As we prepare athletes. We need to coach, watch, listen and choose the correct exercises to get them better.
· “Hot topic” in sports medicine. Diagnosis rate is increasing exponentially year to year.
· Congenital or developmental?
· Much higher incidence rate in athletics than normal population.
NORMAL / CAM TYPE / PINCER TYPE
1. How do we identify athletes at risk?
a. Anterior pelvic tilt
b. Inability to reach full hip flexion, adduction, internal rotation without compensation
c. Anterior hip pain with activity (“Hip flexor pain” when squatting)
2. What do we need to do about it?
a. Reposition pelvis posteriorly to achieve neutral alignment
i. Activate/strengthen pelvic floor & Hip ext, abd, ER
ii. Deactivate/stretch paraspinals and hip flexors
3. How do we need to do that?
a. Activate muscles that produce hip extension, abduction, external rotation
i. Glute max, Glute med, piriformis, lateral hamstrings, etc
b. Inhibit/deactivate/stretch overactive anterior musculature; hip flexors (rectus femoris, psoas, iliacus, etc)
c. Postural respiration
i. Breathing patterns are highly influential on pelvic position
4. What should we avoid?
a. Hamstring stretching for range of motion increase
i. Length/tension relationship of hamstrings has already been affected by anterior rotation of pelvis.
ii. Hamstrings are in a chronically lengthened position and therefore at huge mechanical disadvantage
b. Forced range of motion in lifts requiring deep hip flexion
