Pose of the Week – The “Screw Home” Hip Hack

This week’s Pose of the Week is not your typical yoga posture, it’s a technique I use to preserve and protect (and realign) the hip joint. That means this particular pose can be used INSIDE of other yoga postures in order to create hip integrity and stability.

Hip Joint Preservation – My Mantra in Yoga

Pose of the Week, The Screw Home, Hip Hacks with Dr. Ginger Garner

As a doctor of physical therapy and professional yoga therapist, my specialty is hip joint preservation. That also includes the pelvis. Historically, you may or may not know that yoga wasn’t created for women at all. It was created for young men and boys. So it comes as no surprise then, that yoga poses have not been recalibrated to fit women’s bodies – specifically their pelvis.

That’s what I do as a PT and yogi. I evolve asana to fit women.

Hip preservation happens to be my chief focus when it comes to using yoga therapeutically. In fact, for those of you who don’t know, I wrote a whole textbook on how to use yoga as therapy – specifically for orthopedic injury prevention and rehab, called Medical Therapeutic Yoga. 

The way I approach yoga is quite different, because of my professional experience as a physical therapist and athletic trainer AND because of my personal experience with living with joint hypermobility (try doing that and being pregnant and giving birth 3 times too. Ouch). 

I’ve worked with women with joint problems – often hip dysplasia and pelvic instability – for over 2 decades now. So this week’s Pose of the Week I am sharing a snippet from a LIVE TELEHEALTH session I recently had with an individual with hip pain.

The “Screw Home” Hip Hack

Today’s pose is about a specific HIP HACK I use to help improve hip stability and function called the “Screw Home” Hip Hack. The Screw Home is a movement that activates the Hip Lock (defined in my textbook, see the illustration below) – which is the deep gluteal sling that provides integrity to the hip joint. In women with dysplasia, joint integrity and stability in the hip is a never-ending pursuit. So it is important that they be able to have voluntary control of the superficial and deep gluteal sling, which includes developing strength, endurance, and adequate mobility.

Studies also show women with lack of strength and mobility in the hip and pelvic floor tend to have more incontinence issues, that is, urinary or fecal leakage.

The Screw Home - Hip Hack
The hip lock. Note the 6 muscles of the deep gluteal sling, which includes the gemelli, obturators, piriformis, and the quadratus femoris. including the superficial gluteal sling, which consists of the gluteals.
©2016. Garner, G. Medical Therapeutic Yoga. reprinted with kind permission from Handspring publishing, Ltd. edinburgh, UK.
6.2 Chair Pose
Demonstrating the hip lock & screw home exercise in chair pose
a hip labral tear can occur when there is hip dysplasia, trauma or injury, or repeatedly poor movement patterns, as is often happens in yoga that hasn’t been recalibrated to fit your specific hip and pelvic shape

What is the “Screw Home”?

✅The Screw Home is one of the many hip hacks I use with folks who feel pinching or sharp pain in the groin that is right over the hip joint (not close to the pubic bone). I ONLY use it after I evaluate the femoral head and determine that it is not centering in the hip socket. I will also teach folks how to assess this on themselves via telehealth if they can’t get to me in person.

classic “C-Sign” groin pain indicating hip injury or impairment. The “c-sign” is named so because of the shape someone’s hand makes when someone grabs their hip to point out the area of pain.

✅The Screw Home works to get the ball of the hip joint to sit properly in the socket through muscular effort, sometimes called muscle energy.

✅The Screw Home works by turning off the muscles in the front of the hip and simultaneously turning on the muscles in the deep hip (the back of the hip and butt). This is a key mechanism in getting the exercise right. 

✅This particular exercise utilizes muscle energy, or what is sometimes called mobilization with movement. That means it can combine muscle activation with joint mobilization.

✅The Screw Home requires that the Hip Lock be used. The Hip Lock is a term used by those who practice Medical Therapeutic Yoga.

✅The Screw Home utilizes the Hip Lock, which simply means engaging the deep gluteal sling in the hip. See my full blog post for an illustration of the deep gluteal sling in the Hip Lock. 

✅The Screw Home isn’t for everyone. It works best if you have hip instability and/or sacroiliac joint instability.

X-ray of the female pelvis and spinal column. x-ray films can be used to determine if someone is at risk for hip instability. This particular film shows potential hip femoracetabular impingement (FAI) due to the shape of the ball and socket of the hip.
©2021. Ginger garner. all rights reserved.

What You Need to do the “Screw Home” Hip Hack

You need a 10 foot yoga belt or a strap that is 10 foot long. There are many other ways I teach this Hip Hack, but this is just one method. If this doesn’t work for you, you may need a different exercise to get the hip to screw home. 

2 minutes of your time at most. The Screw Home takes only about 2 minutes to do at most. If it doesn’t work within 1-2 minutes, you need deeper Hip Lock activation. This can be taught by a PT that specializes in the hip/pelvis. 

No pain whatsoever during the exercise. You should NEVER have pain with this movement. This hip hack should provide immediate relief.

Good control over your hip flexors. The hip flexors (muscles in the front of your hip like the rectus femoris, psoas, iliacus, and tensor fascia lata) cannot be “on” or firing. This is an essential problem for a LOT of women with hip instability and pain. 

The Screw Home Hip Hack Dr. Ginger Garner
The rectus femoris, psoas, iliacus, and TFL are often implicated in groin pain at the front of the hip. control of these muscles is a key to recovery.
©2021. Ginger Garner. All rights reserved.

✅You should feel the muscles in the back of the hip and your bottom turn “on” or contract. This action is called “plugging in”. Please visit my blog to learn more about the “Plug In” here – https://garnerpelvichealth.com/pose-of-the-week-warrior-i/ 

✅Do NOT do this exercise without discussing it with your hip/pelvic PT first. 

Ok, happy hip hacking! 

Practicing the “Screw Home”

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1. Free Phone Consult – Not sure if your yoga practice is on target? Struggling with hip pain or rehab? I offer free phone consults to see how I can best help.

2. Take courses with me at Living Well Institute and Yoga U Online!

3. Take advantage of the Free Medical Therapeutic Yoga Basic Video Library.

DISCLAIMER: These movements are for protection and preservation, as well as maximizing, pelvic girdle function (hip, SIJ, low back, pelvic floor). This and any other videos I instruct do not constitute physical therapy or a patient-provider relationship. User assumes risk in performing this or any video. Finally, you need to get the approval of your healthcare provider before doing this or any instructional movement video. Assessment and evaluation of the hip & knee should only be done by a licensed healthcare provider.