The horse stance and hip flexibility | The MSK Physio

Developing any permanent flexibility, particularly as an adult, responds well to high intensity, eccentric exercises (1).

What is a normal movement pattern between the pelvis and femur? When the pelvis posterior tilts, the femur biases towards external rotation. When the pelvis anterior tilts, the femur biases towards internal rotation (3).

How does the horse stance become helpful? It is a useful exercise for developing rotation and frontal plane hip movement under load! It has a large eccentric component to it as you increase your width over time. How does this relate to flexibility?

If we consider passive insufficiency as the neurological component to determining your current ‘tolerable length’ then we must consider this phenomenon when creating flexibility. Essentially, a muscle that crosses 2+ joints is subject to it. If you try and lengthen both ends of the muscle, at the same time, a reflex will restrict your motion (4). Tolerance to this can increase over time (5). This means that if you anchor one end, you will be more able to lengthen the other end!

Back to the horse stance. In this movement we are encouraging anterior tilt of the pelvis and external rotation of the femur. We are trying to create a dissociation of the two. How is this helpful if these are opposites in normal kinematics? We are looking to create more motion at the hip joint by anchoring the pelvis in a particular position. If the pelvis can’t posterior tilt then the hip has to increase its external rotation. We know from research that wide stances, with an upright torso increase the hip joint flexibility requirements (6). As an added bonus you will also increase your groin flexibility via similar mechanisms.

However this exercise may or may not suit different types of hips. For example, with femoral anteversion, we see a structural bias towards internal rotation of the leg, or foot turned in (2). This implies that a narrow squat stance is more useful. However with a retroverted hip, the leg tends towards external rotation and thus a foot turned out stance will feel more comfortable (2). However, this isn’t always a black and white situation. As the referenced study shows, there is ample variation between the two. As always, some experimentation with what squat stance is comfortable is recommended.

Afterwards I encourage you to try your regular squat and see if it feels more comfortable to sit in the bottom. The changes in rotation ability will be felt.
As always, if you have pain with this then stop and adjust until painfree or seek guidance from a local professional.

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References:
1. Vetter S, Schleichardt A, Köhler HP, Witt M. The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review. Front Physiol. 2022 Apr 25;13:873370.
2. Lerch TD, Todorski IAS, Steppacher SD, Schmaranzer F, Werlen SF, Siebenrock KA, et al. Prevalence of Femoral and Acetabular Version Abnormalities in Patients With Symptomatic Hip Disease: A Controlled Study of 538 Hips. Am J Sports Med. 2018 Jan;46(1):122–34.
3. Bagwell JJ, Fukuda TY, Powers CM. Sagittal plane pelvis motion influences transverse plane motion of the femur: Kinematic coupling at the hip joint. Gait & Posture. 2016 Jan 1;43:120–4.
4. Gajdosik RL, Hallett JP, Slaughter LL. Passive insufficiency of twojoint shoulder muscles. Clinical Biomechanics. 1994 Nov 1;9(6):377–8.
5. Avela J, Kyröläinen H, Komi PV. Altered reflex sensitivity after repeated and prolonged passive muscle stretching. Journal of Applied Physiology. 1999 Apr 1;86(4):1283–91.
6. Swinton PA, Lloyd R, Keogh JWL, Agouris I, Stewart AD. A Biomechanical Comparison of the Traditional Squat, Powerlifting Squat, and Box Squat. The Journal of Strength & Conditioning Research. 2012 Jul;26(7):1805–16.