Hip Extension and Falls

FIRST train pelvic control with core engagement to lock the pelvis posteriorly, and THEN focus stretch on the tight kinetic chain link, the hip, to most effectively increase hip extension- StrongPosture Pelvic Tilt training, S Weiniger

StrongPosture Tilts, Hip extension and Falls

At the Florida Chiropractic Assn PosturePractice class last weekend I was asked why we emphasize the importance of keeping the knees “locked” in StrongPosture Tilts. I clarified that locked did not mean hyper-extended, and explained the view that locked co-contraction of antagonistic leg muscles helps isolate pelvic motion to regain control of deep stabilizing intrinsics, but I wanted to add another important reason: strengthening Hip Extension

A reduction in hip extension as people age goes along with an increase in falls. Kerrigan showed how falls are caused by reduced hip extension leading to reduced peak hip extension during gait and reduced step length of the other leg. Prior studies support how age-related changes in gait are due to a reduction in peak hip extension as well as an associated increase in anterior pelvic tilt and diminished ankle plantarflexion. ¹

So it was not surprising when a recent study of a 10-week supervised hip flexor stretching program in frail elderly subjects showed hip stretching improved the hip extension range of motion, and decreased falls. ²

HOWEVER…if you look at the photos of the lunge style stretches, you’ll note a the anterior pelvic tilt associated with diminished hip RoM is increased in compensation during the stretch, correlating with corresponding changes observed on postural assessment as people age.

AND the my and other CPEPs observation is that FIRST focusing control on isolated pelvic tilt with StrongPosture alignment, and THEN stretching the hip gives people doing the stretch a far greater perceived stretch, felt especially in the deep fibers.

SO… for best gait training changes, we suggest you First train pelvic control with core engagement be able to lock the pelvis posteriorly, and Then address increasing hip extension to focus the stretch on that tight kinetic link.

1 Kerrigan DC, et al Effect of a hip flexor-stretching program on gait in the elderly. Arch Phys Med Rehabil. 2003 Jan;84(1):1-6. http://www.ncbi.nlm.nih.gov/pubmed/12589613