POSE DESCRIPTION – see picture

Preparation:

standing with hips adducted and neutrally rotated

ankle is neutral

knees extended but soft

spine erect

Movement:

rotation occurs about the femoro-acetabular joint to produce hip flexion

ankle should remain neutral and not fall into plantarflexion

spine rounds slightly into flexion, curve should be evenly distributed

FUNCTIONAL MOVEMENT

relevant for bending and lifting, may replicate dressing (pulling on pants/shoes)

RELEVANT NEUROMYOFASCIA

Neural

mobilization of sciatic and tibial nerves

appropriate tone of all muscles involved

Muscle

concentric contraction of anterior chain

anterior tibialis – prevents ankle plantarflexion

rectus femoris – maintains knee extension, creates anterior pelvic rotation

rectus abdominis – provides trunk stability

eccentric contraction of posterior chain

plantar fascia/toe flexors – maintains neutral arch

triceps surae – maintains neutral ankle

hamstrings – control of knee extension and hip flexion

erector spinae – maintain spinal stability

Fascia

appropriate length of posterior chain

allows for neutral ankle, extended knee and flexed hip

PROGRESSION TO HOME PROGRAM

Patients can be instructed on more traditional stretches initially that breaks the movement into its individual parts: ankle/hip mobility and knee/trunk stability. Once appropriate mobility/stability of the impaired joint(s) has been achieved, the full hip hinge may be instituted back into the patient’s routine.