Episode #39: Functional Anatomy of the Hip in Barbell Training with Dr. John Petrizzo, PT, CSCS, PRSCC, SSC
HIP PAIN IS COMMON IN BARBELL TRAINING BUT THAT DOESN’T MEAN THAT BARBELL TRAINING CAUSES YOUR HIP PAIN, IS BAD FOR YOUR HIPS, YOU NEED IMAGING OR EVEN SURGERY TO RESOLVE YOUR HIP PAIN. BETTER UNDERSTANDING YOUR FUNCTIONAL ANATOMY, TECHNIQUE, AND HOW TO OPTIMIZE YOUR MOVEMENT, ALONG WITH OPTIMIZING YOUR TRAINING PROGRAM, ALLOWS YOU TO ADDRESS YOUR SYMPTOMS WHILE CONTINUING TO TRAIN.
In this episode of the PRS Podcast, PRS Clinical Coaches, Drs. Rori Alter, Alyssa Haveson, and John Petrizzo discuss the functional anatomy of the hip and the role it plays in barbell training. They discuss common concerns surrounding the structure of the hip and how the hip’s movement significantly contributes to various aspects of your technique.
This episode is an educational experience for barbell trainees, powerlifters, Crossfitters, weightlifters, and other strength lifters to deeply understand their hips to optimize their training and technique to either address their symptoms or reduce the risk of injury in the future.
If you’re a chiropractor, physical therapist, medical doctor, strength coach, or student clinician, this episode is a great review and application tutorial regarding the hip and barbell training.
IN THIS EPISODE WE DISCUSS THE:
Normal movement of the hip joint
Internal structures and surfaces of the hip
Tendons, ligaments, and muscles surrounding the hip joint
How the hip affects the knee
Hip pain, labrum tears, and femoroacetabular impingement (FAI)
Knee calve on the squat
Concerns with wide-stance squats relative to the structure and function of the hip
RESOURCES MENTIONED IN THIS EPISODE:
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Email: podcast@progressiverehabandstrength.com
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Alyssa IG: @alyssahope_prs
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:26] All right, folks, welcome back to the Progressive Rehab & Strength podcast. I'm your host, Dr. Rori Alter head clinical coach here at Progressive Rehab & Strength with my awesome co-hosts, Dr. Alyssa Haveson and Dr. John Petrizzo. Dr. Alyssa, we are not firing you from co-host, but John just seems to be here very regularly now on the podcast. So it's just it's fun to have my husband in the, in the co-hosting seat with, with all of us. So in today's episode, we are going to be talking all about the hip in barbell training, so all about the functional anatomy and biomechanics of how the hip functions and works, how the muscles, the bones somewhat of the neurological system function in barbell training loaded and that we don't have to be so scared of it. And I think that this series on the functional anatomy stuff related to barbell training each area of the body has been really helpful for a lot of people because the more you know about your body, the better you know how to utilize it and work with the body barbell system. So we have brought back John Petrizzo, professor at Adelphi University in the Exercise Science department. He teaches Kinesiology, Biomechanics Intro to Sports Medicine. You teach a lot of other classes that I always forget. Allied Health. What else do you teach?
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:01:59] Well, not all of that is accurate, but we'll just say okay, for now.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:06] What do you teach? I know you teach kinesiology and biomechanics.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:02:10] I do.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:11] And you teach Intro to Allied Health Professions. Right?
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:02:15] Uh, that is not a class.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:16] No, that is not a class. So then what's the class? What's your intro class?
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:02:20] Introduction to Exercise Science.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:22] But isn't there an allied health? Allied Health Professions class that you teach? No, there was never one. No, no. That's just like me not remembering what year you were born. For the first ten years of our relationship, well, yes, I know what year it is, but I will not give away your age on the podcast. But. So what do you teach?
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:02:45] Uh, every semester I teach kinesiology and I teach a class called Medical Aspects of Sport, which is kind of like an introduction to orthopedics. And in the fall, I teach biomechanics and I do teach that introduction exercise science course. Um, and we also created the new clinical training course that I'm doing in the fall. And then in the spring I teach a strength and conditioning methods course and theory of exercise prescription course as well.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:15] Oh, wow. Yeah.
Dr. Alyssa Haveson, PT, CSCS, PRSCC: [00:03:16] So you were a little off Rori.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:18] I was a little off. It's hard to remember all these courses. Every semester is different. His schedule always changes. He's, you know, in advisement and working on this study and that study and, like, I'm just like, okay, you're great, you're awesome. You're like a world-renowned professor and I'm just this little person. You are just totally awesome. Anyway, so see, John is a professional in all of this stuff, and he teaches this stuff and he's tenured professor at Adelphi University. So he has been teaching kinesiology professionally and biomechanics professionally for ten years. He's been in the physical therapy profession for 12, almost 13 years.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:03:58] Almost 11.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:59] 11, as long as I have. So I don't even know how long I've been in this profession. And you've been in the personal training and strength and conditioning realm for.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:04:10] 17 years.
Dr. Rori Alter, PT, PRSCC, SSC: [00:04:12] 17 years. And, you know, you started weight training in high school. So this is something you obviously like, Alyssa and I are professionals at this, but you teach, teach, teach this.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:04:23] So I try to.
Dr. Rori Alter, PT, PRSCC, SSC: [00:04:27] All right, John. So give us hip anatomy and functional anatomy.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:04:36] Okay. So if we are going to talk about the anatomy of the hip, we should start by talking about the bony structure and the joint. So the hip is a ball and socket joint. It's a fairly deep socket, very robust joint. Obviously, it's responsible for transmitting a significant amount of force between the upper extremity and the trunk and the lower extremities. But it's also a fairly mobile joint moves in all three planes of motion so it can flex and extend AB and adduct and internally and externally rotate. So it has three degrees of freedom. So really is a nice kind of balanced structure from that standpoint. So, the socket of the hip joint is what we refer to as the acetabulum, and that is comprised of all three pelvic bones. So the Ilium, the Ischium and the pubic bones all contribute to the formation of the acetabulum.
Dr. Rori Alter, PT, PRSCC, SSC: [00:05:44] And just my usual disclaimer at this point in the in the functional anatomy podcasts, if you're listening to this on our podcast platform and this stuff is totally confusing you and you cannot envision what he's talking about. If you head over to our YouTube channel, which we'll link in the show notes, you can watch the YouTube video of this podcast with the respective anatomy images overlaid so that you have an understanding of what he's talking about.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:06:16] And so the Acetabulum articulates with the femoral head, right, the head of the femur. Now, the femur is the longest and strongest bone that we have in the body. And what's kind of interesting about the interaction between the acetabulum and the femur is that the femoral head doesn't sit all the way inside of the socket. So there's a little bit of space in between the head of the femur and the essentially deepest part of the acetabulum. But that kind of works a little bit like a vacuum and kind of aids in the suction between between the two structures. So in addition, we have the acetabular labrum, right? And the labrum is a ring of fibrocartilage around the acetabulum that attaches to the femur that aids in stability of the joint decreases the amount of force that gets transmitted to the articular cartilage. So it's protective of the articular cartilage. So it's an important structure from that standpoint. We have a very robust joint capsule around the hip joint, and the joint capsule has several capsular ligaments. So the iliofemoral ligament, the ishiofemoral ligament and the Pubofemoral ligament. So essentially one ligament that runs from each of the three pelvic bones and attaches to the femur and all of those ligaments limit extension of the hip so they get tight. So and the capsule in turn gets tight as we move into greater amounts of hip extension.
Dr. Rori Alter, PT, PRSCC, SSC: [00:07:58] And hip extension. Just because I think that there could be some people who don't know what these positions are or like the femur is your thigh bone, you know, all that kind of stuff. So if you're just listening, so extension of the hip is when your leg moves backwards, so to the back side of your body. So you.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:08:17] Um, so the pubofemoral ligament also limits abduction range of motion to a certain degree as well. So those are kind of the passive structures surrounding the joint. Something else that I think is worth talking about is that we have a few different angles that get created between the femur and the acetabulum. So the first one is the angle of inclination. So that's an angle that gets created between the head and neck of the femur essentially, and the shaft of the femur. And in adults, it's roughly about 125 degrees or so. Now, if you have an increased angle of inclination, we refer to that as being coxa valga. And if you have a decreased angle of inclination, we say that that's coxa vara. Now, the only reason I mention that is because those two things are associated with other, you know, alignment issues, let's say at the knee. So if you have coxa valga, you are more likely to have genu varus, which is what most people refer to as bow leggedness. You know, when they look at the femur and the knee and if you have coxa vara, then you are more likely to have genu valgus, which is what a lot of people refer to as being knock-kneed. Right? So, so there's a relationship between the hip, the knee and the foot and ankle in terms of, you know, how someone presents from an alignment standpoint.
Dr. John Petrizzo, PT, CSCS, PRSCC, SSC: [00:09:53] Another angle that we see that's created at the hip is referred to as the angle of torsion. And essentially this would be an angle that you'd be able to observe if you were looking at your femur from the top down, which is kind of hard to picture, right? But torsion implies like twisting. So the femur itself, I mentioned, it's the longest and strongest bone in the body, but it has a twist in it essentially. So the femoral head and neck at the top are rotated anteriorly relative to the femoral condyles, which are the most distal part of the femur. That's what helps to form the superior portion of the knee joint, about 12 to 15 degrees roughly. And you know, again, we talked about this with the spine. You'll see some different numbers in regards to like the normal ranges for this stuff. So but just assume that it's roughly around there. So essentially the superior portion of the femur is rotated anteriorly or twisted a little bit anteriorly relative to your knee. You know, you can think of it that way. Now, if someone has an excessive torsion angle, either forward or backwards, right? We refer to that as being anteverted or retroverted. So if someone is anteverted and they have more than a greater angle of torsion than we would expect to see, right.