Keeping your hips healthy with pilates - what a hip and knee surgeon has to say.

Updated: Sep 14






I'd like to thank the very wonderful Mr. Kevin R. Wembridge , Consultant Hip and Knee Surgeon with our beloved NHS for this month's guest blog post all about the importance of looking after your hips proactively. This is an amazing blog post that will really help you understand not only how the hip works but why it's so important to look after your body now for later life. It also includes some handy tips on how to test out your hip strength and mobility and how pilates is helping his patients regain muscle balance and strength.


Pilates is the perfect method for stretching and strengthening all of the key muscle groups Mr. Wembridge mentions here, so why not try it for FREE now with my 20 minute Strength & Stretch Pilates Workout I created to help keep your whole body hip and healthy! (Bad joke!). Select the link above or click here and it's all yours.

Have fun with it!


Biomechanics, is a big word which is bandied around a lot in exercise circles, but what does it actually mean? In its simplest form it is the science of movement of a living body. So, why is it so important and why are there 28,700,000 items related to it on a simple Google search?


Essentially, people are not usually interested in biomechanics until something goes wrong with their own and they have a problem.

They seek help from physios, doctors, alternative therapists and are introduced to the term, seldom understanding what it means or why it is important to them.


There may be a recent injury, a chronic injury or long-term joint wear underlying their problem: however, it may simply be that their muscles are not balanced and working in harmony to allow normal motion.


If we focus on the hip, it being the joint which connects the leg to the torso, the issues should become apparent. Essentially it is a ball and socket joint, which whilst being very stable, allows a large range of movement and has very strong forces which act upon it to help propel us when walking or running.


There are over 20 muscles which move this largest of joints, including the biggest muscle in the body (gluteus maximus).

Fun fact – the acetabulum (socket) is derived from ancient Latin and means ‘little vinegar cup’, as it was used to store and serve vinegar.

Concentrating on three of the hip movement groups (flexion, extension and abduction) should help simplify this further. For each of these, we will focus on the more important muscles only.


Movements of the hip


Hip Flexion


Let’s start with hip flexion. The main hip flexor is the iliopsoas muscle, which is formed from two muscles – the psoas (fillet steak for the carnivores amongst you) and the iliacus. The psoas arises from the inside of the lumbar vertebrae (lower spine) and is joined by the iliacus (from inside the pelvic wing) in the pelvis. It forms a combined tendon which passes over the front of the hip joint, before attaching to the top of the femur (thigh bone). It is the most powerful flexor of the hip, but also externally rotates the hip (imagine placing your left ankle on your right knee for instance).


If this muscle is tight it will pull the spine and pelvis forward, rotating them around the hip often leading to back pain and imbalance. Conversely if it is weak, stair climbing, hill walking and getting on a bus become tricky.

Hip Extension


Whilst hip extension is driven by gluteus maximus, the hamstrings play a significant part with it too. The hamstrings come from your ischium (sit bones) and cross both the hip and the knee to attach on to your tibia (shin). Once you understand that this large muscle group crosses both of these joints, it isn’t a large step to understand that tight hamstrings will not only bend the knee, but also tilt the pelvis backwards.


If you wish to test this yourself, sit on the floor with your back up against a wall, put your legs out straight in front of you and lean forward, tilting your pelvis. The chances are this will feel tight down the back of your legs and behind your knee, unless you are very supple!

This indicates hamstring tightness, which is extremely common, especially amongst cyclists and people who sit for long periods of time.





Hip Abduction


What is the purpose of abduction? If you have ever been to a gym and seen or used the abduction machine (pushing your legs out to the side), you may think it is just another muscle group to train. It is vital for walking normally. The gluteus medius starts on the outer wall of your pelvis and attaches to the greater trochanter (the bony bit on the outside of your hip) and pulls your pelvis down towards your femur. It is this that allows you to walk easily.


To feel what I mean, place your hands on the outside of your sides between your pelvis and the greater trochanter. As you walk you will feel two things happen. When your right foot is on the ground, you should feel the muscles on your right hand side tensing and the left hand side of your body lifting up a little. This allows your foot to clear the ground, so you may walk normally. A weak abductor leads to a very abnormal and challenging walk!

These are just some of the muscles around the hip and to coordinate the simplest of tasks, walking normally, means they all need to function properly and together.

Training them as groups, stretching them off and ensuring they are balanced will help you prevent future problems with walking.

Whilst it is impossible to ‘future-proof’ your body completely, everything which you may do to help yourself now, will help your future self more.




One of the issues we have when we undertake hip surgery, is to try and restore the biomechanics of the hip as much as possible. Whilst we can do that to some extent mechanically, it then relies on our patients retraining their hip muscles around this through exercises and physiotherapy.


I have a number of patients who have found significant benefit using pilates to help balance their hip and knee muscles, lower back and core, both before and after surgery.

People often spend a great deal of time and effort in planning their future finances and retirement, only to be too unhealthy to enjoy them fully.


Spending some time now investing in ourselves and our bodies, is surely as, if not, more important? Looking after your body is a hugely rewarding thing to do both now and for your future self.

Wouldn’t it be good in years to come if everyone could look back and say to themselves, I’m really glad I looked after myself when I was younger? Above all, do not get old weak, you won’t regret it.


Feeling inspired? Grab your FREE 20 minute Strength & Stretch Pilates Workout designed so as you can feel the incredible benefits of pilates in a very short space of time. Select the link above or click here to have it sent straight to your inbox right now!


Don't forget to leave a comment and let me know if you loved this blog post as much as me!


Love Julie x


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