Hips Don't Lie

Raised in the classical tradition of Pilates, I was first taught to use Pilates V or external femoral rotation in most exercises across the method. My early Pilates training was also overseen by retired dancers that had more turn out than any healthy body truly needs. It was not until I started teacher training that an incredibly wise teacher told me the truth about my hips. That my internal and external rotators were imbalanced from years of striving for the ultimate turn out and subsequently causing most of the strain on my knees. Guess who went through most of her classical teacher training in parallel to achieve balance? Yup, this girl right here.

So What is Pilates V?

If you lie down on your back and relax your legs long and apart from one another. Gravity should slightly externally rotate your femur. You’ll see it by your big toes falling away from each other. Slowly, pull your legs together toward center work deep in your glutes to maintain the degree of rotation or the angle of your toes. Take note of the things you notice along the way. Is one leg more rotated than the other or does one not rotate at all?

How does it change the position of your pelvis to your low back?

Do your legs collapse outwards under gravity’s force? In my case, my left leg collapses outward almost pinky to the floor. The right doesn’t go quite as far. When I begin to draw into center both legs have to internally rotate. The left more so. I can squeeze my heels together but not everyone should use heels together as the judge of proper rotation. A balanced and proper Pilates V recruits total musculature integration of the hip socket and is supportive for most exercises in the method. However, it can not be the rule for everybody all the time.

Ballet is an Extreme Sport

Classical ballet has five positions of the feet that are dictated by the ability to externally rotate the femur to its extreme in the acetabulum or socket of the pelvis. No one needs a dancer’s turn out to move around functionally in the world and it certainly says nothing about overall hip health. I’d place a heavy bet on most dancers retiring with Arthur settling in at least one hip (Arthur = arthritis. It sounds better). Just like I’d bet most MLB catchers retire with wrecked knees. That hockey goalies hurt everywhere, and I have yet to see an 80-year-old fitter of cross.

My point is this. Repeatedly push any joint to its extreme and there will be consequences. My knees got better not from conventional physical therapy but a Pilates teacher who taught to my body. The reality is I forced rotation past what my hips could stabilize. My knees absorbed the lateral torque until an acute attack of gravity in the middle of the night that changed everything. PT went for my knee itself. It got stronger but never better. Pilates came for my hips and EVERYTHING changed.

Hips Go Round

How many times have you been cued to fold the hip socket or crease the hip socket? I’ve said it myself many times even though the hip is not a hinge joint. It does not fold. The ball (femur) rolls in the socket (acetabulum) and the socket rolls on the ball. There is an intricate symphonic timing of musculature to make every action of the hip.

The key is making sure the orchestra is balanced. Glutes and hamstrings must be strong enough to extend tight overworked hip flexors and quads. Inner thighs need strength to adduct against tight outer thighs and the IT Band. Inner thighs must also counter the deep external rotators of the gluteal muscles.

I could geek out on anatomy but keeping it simple is best when so many parts are involved. I always say Isaac Newton would have loved Pilates because “Every action has an equal and positive reaction”. Every action of the hip requires balance and timing coordinated by a whole bunch of muscles. There are three things to remember when trying to cross-train muscle groups.

Bone Structure – The deeper the pit of the acetabulum the deeper the femur will sit in the pelvis. The head of the femur will then have less room to orbit in the socket reducing range and turn out. The shallower the acetabulum the greater range and rotation one will have. Literally, some of us are just born for deep squats and some of us will only ever get but so low. Unless you have a bone x-ray then you will never know your true hip shape.

Flexibility – No secret there. Musculature of the hips, legs and back must be flexible to allow the femur to explore range. Muscle tightness inhibiting the ability for the rolling action of the joint is the underlying culprit of many painful conditions. Stretching is vital but must been done with support and form.

Strength – Also not a huge shocker but remember the goal is balance. The action must have an equal counterpart. My inner thighs are strong but not as strong as my rotators and outer hips. I still work to maintain this balance to keep my knees as healthy as I can. Everything is connected!

So V or no V?

You must do what is right for your body or your client’s body. Always consider what your movement goals are against how the body is being used in daily life. A gymnast and a gardening enthusiast need quite different things to access their movement potential. There are certain things in Pilates where external rotation is unavoidable but can be varied for most exercises. The choice to vary should be influenced by assessment of a skilled teacher. Particularly if choosing Pilates for its rehabilitative qualities.