I’ve been moving around the body a bit when discussing common trouble areas, first starting at the lower back, then addressing the shoulders and knees, and arriving this week at the hips. Each week I’m getting a growing number of emails from readers looking for help and guidance with their own specific issues.
Some of the people who have emailed, and a number of my current clients, have hip troubles. The issues range in severity, but all should be properly managed. Because the hip joint is so large and central to the body, it supports a lot of weight and takes much of the load during walking, running, and sports. When one or both hip joints become dysfunctional for any reason, movement patterns are often interrupted and other serious issues develop.
My good friend Bobby Lenarduzzi was referred to me almost 5 years ago because of hip pain. After a world-class soccer career that ended two decades ago, Bobby hadn’t done much regular exercise aside from jogging.
When he was diagnosed with a congenital joint condition, Bobby trained hard to get in good shape in order to delay surgery as long as possible, and improve his post-operative outcome. After a necessary hip replacement surgery he has again worked very hard on his rehab. Bobby is now very fit and athletic and credits his training for this success. He’s also seen a positive change in his overall outlook and motivation despite his hip condition.
Because his other hip is showing signs of similar issues, Bobby knows he must maintain his strength, flexibility and overall athleticism. With one artificial hip, and another that will likely need to be replaced in the future, Bobby is getting in better shape every day.
When working your hips, always remember to perform a progressive warm-up beforehand, and get medical approval before beginning a new fitness program.
Knowledge – Hips can be tricky. Although this is a relatively simple joint in terms of it’s anatomy, the function of the joint can be influenced by many factors, and there are numerous things that can go wrong. There are also congenital conditions that can cause the hip joint to be less stable than ideal, which often results in early degenerative changes. No matter how it starts, if you’re dealing with hip trouble, be sure to get a thorough assessment by a trusted practitioner. Once you’ve determined the cause, an effective management strategy can be put in place for your hips.
One reliable indicator of hip function, and the health of the hip joints, is the available range of motion during rotation. A healthy hip joint will have a decent amount of rotation, both inward and outward. This is often assessed in a position of hip flexion, with the subject lying on their back. Total range of motion of 70-80˚ or more is ideal. Usually there is more rotation outward than inward, and the movement should be relatively smooth and pain-free. If there is restricted mobility in any/all of the four directions, or pinching pain in the joint during movement, there can be an increased risk of joint issues.
Treatment – Whether you’ve had a new diagnosis of hip problems, or you’ve been struggling with painful joint degeneration for years, I believe that improved flexibility and strength can reduce pain and dysfunction. When you couple this with better body position, core function and movement quality during all activities, you can’t help but be successful in improving your overall comfort and mobility.
Start by taking the time to stretch all of the muscles around your hips, legs and pelvis. Simply balancing this muscle tension can reduce the compressive forces at the joint and reduce inflammation. Then, find ways to perform the most basic strengthening exercises, as long as they fatigue your muscles but don’t cause joint pain. Even little 3” squatting movements can strengthen and stabilize your body and help your joints. Focus on core stability, balance and symmetrical body position as much as possible to limit any tendency to compensate for a weaker hip.
Prevention – I feel the best way to address the topic of prevention is to look at what we’re doing with Bobby to delay further degeneration of his ‘good’ hip. I know Bobby won’t mind me revealing that he isn’t the most flexible guy around. Today we spend a good portion of our training sessions focusing on mobility in his hip joints. As we continue seeing progress in his flexibility and joint mobility, we also work on his posture, functional strength and athletic movement quality.
We carefully manage the rest of Bobby’s body with regular chiropractic care for his structural health, and Active Release Techniquetm for his soft tissues. This doesn’t mean that everyone with hip pain needs a team of trained practitioners working on them weekly, but it emphasizes the importance of diligent care of your body for optimal function.