Have you ever seen a pitcher throwing a baseball? This action, which involves maintaining stability on one foot while also moving both the free leg and the torso, activates the hip external rotators.
Your hip is a ball-and-socket joint attached to the uppermost part of your leg. The hip joint allows the leg to rotate inward or outward. Hip external rotation is when the leg rotates outward, away from the rest of your body.
Of course, you don’t have to be a baseball player to use your hip external rotators on a daily basis. We use this motion in a lot of everyday actions, such as stepping sideways or getting into or out of a car.
In general, whenever you put all of your weight on one leg, you are relying on your hip external rotator muscles to stabilize your hip joint.
Without these muscles, it would be difficult to maintain stability while standing, walking, or extending either of your legs away from your body. Prolonged sitting can contribute to weakness in the external rotators of the hip. Injuries and hip surgery are other common causes of weak hip external rotators.
Hip external rotation activates a variety of muscles in your pelvis, buttocks, and legs. These include:
- the piriformis
- the gemellus superior and inferior
- the obturator internus and externus
- the quadratus femoris
- the psoas major and minor
- the sartorius
Small muscles such as the gemellus and obturator groups, and the quadratus femoris originate in the pelvis and connect to the upper part of the femur, the large bone in your thigh. Along with the piriformis, which originates from the sacrum or spine, they make the sideways motion required for hip external rotation possible.
The gluteus maximus, a large muscle in your hip/buttocks area, provides most of the power used for hip external rotation. When all of these muscle groups work together, they provide both lateral rotation (torque) and stability.
Exercises can help strengthen the hip external rotators, improving stability and preventing injuries in the hips, knees, and ankles. Strong hip external rotators can also reduce knee pain and lower back pain.
Stretches can help to improve hip external rotator flexibility and range of motion.
Exercise 1: Clamshell
- Lie on your left side with your legs stacked. Bend your knees to an angle of approximately 45 degrees. Check to make sure your hips are stacked one on top of the other.
- Use your left arm to prop up your head. Use your right arm to stabilize your upper body by placing your right hand on your right hip.
- Keeping your feet together, move your right knee upward as high as you can, opening your legs. Engage your abdominals by tucking in your belly button. Make sure your pelvis and hips don’t move.
- Pause with your right knee lifted, then return your right leg to the starting position.
- Repeat 20 to 30 times.
- Do the same on your right side.
Exercise 2: Lying-on-stomach hip external rotation
- Lie down on your stomach with both legs extended. Place your palms flat on the floor under your chin. Rest your chin or either cheek on your hands.
- Keep your left leg extended. Bend your right knee at an angle just less than 90 degrees, bringing the leg toward your torso. Rest the inside of your right ankle on your left calf.
- Gently lift your right knee off the floor. You should feel your external hip muscles activate. Lower your right knee to the ground.
- Repeat 20 to 30 times, and then switch legs.
Exercise 3: Fire hydrants
- Begin this exercise on your hands and knees with your back straight. Draw in your belly button to engage your abdominal muscles.
- Keeping your right leg bent at 90 degrees, lift your right knee out to the right and up, away from your body, opening your right hip. Hold this position briefly. Return your right knee to the floor.
- Repeat this movement 10 to 20 times, ensuring your elbows remain locked.
- Complete the same number of reps on the other side.
Stretch 1: Figure 4
- Lie on your back with both knees bent and the soles of your feet flat on the ground. Lift your left leg toward your body, turning it sideways so that your left ankle is resting on your right thigh.
- Clasp your hands around either the back of your right thigh or the top of your right calf.
- Lift your right leg, bringing your left leg closer to your body. You should feel the stretch in the outer area of your hip and buttocks.
- Hold for about 30 seconds, then do the other side.
Stretch 2: Seated 90-90
- Start from a seated position on the floor with feet flat on the floor, knees bent and shoulder width apart.
- Keeping your right leg bent, rotate it down and to the right so that the exterior of this leg touches the floor.
- Adjust the position so that your right thigh extends forward from your body and your right calf is at a 90-degree angle to your right thigh.
- Keeping your left leg bent, rotate it down and to the right so that the interior of this leg touches the floor.
- Adjust the position so that your left thigh extends to the left of your body and your left calf is at a 90-degree angle to your left thigh. Your right thigh should be parallel to your left calf. Your right calf should be parallel to your left thigh. Check out this video to see how your legs should be positioned.
- Keep your spine straight and your sitz bones pressed into the floor. Then gently lean forward, placing your hands on your right calf or the floor beyond it.
- Hold for about 30 seconds, then release and do the same on the other side.
Prolonged sitting can lead to hip external rotator weakness. The following exercises can be done in a chair at work to improve hip external rotation.
Seated hip opener
Sit in a straight-backed chair with your legs bent at a 90-degree angle and your feet flat on the floor.
Put your hands on your knees. Keeping your knees bent at a right angle and your feet on the floor, move your legs in opposite directions to open your hips. Use your hands to gently hold this pose for up to 30 seconds.
Seated figure 4
In a chair, sit with your knees at a right angle and your feet on the floor. Lift your right leg up and, keeping it bent at a 90-degree angle, rest the exterior of your right ankle on the top of your left thigh.
Keeping your spine straight, lean forward to intensify the stretch in your outer hip. Hold for approximately 30 seconds, and then do the other side.
Lifted leg to chest
Sit in a chair. Keep your left leg bent at a right angle and your left foot flat on the floor. Clasp your right leg just below the knee and lift it toward your stomach or chest and slightly to the left. If possible, rest the outer part of your right ankle near the outside of your left thigh.
Hold for at least 30 seconds, and then do the same movement on the other side.
Your hip external rotators stabilize the hip in single leg stance and help to maintain proper lower extremity alignment in single leg stance.
They also help you to extend one leg away from the midline of your body. Hip external rotator exercises and stretches can help to improve lower body stability and prevent pain and injuries in the hips and knees.