ACL injuries bring hips into play

• Hip muscles are a key in rehabilitation after ACL surgery to help stabilize the knee
• Those muscles get 'turned off' after an injury to the leg
• A series of leg raises is one of the rehabilitative exercises

You're an NFL player who has just torn the anterior cruciate ligament (ACL) in your knee. Why the concern with muscles deep inside your hip?

Because the hip is a key to the prehab that an athlete goes through before ACL reconstruction surgery.

"Whenever you have an injury to your lower extremity, whether it be an ankle sprain or an ACL, on the same side of your body is the hip stabilizer. … These (are) muscles deep in your hip joint," said Anna Hartman, director of Performance Physical Therapy at Athletes' Performance in Phoenix.

Those hip muscles, with a pelvic muscle called the gluteus medius, get "turned off" after an injury to the leg, she said. "The quicker we can get those (muscles) to turn back on, then after surgery it's going to be an easier rehab just getting their full leg active again.''

One of the remedial techniques is a series of leg raises, done while lying on your side.

"A lot of it is teaching the athlete where that muscle is and what the muscle does, how it moves the bones," Hartman said. " … You're making sure that every single time they lift their leg up they're doing it with the right muscle, the right timing."

Hartman said one of the leg raises is "sort of like the old school Jane Fonda exercises."

She said a lot of athletes like to call another type of exercise the "clamshell." On their side, with their feet together and their knees bent, they open and close their knees to work the hip.

"You teach muscle how to move again," Hartman said.