A Step-by-Step Guide to Improving Hip Internal and External Rotation

Hip rotation involves specific movements of the hip region that can be divided into two types: external hip rotation, which refers to rotating your legs outward, and internal hip rotation, which is the process of rotating your legs inwards. Exercises designed to target these particular muscles include flexibility exercises, mobility exercises and strength exercises.

Hip rotation can take place in:

• An anatomical position
• In flexed hip position
• In abducted hip position
• And of course, any position in between these three.

Hip rotation is a movement used to rotate your hip joint, which can be done both internally and externally. The muscles that are used for internal hip rotation involve the piriformis, gemellus, obturator internus, and quadratus femoris. For external hip rotation you use the gluteus medius and minimus, along with the tensor fascia lata and sartorius. You will see these movements more often in an adducted hip position or an extended hip position.

While the muscles responsible for internal and external hip rotation vary in different positions, some of them are more active with certain motions. For example, when the hip is flexed, the piriformis muscle provides outward or lateral rotation to the hip, but as soon as it’s extended or abducted, it acts as an internal rotator of the hip joint.

Internal and external hip rotation, also known as medial and lateral hip rotation, are essential for good sports performance and everyday movement. Sports such as Martial Arts and Dance rely heavily on hip mobility, but many other sports tend to overlook these important rotations. Understanding and exercising hip rotation can improve your performance in any activity, so it’s definitely worth exploring!

Internal vs. External Hip Rotation

Hip Rotation rotation is easy to understand when the leg is straight.

• The external rotation is when the leg is turned out. From a standing position, toes point out to the side.
• The internal rotation is when the toes rotate in and the kneecap rotates and points towards the opposite side of the body.

The hip rotation, both internal and external, can get a little bit confusing with the knee bent.

Internal hip rotation occurs when the thigh of a bent knee rotates towards the body’s midline while the foot turns outward. This motion can be easily identified by standing and performing a lower body movement, such as bending your knee, which causes the quadriceps (thigh muscles) to turn towards the opposite side of your body, resulting in your foot turning outward. Due to this outward turn of the foot, many people mistake this for an external rotation–however, it is in fact an internal rotation.

External and internal hip rotation are among the most commonly seen movements of the hip. These revolving motions can be found in everyday activities, as well as a variety of sports. When experienced during movement, external and internal hip rotation is often accompanied by other actions of the hip such as flexion, extension, horizontal flexion or extension, and abduction or adduction.

3 Types of exercises are needed to improve your Internal and External Hip Rotation:

To improve your internal and external rotation three types of exercises are needed. They are:

• Flexibility exercises
• Mobility or range of motion exercises
• And strength exercises.

Ever wonder what exercises can help you increase your flexibility? Here are some unique exercises that specifically target internal and external rotation of the hip! We will first show a demonstration of these exercises, followed by mobility drills, to then finish up with strength work. If you want to know more about the muscles involved in hip rotation, read the short description that follows. Otherwise, feel free to skip ahead!

Kinesiology of Hip Rotation (Muscles involved in rotation of the hip)

Hip kinesiology looks into the way muscles surrounding the hip joint work to enable movement of this important ball-and-socket joint. To create the rotational movements so essential to many everyday motions, strong rotators such as gluteus medius, piriformis and obturator internus work in conjunction with weaker or secondary rotators including sartorius, rectus femoris and iliacus. All muscles involved in hip rotation will either move it inward or outward based on their line of pull.

Adductors of the Hip

There are four adductors. They are:

• Adductor Magnus
• Adductor Longus
• Adductor Brevis
• Gracilis

The four muscles that make up the adductor group include the Adductor magnus, longus, brevis, and Gracilis. Generally, they act as medial rotators of the hip, meaning they help rotate it inwards towards the midline of the body. There may be some exceptions to this rule, but this is generally what these muscles do.

Gluteal Muscles

There are three gluteal muscles. They are:

• Gluteus Maximus
• Gluteus Medius
• Gluteus Minimus

The Gluteal muscles, which consist of the gluteus maximus, medius and minimus, are responsible for hip rotation. The gluteus maximus tends to be a lateral or outward rotator while the gluteus medius and minimus are generally used as medial or inward rotators. However, depending on the fibers that have been stretched, some of these muscles can perform multiple types of rotation.

Deep Six Lateral Rotators of the Hip

There are six lateral rotators of the hip known as the Deep Six. They are:

• Piriformis
• Obturator Internus
• Obturator Externus
• Gemellus Superior
• Gemellus Inferior
• Quadratus Femoris

The term “deep six” is commonly used to refer to the six muscles of the lateral rotators of the hip, which includes Piriformis, Obturator internus and externus, Gemellus superior and inferior, and Quadratus femoris. They are responsible for rotating the hip outward. Although Piriformis can become a medial rotator when the hip is flexed, it is generally considered a lateral rotator in the standing position.

The Hamstrings Muscles

There are three hamstrings muscles. They are:

• Biceps Femoris
• Semitendinosus
• Semimembranosus

The hamstring muscles are responsible for both medial and lateral rotation of the hip joint. The lateral hamstring, or biceps femoris long head, will rotate the hip outward, while the semitendinosus and semimembranosus muscles rotate it inward. Though not the most powerful rotators in the body, these muscles are integral for adequate movement at the hip joint.

The Hip Flexors

There are six hip flexors. They are:

• Pectineus
• Tensor Fasciae Latae
• Rectos Femoris
• Sartorius
• Soleus
• Iliacus

The hip flexors are a group of six muscles that connect the femur (thigh bone) to the pelvic area. These muscles, which are located around the top of the leg and help form the hips, include: Pectineus, a medial rotator; Tensor Fasciae Latae, a medial rotator; Rectus Femoris, a weak lateral rotator; Sartorius, a lateral rotator; and both Soleus and Iliacus assisting in lateral rotation of the hip or outside rotation of the hip.

Zaichik Stretching Techniques – Unique Flexibility Exercises for Internal Hip Rotation & Hip External Rotation

If you’re looking to increase your hip flexibility, in addition to passive stretches, it’s important to focus on specific exercises that target individual muscles involved in the rotation of the hip. These exercises will help isolate the correct muscles and make sure that any issues preventing optimal mobility can be addressed.

Isolated muscles stretching is an effective approach to improving flexibility and mobility. This practice, as implemented in the EasyFlexibility system, requires targeted exercises focused on rotating different muscle groups. To illustrate this approach, two such exercises are illustrated below – one for internal hip rotation and the other for external hip rotation. These moves are significant departures from traditional stretching techniques, so if you haven’t worked with the EasyFlexibility system before, these might be unfamiliar to you.

~Confidence~ ZST (Hip Internal Rotation)

The following Zaichik Stretching Technique (ZST) is taken from the EasyFlexibility Internal Hip Rotation program. This ZST works on Internal Hip Rotation. *Note that there are subtitles in the video, to see subtitles click on the cc button on the video itself.

To perform ~Confidence~ ZST:

~Fulfillment~ ZST (Hip External Rotation)

The following Zaichik Stretching Technique (ZST) is taken from the EasyFlexibility Hip Turnout Program. This ZST works on External Hip Rotation.

To perform ~Fulfillment~ ZST:

Please note that what we’ve shared with you is only 2 ZST’s from the EasyFlexibility system of over 100 programs. To get full benefit for your hip turnout and internal hip rotation it several ZST’s or Zaichik Stretching Techniques to work on all the muscles involved. Here we’ve shared with you only one ZST for lateral rotation and one ZST for medial rotation. To learn more about the Hip Turnout Program please click here. To learn more about the Internal Hip Rotation Program please click here.

Hip Internal & External Rotation Mobility Exercises

And now let’s take a look at the range of motion exercises with lateral medial rotation.

1. Standing Lateral Hip Rotation

Let’s start with the mobility exercises. First in an anatomical position.

• Stand vertical
• Lift your toes (of one leg, either right or left)
• Keep your heels on the floor
• Rotate your leg out by bringing your toes to the outside
• Rotate it back in to starting position

This is a simple lateral hip rotation or outside hip rotation mobility technique.

2. Standing Medial Hip Rotation

• Stand vertical with your feet a foot apart
• Lift your toes
• Keep your heels on the floor and rotate your leg in so that your toes move in the direction of the opposite foot
• Rotate it back out to parallel position

This is a simple medial hip rotation or inward hip rotation mobility technique.

3. Combined Lateral/Medial Hip Rotation Mobility Exercise

You can also combine the two.

• Stand vertical with your feet one foot apart
• Lift your toes
• Keep your heels on the floor and rotate the leg out so that your toes point out to the side
• And then rotate the leg all the way back in

This exercise helps to develop the range of motion, but it also strengthens the muscles that are used for rotation.

4. Standing Toe Pivot Lateral Hip Rotation

Now you can do invert and outward rotation.

• Stand vertical with your feet a foot apart from each other
• Lift your heel
• Keep your toes on the floor and rotate the leg out by bringing your heel forward

This is a simple lateral rotation pivoting on the toes instead of the heel mobility technique.

5. Standing Toe Pivot Medial Hip Rotation

• Stand vertical with your feet a foot apart from each other
• Lift your heel
• Keep your toes on the floor and rotate the leg in by bringing your heel out

This is a simple inward rotation pivoting on the toes instead of the heel mobility technique.

You will notice that the range of motion on a lateral rotation is greater than on the medial rotation. Here you will see a comparative range of motion for the medial and lateral rotation.

Flexed Hip Position Mobility Exercises

6. Flexed hip straight leg neutral to lateral hip rotation

Next, let’s do the hip rotation exercises in the flexed hip position.

• Sit on the floor (or a yoga mat)
• Both legs straight in front of you
• Keep toes up
• Drop your toes out to the sides
• Keep your heels together
• And bring them back to the starting position

7. Flexed hip straight leg neutral to medial hip rotation

• Sit on the floor (or a yoga mat)
• Both legs straight in front of you
• Keep toes up
• Bring your toes towards each other by rotating your legs inward
• Keep your heels a foot a part from each other
• And bring them back to the starting position

This is your medial rotation of the hip.

8. Flexed hip combined inward and outward hip rotation

And you can combine the two by rotating your toes out and then rotating your toes
in.

• Sit on the floor (or a yoga mat)
• Both legs straight in front of you
• Keep toes up
• Keep your heels 2 feet apart from each other
• Rotate your toes out
• And now rotate toes in

9. Sitting Flexed Hip Inward Rotation with bent knees

You can do the same thing with your knees bent.

• Get a hold of a sturdy chair
• Sit in a chair
• Lift your feet off the floor a little bit so that they are hovering above the floor
• Without moving your thighs medially rotate your hips by bringing your feet out to the sides.

This is your internal rotation. You can do this one leg at a time, or with both legs at a time.

10. Sitting Flexed Hip Outward Rotation with Bent Knees

• Get a hold of a sturdy chair
• Sit in a chair
• Lift your feet off the floor a little bit so that they are hovering above the floor
• Without moving your thighs laterally rotate your hips by bringing your feet inward

This is your outward rotation. You can do this one leg at a time, or with both legs at a time.

11. Supine Bent Hip Outward Hip Rotation

These exercises can also be done lying on the back. To do this with straight
legs:

• Lie down on your back
• Bring your feet up to the ceiling
• Keep your heels together
• Rotate your hips out by bringing your toes apart
• And come back to the starting position

This is your lateral rotation. You can do this one leg at a time, or with both legs as demonstrated.

12. Supine Bent Hip Inward Hip Rotation

These exercises can also be done lying on the back. To do this with straight
legs:

• Lie down on your back
• Bring your feet up to the ceiling
• Keep your heels together
• Rotate your hips in by bringing your toes toward each other.
• And come back to the starting position

This is your medial rotation. You can do this one leg at a time, or with both legs as demonstrated.

13. Supine Flexed hip, Flexed Knee, Medial Rotation

To do this with bent legs.

• Lie down on your back
• Bend your knees while you are on your back
• Keep your knees together
• Bring your feet apart from each other.

This is your internal rotation.

14. Supine Flexed Hip, Flexed Knee Lateral Rotation

• Lay down on your back
• Flex your hips to 90 degree angle
• Flex your knees to 90 degree angle
• Now criss cross your legs at the shin level thus performing a lateral rotation.
• And come back to the starting position.

This is your lateral rotation on the back with bent knees. Or you can do one side at a time by bringing the leg across the midline (an imaginary vertical line that runs down the center of your body) while the other leg is flat on the floor, creating an external rotation of the hip.

15. Lying Down Abduction with Lateral Rotation

To do rotation together with abduction.

• Lie down on your side.
• Lift one leg up to the side so that the leg is up in the air perpendicular to the floor
• And perform a lateral rotation so that your toes are pointing in the direction of your head. (Because abduction without lateral rotation is not possible past 45 degrees)

This is your lateral rotation.

16. Lying Down Hip Abduction with Medial Rotation

To do rotation together with abduction.

• Lie down on your side
• Lift one leg up to the ceiling as far as you can without turning the leg out
• Keep the leg up in the air and turn the toes inward in the direction of the floor
• And come back to the starting position.

This is your medial rotation in the hip abducted position.

17. Lunge Extended Hip Lateral Rotation

If you are feeling adventurous and you want to take your hip rotation in the hip extended position to the next level you can do the following exercise:

• Get into a lunge position
• With the back leg straight
• Keeping the back leg straight perform the lateral rotation of the hip by placing the inner border of your foot on the floor.
• And come back to the starting position.

This would be your lateral rotation when the middle border is on the floor.

18. Lunge Extended Hip Medial Rotation

• Get into a lunge position
• With the back leg straight
• Keeping the back leg straight perform the medial rotation of the hip by placing the outer border of your foot on the floor.
• And come back to the starting position.

This would be your medial rotation when the outer border of the foot is on the floor.

Strength Exercises

Next, let’s explore the strength exercises that will strengthen the lateral and medial rotators of your hip. An important note here is that in actual sports applications, very often the hip rotation is combined together with other actions at the same time.

For example, if you think of the soccer kick with the inside of your foot, you’re going to have the lateral rotation together with the flexion of the hip. If you think of the martial arts sidekick, you will have hip medial rotation together with extension and/or abduction, depending on how the kick is performed. And if you think of dance, you might have flexion or abduction of the hip together with lateral rotation like in Developpe.

The strength exercises for the rotation are best performed with cables or resistance bands. In some cases, ankle weights are also a good option.

If you’re practicing for specific sports skill where you want stabilization from other muscles while the hip rotates, then an exercise such as sit in hip rotation would be good for you. Below you will see the demonstration of sitting hip rotation with resistance bands.

Doing this for purely isolation purposes, keeping the heel on the floor allows the weight of the body instead of the stabilizing muscles to keep the leg in place. So if you want to isolate the rotation movement with a bent knee, performing this exercise on the floor would be better for hip rotation isolation.

19. Isolated Medial Rotation with Ankle Weights

Place an ankle weight on your top foot (if you’re laying on your right side down, your left side is your top)This can also be done with resistance bands, but it’s more challenging to doLie down on the floor on your side keeping your legs and body in straight lineBend your top knee to 90 degrees and rotate the leg in by lifting your foot toward the ceiling.Notice the range of motion in this exercise will be small unless you have hypermobile joints.

20. Isolated Lateral Rotation with Ankle Weights

• Place an ankle weight on your bottom foot (if you’re laying on your right side down, your right foot is your bottom foot and your left foot is your top foot) This can also be done with resistance bands, but it’s more challenging to do.
• Lie down on the floor on your side keeping your legs and body in straight line.
• Bend your bottom knee to 90 degrees, flex your top knee to get it out of the way by bringing your knee a little bit forward and across the floor and rotate the bottom leg outward by lifting your foot off the floor.

The floor functions as a stabilizer in these exercises and the hip joint movement becomes focused on the rotation, both medial and lateral.