pitcher’s shoulder. So I don’t know that there is a major league baseball pitcher who doesn’t have some shoulder aches and pains from time to time, but I’m talking about a real, true injury. You can’t be successful if you have an injury to your shoulder as a pitcher, or an injury to your hip as a goal tender.

Before we get started, I’ll remind you this episode’s brought to you by priceblocks.com, which is if you’re a goalie coach, it’s where you can post what times you have available. So that goalies who live in your area, they can search by area. They can see, oh gees, like Steve has a session over at Brookside. He’s available at 3:00 tomorrow. That’s actually works perfectly for me. It costs whatever, $8,000,000 an hour. That’s exactly what I wanted to spend. You can book your appointment. You pay for it right there. You’re all set up. You’re good to go. So check it out!

Okay. Let’s talk first about the hip structure. So, for the video portion of this, I printed off some audio visual aids and then I also borrowed Brian’s pelvis. (I don’t mean really actually Brian’s pelvis. I mean Brian’s model of the pelvis. See what I did there?) But if you can’t see the visuals I will do my best to explain!

So, basically what I want you to take from this is that there’s your femur, there’s your thigh bone, and then there is a little angle there and a ball. And that ball of your thigh bone fits into the socket of your pelvis. And that is called your acetabulum. So the ball of your femur goes into your acetabulum and then away you go and you do your thing! You do the boogie-boogie!

There’s also in there a sort of a cartilage ring around the rim that gives it a little more depth. You can see it’s a pretty deep socket, but there’s a little cartilaginous ring that gives it some depth, and a little bit of cushioning and that is what your labrum is.

Okay, so that’s kind of the structure. So basically, that’s talking about the pelvis from the front. And also in the front you have your pubic symphysis. But if we turn it around, you have your tailbone right down there. Then above that is your sacrum. You also might have heard of the sacroiliac joint. Well, there is an outer part of your pelvis that is called the ilium which is connected to the sacroiliac joint.

(Oh! And your tailbones are actually called your coccyx.)

So above all of that are your lumbar vertebrae. So this would be L4, L5, and S1. A lot of disc injuries, most disc injuries happen between L4 and L5, or L5 and S1. We’ll talk about that a little later.

And if it’s possible to imagine it from the inside, you also have your ASIS. Also you have your anterior superior iliac spine. And you have your rectus femoris, which is a hip flexor and the knee extensor. So it’s a quadriceps muscle. It attaches all the way up so that it can flex your hip, but it also crosses your knee, so it can also extend your hip.

And you actually have your intervertebral discs too. Man this thing is full of information. There are your ischial tuberosities, that’s sort of like your sit bones. And your hamstrings come up and they attach in there as well

I think that’s kind of covers it.

So muscle all attaches to all of this. You can see it’s full on integrated with your spine. Like it’s a really crucial piece of hardware here that we need to take a look at.

Now let’s talk about the muscles … But like you guys would know, if I said, “What’s a big hip muscle?” You’d probably say, “Oh, your glutes.” Okay. And we’ll talk about this in a second. There’s a glute medius. There’s a glute minimum. There’s a glute maximus. But then, peel away those and this is what you get. How many of you honestly knew that you had a gamellus superior? And a gamellus inferior? And an obturator internus and externus?

So I want you to just get a sense of all the stuff that is in there. And if you look at these muscles, and you look at where they attach, like they’re attaching to your thigh bone. So hey. What are they in a position to do? They’re in a position to rotate that thigh bone in and out.

Well you guys do a lot of rotation of your thigh bone. You know when you do a butterfly or recovery, you’re doing rotation at your thigh. So, these are important muscles for you. And some of you will say there’s no rotator cuff in the shoulder. I know there’s not a rotator cuff in the shoulder. But really, just because nobody’s called it that before. There is a rotator cuff in your hip! Because it really looks very, very similar although it’s like way more complicated than the rotator cuff in the shoulder.

And that’s just peeling away on the backside, on your rear end side. So then let’s look at what’s going on from the inside. Well we’ve got another whole hot mess in there. Like, holy crap! There are so many muscles in there. Like, there’s your iliacus that crosses your hip, and it attaches to your lumbar spine, to your low back vertebrae. Are you kidding me?

There is the iliacus that attaches all on the inside of the ilium, and then crosses the hip, and it’s another hip flexor. There’s your adductors. There’s the pectineus. Like, so many crazy, crazy muscles.

So, again, we talk about like, oh the team trainer says I strained my groin. Okay. But like, what’s your groin? Because I see a gracilis, an adductor magnus, an adductor longus, an adductor brevis. I see a sartorius. I see all these things. So what do you mean is involved? I see muscles, yeah, that attach all in here and then cross my hip. But then they kind of share a common insertion of a muscle that comes all the way up through me and attaches to the front of my lumbar vertebrae, and then they can flex my hip. It’s crazy!

So, the hip is complicated, and do I need you to train your gemellus? It’s so complicated. It’s a lot like the shoulder again. But I think it’s more so because that close integration with those muscles, and the torso, and the spine, and the pelvis. There’s a lot of moving parts. So, look at the anatomy. (Or you don’t have to. I look at it for you.) But I want you to just appreciate the complexity of these muscles, and how important they all are, and how dysfunction in one can have a big effect. You know that’s why yeah, a lot of times you get … Someone will say, “Well, I have a sore hip.” Well it might not have anything to do with your hip, specifically. Might be one of these other areas, or vice versa.

Okay. That was the easy tricky part and now it gets even trickier because of the muscles that cross your hip, some of the actions depend on the position of the joint. So we’re gonna go back to our friend the glutes, because they’re pretty basic muscles. But, if we stripped away the glute max it would show the glute medius, and then underneath that the glut minimus (which a lot of you probably didn’t even realize that you had).

Let’s look at glute med and glute minimus. If I have my hip flexed, they work to internally rotate my hip. So, they internally rotate my thigh because it’s my thigh relative to my pelvis that’s internal rotation. But if I’m in extension, they work to externally rotate my hip.

So, it’s not even just like, these muscles do this. It’s like no, no. It depends if the hip’s in this position, they internally rotate. If it’s in this position, they externally rotate. So, it’s a little bit confusing. So I just want you to appreciate how much is going on and how little attention we give it.

I will bet you 47 cents that you do the same four to six stretches in the same position, stretching the same muscles in the same position, over and over and over and over again, and then wonder, “I don’t know why I’m not getting a wider butterfly flare. I don’t know why my hips always feel tight. I don’t know why. I stretch. I have a really good stretching routine. It’s so good that I’ve been doing it the same thing for three years.”

Those muscles are so intricate, and so integrated, we need to integrate our torso in different positions to really get them through the range. So, they are your bread and butter, those deep muscles. And yeah. I think most of you don’t even ever stretch them, let alone train them, ever. So, and again, totally not your fault. You could probably look at some of pictures of the hips thinking, “Holy crap. All that is stuck here into my hip? I can’t even believe it.”

Okay! So let’s talk about mobility and stability. I would say you need internal rotation obviously. That’s what gives you your wide butterfly flare. You need the abduction. That’s what give you your splits, which you all want even though it’s really way, way, way down on the list of the tools that you need to be a successful goalie. I know that you want it, but you need strength there. You need strength in those positions.

But they’re also kind of vulnerable positions for the hip. They’re the positions that your hip sometimes gets overworked in any way. So how do we do that in a safe and effective manner? So teach you to develop strength in those end ranges of position, our end ranges of motion.

So the easiest way to do it, I mean, there are a million ways. But the easiest way we can do it is with some isometrics. So, if I just get into my butterfly, and don’t worry about your foot being flat. We’re really just focusing on the hip at this stage. But if I get in that position, and just actively try to pull my feet apart, so you’re not gonna see any movement. But really what I’m doing is get as wide as I can, but staying tall in my hip. So I don’t want to bend over forward, because that’s not really a functional position.

So I just push my feet out for five seconds, and then relax. Push for five seconds like I’m trying to make that flare wider, then relax. That will help build some strength in those muscles. But it’s pretty safe because I don’t have an external load. I’m not really so that I’m gonna may be using other muscles to cheat, to help. So, that’s one way you can do it.

Another way we can do it is, let’s say for our adductors, which is actually the grownup name for your groins, I can do the same thing. Nice tall torso, good wide stance, and feeling a good stretch. And I’m just gonna push this foot down into the floor for five seconds. And then relax. And push down. And then relax.

So now we do maybe five repetitions. Once I’m pretty good at that, I can then make it a little bit more dynamic. So I’ll just take off my shoe. My foot’s on a smooth floor. And then I’m just gonna lower out over a count of about five or six seconds. I’ll use my hands to bring me back up, because I’m really just wanting to work on that lengthening action, so that I’m building some strength in those lengthened and vulnerable positions.

And then the other one is really learning to be balanced. So, we do a lot of balance from our feet, but you guys actually have to balance from your knees a lot. So, just coming into a kneeling lunge position, nice and tall, lifting that front foot up, and trying to stay nice and balanced over that one knee without using your arms, or flailing around, or doing anything crazy.

So, those are a few things you can do that are really gonna help sort of improve the performance of those muscles, some of those missing muscles that we don’t normally get that cross your hip joint.

Okay. Let’s move on. Let’s talk about what could go wrong because when things go wrong, it’s no fun for anybody.

So, your femur is like a long wrench, right? So think of a big … What’s it called? Like a socket wrench, with a big, long handle. So we’ve been tires up here in Canada Land, taking off our summer tires, putting on our winter tires. So those lug nuts are hard to get off, so you get a wrench with a long lever so you can generate a lot of torque. Well, that wrench with the long lever is a lot like your femur, right? So the ball goes in, that’s the socket. And then you’ve got this long wrench handle.

Well, so it can torque your pelvis too. So then we do crazy things like we go into the reverse VH. We get a rotation in the hip. We get one skate out, we brace, we kind of sit our hips back, and we try to block at that post. Well, do you see how much torque is on your hips through that long lever, that long socket wrench of my pelvis?

It’s a lot. It’s in there and it’s going grrrr. It’s twisting my pelvis. So, that’s not a very nice thing to do.

So to hold everything together we have kind of cartilaginous fusions. Like, it isn’t all one bone. These are separate bones that you kind of fused together. So when we get in there and do our reverse VH, and torque on that thing, we can actually bend the pelvis out of alignment.

Big deal. Whatever. Torque your pelvis. Go ahead. Knock yourself out, right?

Well, if I think back to like 10 minutes ago when we talked about all the muscles that crossed our pelvis or attached to our pelvis, let’s say we’ve got that rectus femoris that attaches there and goes across, and crosses our knee. Well, if I torque my pelvis, so that one side sits forward a little bit, and one side sits back a little bit, well now one rectus femoris is a little bit looser. And the other rectus femoris is a little bit tighter. It is gonna change the tension on my hamstrings too. One hamstring’s gonna feel a little bit tighter. One’s gonna feel a little looser. And when I move, I’m gonna be pulling in a off balance kind of way.

So, I think that pelvic asymmetries are probably one of the biggest undiagnosed, not really injuries, but dysfunctions in a goalie’s pelvis and hips. Just like when our tire’s out of alignment, or our wheel’s out of alignment, we wear out our tires. In an odd way, the same thing can happen with our hip joint. So, it could be that again, because of that torque, and because our adductor muscles, our groin muscles come in and attach, it makes one side automatically tighter. The other side is a little loose. We go out and we tear our groin.

 

So, the pelvic asymmetries, I think every single goalie has them and gets them. And that’s why I think it’s worthwhile too, just like you go to a strength coach, that you see a physiotherapist, maybe once a month, in particular during the season. Because even your positions like the reverse VH, those kinds of positions, or just you’re trying to get a puck and you kind of fall over this way or that way, or you get pushed one way or the other, you can torque your pelvis out of alignment.

Okay. Then we’re going to talk about FAI, Femoroacetabular Impingement Syndrome. And it makes you guys scared, and I think some of you bury your head in the sand, because you think, “Well if I don’t see it or think about it, then I won’t get it.” Which is, unfortunately, with this type of injury, the absolute worst thing that you could do.

Strength training won’t prevent it. If you have a true FAI, limiting the amount of force in the positions that you put it in, or eliminating the amount of force and the end range, and the positions you put it into, that will help spare your joint, and save your joint. So, for some athletes, it really is finding a way to work around it.

So, let’s talk about what it is. So Femoroacetabular Impingement is just exactly what it sounds like. Femoro, your femur. Acetabular, your acetabulum. There’s an impingement.

So when we’re made, it’s not like there’s a bucket of perfectly shaped acetabulums that go with the perfectly matched femoral head. We develop from two cells, so how’s everything gonna be perfect? So there are two kinds of impingement. One is called a cam impingement. And one is called a pincer impingement. So basically, and a lot of times you will have them both. But a cam impingement is where the head of the femur is kind of an odd shape, and it rubs on the acetabulum, and gums things up a little bit. Yeah, it rubs on it. It’s not a smooth joint.

And then there’s a pincer, which is basically the acetabulum has a little hitch in its giddy up, and it butts up on the femur and limits your range of motion. So the worst thing we can do with athletes like that is to be like, well let’s just really try and get your deep squat better. These are the athletes that just, you know, a little squat. And they’ll just like, I’m stuck. I can’t. He’s saying, “Well what limits you?” “I don’t know. It just won’t go.” Okay, well then it’s like lift your heels and really try to get you squatting deeper, and really like stretch you hard. It just won’t work because we’re butting into bone.

Now, there is a little bit of a glide in the hip joint. So sometimes your femur can sort of be stuck to the front, or stuck to the back, and that will limit range of motion. Sometimes your joint capsule which is sort of a connective tissue sock that goes around the joint, it can get restrictive and gum things up.

So, it doesn’t mean it’s like, oh yeah, you’ve got FAI. You got boney impingement. You’re gonna need surgery. Maybe it’s joint capsule. Maybe it’s just the position that your femur is sitting in your acetabulum. So a good physiotherapist with manual skills, a good manual therapist, can actually mobilize that joint and get it moving for you. And you’ll know, because you’ll just get up off the table, and be like, “Ah. That’s way, way, way better.” So, don’t worry about … Don’t bury your head in the sand because you’re afraid of it.

So, trying to force your body into a range that your joint doesn’t have, then what happens? So, we just try to keep getting it. We try to keep getting it. So, we’re just butting in to that. We’re smashing those bones together. It’s like if I just punched myself, or somebody just punched me all the time, at first it would hurt and it would cause a little irritation and inflammation, so that our body will respond, “Hey wow. This area is taking a lot of wear and tear. Let’s respond by building up a callus so that it doesn’t hurt so much, and so that it can’t get damaged so much.” That’s what happens in your hip joint. You build up boney calluses. But, again, there’s not a lot of space in there.

So if I’m building up boney calluses, you can see pretty much how that’s gonna continue to limit my range of motion, until then it gets to the point where, hey, I’ve lost so much range of motion that I can’t even get into the positions I need to to play. And it’s actually painful. And then you very well may need some surgery to help reshape your acetabulum, to help reshape the head of your femur. And a lot of times too, don’t forget you have that labrum in there. It will get worn and damaged and irritated and then you are looking at FAI surgery.

So if you feel a pinge or a block, doesn’t mean it’s like a boney impingement. It doesn’t mean you need surgery. It just means hey, it shouldn’t be this way. I want to find out sooner than later why it is this way because if I let it keep going, it could be one of those things where, if you looked after it three years ago, you would be okay. You’d learn how to work around it. But since you were scared and wanted to ignore it, now you are definitely gonna need surgery.

I was reading a research article and they talked about the worst movements for end range torque in internal rotation. And so we’re talking about motions that are stressful on the hips, because being a goalie is really, really stressful on the hips, as you all know. I’m not telling you something you don’t know.

And a lot of times, we think … It’s natural to think, oh it must be the butterfly must be the most stressful. But it’s not. The most stressful position is, if you think of doing a T-Push, and then how you break at the end with that internal rotation moment. That is actually the most stressful on the hip joint, in terms of forcing it into an end range of motion. And it makes sense, again, because when you’re on your knees, when you’re in your butterfly, it’s a shorter lever. Plus, your pads slide on the ice so they can dissipate a little bit.

When I’m standing, and I do that breaking impulse at the end of a T-Push, my skate is really grabbing the ice, so it’s really transmitting the force. All that breaking force gets transmitted into my leg, and so I can really hold that internal rotation, be driven into that internal rotation. Plus, it’s such a long lever that you put a lot of torque on the hip.

So that’s one thing that was kind of like, oh, that’s interesting. Yeah, I never really thought of that before. So again, I think it’s good that some camps and some practices, they’re limiting going into the butterfly. And you see those T-Pushes getting less and less. When I went to camps maybe four or five years ago, it always started with that. And it was cool, because you can hear it. And it’d be like swoosh, swoosh, swoosh. It sounded really good, but it’s also a lot of torque. And so that’s also part of the reason why I’ve stopped talking quite so much about big powerful pushes and learning how to use just those quick impulses.

When we do those big power pushes, then we’re left open too. So if I push further … I guess we’ll go standing, but if I’m pushing here and getting a big power push, well I’m opened up here, and I have to close here. Whereas if I can just get that quick push, I’m not as open as long and I don’t have as much distance to close.

So strategically it makes sense plus you’re not creating all this energy that takes muscle energy to develop. So you’re using up more energy. It’s more fatiguing. But then also you have to dissipate it which also takes muscular energy to decelerate. So we want to get those quick pushes so we’re not just burying up energy and adding more stress to our hip.

I could talk for a week about the pelvis. I could talk for months about the pelvis. So I’m going to wrap it up with this…

The things we do on the ice are not great for our hip. And I do see some ways around it. But we’re never gonna get rid of it. It’s like a baseball pitcher. That’s something that no shoulder was meant to do. What you do as a goalie is something no hip was meant to do. It’s never gonna be good for your hip or your shoulder, but how can we minimize it?

Well let’s start also by looking at, what are you doing to your hips the 22 hours a day that you’re not on the ice? Are you walking around with an anterior pelvic tilt? Which, the answer for a lot of you is yes. This is what I mean by an anterior pelvic tilt.

So, basically to find neutral, I want to line up my ASIS and my pubic symphysis, and I want them basically on a flat plane. So that if I had a dish on there, a cutting board on there, it would be straight up and down. So that’s the neutral back position. Because we sit a lot, because we play in a certain position a lot, our hip flexors do get tight. And remember that some of our hip flexors attach right here to the front of the pelvis. Others attach to the inner surface of the pelvis. And then some come up and attach to our lumbar spine.

But what they do is, that ends up pulling us forward. So I have an anterior pelvic tilt right now. My bum sticks out the back. Some people see this and be like, oh, you got hockey player’s butt. No, you just have an anterior pelvic tilt. So then we just get accustomed to this.

Dr. Thomas Myers, he’s the guy behind Anatomy Trains, he had a good saying and I’m gonna screw it up, but it’s like, “Habit creates posture. Posture creates structure.” So if our habit is to always be in this anterior pelvic tilt, then that dictates our posture. So then really, our standing posture becomes something that just feels normal. But then that dictates our structure. So then these muscles just shorten because that’s what they’re told to do. These lengthen out because that’s what they’re told to do. My abdominal wall lengthens out which makes my core weak, because that’s just what we’re telling it to do.

So then we get on the ice, and we start trying to play hockey and net, in particular. And when I’m in my anterior pelvic, well a couple things happen. Number one, people always saying, “Well try to be big in the net.” So then I have to sort of almost hyper-extend my low back to get big in the net because really, with my anterior pelvic tilt, I’d probably be more comfortable down lower. But the other problem is when my pelvis is tilted forward, I don’t have as much room in the front of my hip.

It’s very similar to when we get you to round your shoulders forward, and try to make a circle. You don’t have the room to do it because your shoulder socket is tilted forward. If I pull it back, and get it neutral, I can make a really nice circle. So it’s kind of the same type of thing. So when my pelvis is tilted forward, and I try to recover my skate underneath me, I don’t have as much room there. I could be bashing the front of my femur off the front of my acetabulum, off the front of my hip joint.

So then one of two things happen. I’m gonna be jamming in there, so maybe creating some wear and tear on my hip joint. But also I might get stuck. So then in order to to get over that, what I have to do is kind of round my back to get my pelvis to tuck under to then get my skate underneath me.

And not that you’re saying, “Oh geez. I’m stuck. I guess I better round my back and drop my chest to rotate my pelvis.” But it’s just how your body compensates. So when you see guys, and you probably do it too or have done it in the past, that when they bring their foot up to recover, they drop their chest down. That could be because they have that anterior pelvic tilt.

So you want to try to work on finding your neutral pelvis, and then just using it throughout the day. Using it when you’re walking between classes, walking to the car, walking to the rink, whatever you’re doing, even sitting at work, sitting in your class. When you sit, you should be sitting on your sit bones like this, not sitting on the back side, like a big slouchy position. You should be right over your sit bones, in a nice neutral pelvis, sitting like a proper person.

So, that’s the thing. Practice those good habits in the 22 hours that you’re not on the ice. Even sleeping, and it’s hard because I’m a total like curl up on my side sleeper, but I’m sleeping with my hips in a flex position. So what I want to do now is spend more time getting out of that position, trying to sleep on my back with my legs extended. It’s brutally hard for me to do.

Oh I gotta tell you about the thing I went to get. So, again, I mentioned this in live Q&A this week, but have had an episode of back trouble that started in about May. So I had an MRI and everything because it wasn’t getting better. And it’s like some arthritis and a little disc bulge, and a little bit of an Nplate fracture thing.

But one thing that really helped, and we talked about the pelvic assymetry. I’d like to mention something that, again, if you’re suffering with some back pain or even sometimes you’ll get sort of that discomfort down in here, that sort of seems like it is an SI joint pain, one little thing might help. So you might want to invest. It is about 50 bucks, but you know what? I feel a lot better and I wear it now when I go on the ice, because of the torque on my pelvis.

It’s an SI belt. I was skeptical. At home, I just took a belt from my jeans and put it around my hips to see if supporting my pelvis would help. My back pain would go away and it really did help. So my mission now is to try and get that back pain so under control that I don’t need to get the injections that are scheduled for March, because I don’t really like needles even stuck into my arm, let alone straight into the joints of my spine. So, I’ll show you how it works.

What you do is you put it low on your hips. So find your ASIS. It’s going low on your hips. And then there are just like kind of elastic pieces in the back. So I pull them out and snap them down in the front. And so then, it’s really just squishing my SI joint together, to try to make it a little rigid so it can’t be quite so sloppy.

Again, if someone else is telling me this, I’d be like, “Oh, good for you. Excellent.” But, I really do think it helps. Almost like, you know a lot of volleyball teams, they just want their players, I don’t know if they still do it. When I was strength coach at Western, they did for sure, to prophylactically wear an ankle brace, even though it doesn’t give so much support. But it gives a little more feedback about the position, and a little bit of support. They think it helps reduce the risk of ankle sprains.

I think that wearing this when I play helps reduce the risk of getting my pelvis torqued out, and makes it a little more stable so that then, the muscles that attach to it which also help support my spine, are in a little more stable foundation position too. So that’s my thinking on it. I wouldn’t be surprised if it was just standard gear for you guys going forward.

So if you’ve been having some trouble, you might try it. Like I said, I just took a belt that I wear with jeans, and put it low on my hips and did it up like that, and wore it around the house for an afternoon. And it was like, honestly, from the second I put it on, it was like hey. I can touch my toes. And so it’s pretty cool.

Okay. That’s it. Next week, we’re gonna be back to talk a little bit about your torso, your abs, your back, that kind of thing. If you have questions, leave them on the Goalie Training Pro page. So on this page, just leave a message and then I answer them every Friday during my weekly live Q&A. But otherwise, this is Maria from GoalieTrainingPro.com with Goalie Training Pro TV, episode seven. We were talking all about your pelvis. See ya.