"Hip Drop", What is it and What to do?

As a runner, you might of heard of the word "hip drop" before. It is a common issue that we as physical therapist see a lot, luckily, it is easy to fix if you have the right tools. If you are a runner that has been dealing with nagging/constant injuries like knee pain, IT band syndrome, or lower back discomfort, you might have a little bit of weakness in this hips that create this "drop". The weakness creates a subtle yet impactful gait issue that we see with gait assessments and strength test. 

Hip drop refers to a biomechanical problem during running (or walking) where the pelvis tilts or drops down on the side opposite the stance leg. For example, when your right foot is on the ground and your left hip noticeably dips lower than your right, that is hip drop.The proper name that you might hear in a doctor's office is, Trendelenburg gait which is caused by weakness in the gluteus medius,one of the key muscles responsible for stabilizing the pelvis during single-leg stance.

Why Is it a Problem?

Running is essentially a series of one-legged hops. When your pelvis is not properly supported during each step, you create imbalanced forces through the hips, knees, and the ankles. Over time, this compensatory movement can lead to a variety of different issues. Some of those include: Runner’s knee (patellafemoral pain syndrome), IT band syndrome, hip impingement, and low back pain. 

If you currently do not have any pain but have weakness through your hip stabilizers, it can lead to poor running mechanics and energy expenditure, making you more prone to injury as your mileage increases.

How do I know if I have it and how do I fix it?

The best way to identify hip drop is through a running gait analysis, something we here at Precision and Performance specialize in. As running medicine specialists, we do gait analysis almost daily and are able to pinpoint any gait abnormalities that could be contributing to your pain or help prevent future injuries. 

Improving hip stability takes a combination of targeted strength training, neuromuscular control, and mobility work. Some of the best exercises for improving hip stability and strength include: standing clamshells, single leg bridges, lateral banded walks, and step downs. Your physical therapist can develop a specific tailored plan based on what is seen from the gait analysis. But these are good exercises to include in your daily workout routine! Here are some examples of the exercises for reference.

1. Standing clamshell

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2. Single leg bridges

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3. Lateral banded walks

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4. Step downs

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In Conclusion, 

Hip drop may seem like a small issue, but over thousands of strides, it can add up to major biomechanical stress. Whether you’re training for your first 5K or your next marathon, addressing movement flaws like this can be the difference between hitting a new PR, or sitting out your season with injury.

Hope this helps & happy running!

Dr. Noelle O’Hara, DPT