Exploring the Rotator Cuff of the Hip
Today’s guest post was written by guest author Jennifer Cataldo of the NeuroStudio Mentorship Program
Hip cuff? What the heck is a hip cuff? That’s what I first thought when I heard the term from Meghann Koppele in the Pilates for Neurological Conditions workshop. Sure, I knew the basic anatomy of the hip: a ball and socket joint that includes the musculature that makes the leg flex, extend, abduct and adduct, but for some reason I never connected the similarities between the hip and the rotator cuff of the shoulder.
Meghann's very simple introduction to a new-to-me term inspired me to explore the function of the hip more deeply. When I think of the rotator cuff of the shoulder, I think of the mechanical stability it provides to the shoulder. I naively assumed that that the hip was naturally more protected as a result of gravity’s force on our body weight, which presses the head of the femur into the socket, thereby creating greater stability. To some degree this is true, in a perfectly functioning body (a what?) and when the foot is actually on the ground (closed chain). However, when you take into consideration sedentary lifestyles, compensatory movement patterns due to injury or neurological conditions that result in foot drop (or a number of other possibilities), the “cuff” or muscles of the hip become weak and unable to provide three-dimensional stability.
I've taught Pilates for more than a decade, so working the hip is not new to me, nor is the concept of teaching stability. But diving into the “why” has allowed me to think about hip stability a bit differently.
In the Pilates, fitness, and PT industries we often hear all about the gluteus medius. Yes, the “glute med” does stabilize the pelvis along with hip abduction and internal rotation, as does the gluteus minimus. However, muscles, especially when stabilizing, are designed to function synergistically. I can’t imagine working with a client to strengthen their rotator cuff and saying “Okay, now let’s work your subscapularis!” The idea is to get all the muscles in that group working together.
When it comes to hip cuff stability, I have been taught that it is more about the deep outward rotators (DOR), AKA the deep external rotator muscle group, which is comprised of the piriformis, obturator internus, obturator externus, gemellus superior, gemellus inferior and quadratus femoris. The DORs function as a group to help hold the head of the femur in the acetabulum and help prevent upward jamming of the femur with hip abduction. This makes its function similar to the rotator cuff’s function at the shoulder joint. It is very interesting and eye opening to hear Meghann’s take on the “hip cuff” and the importance of joint centering, and discussing how the relationship to the spine and shoulder can affect it.
If you want to learn more about the “hip cuff” you should definitely take the Advanced 2-Day Course, but in the meantime you can find some great videos on the Neuro Studio using this concept in neuro-focused workouts. As a member of the Neuro Studio, I find great cueing ideas and have a chance to practice them while moving, which always helps me.
I will continue to explore this concept and others throughout my mentorship with Meghann and Mariska, so stay tuned for next month when I discuss the difference it has made in my body and for my clients (both neuro and non-neuro!).