Get Hip to the Hip
The hip is a ball and socket joint, meaning it has 360 degrees of motion, and can move through all planes of motion. The vast array of movements in the hip are supported by 17 different muscles! It makes sense that a joint responsible for movement in all planes of motion would have so many muscles to support those actions. However, this can be overwhelming when considering why you have hip pain. To counter hip pain, you should:
- Understand the movements the hip is capable of
- Observe what movements cause pain
- Reflect on how your lifestyle may impact optimal functioning of the hip joint
- Take action, based on the above information, to rid yourself of hip pain
What Can the Hip Do?
As mentioned previously, the hip is a ball and socket joint capable of muscle action through all planes of motion. Here, I will list and explain the many actions of the hip.
This muscle action of the hip entails bringing your thigh closer to your body. Simply imagine standing up and marching in place. The muscles that cause hip flexion allow us to walk, run, and help to stabilize the spine.
This movement is the opposite of hip flexion. So, the muscles responsible for hip extension move our thigh behind us, think of kicking your leg back. These muscles help allow us to rise up from sitting, stabilize the spine, and propel ourselves forward when walking or running.
An easy trick to remember this muscle action is to think of an alien standing next to you and attempting to abduct your leg. This movement allows us to raise our leg out to the side. These muscles can help alleviate knee pain, improve balance, and take pressure off the low back.
To remember this muscle action just think about adding your leg to the center, the exact opposite of abduction. By targeting the muscles capable of adduction you can decrease groin and knee pain, and improve balance.
Internal and External Rotation
When imagining these two muscle actions think of windshield wipers. The back and forth movement of the wipers are a great representation of how your hip is able to rotate, or bring your thigh toward and away from the midline of your body. These muscles help us to change direction, squat with a full range of motion, and prevent injuries to the lower AND upper body.
Ok, so now that you understand what the hip joint can do, and how it contributes to your activities of daily living, lets talk about how you can figure out the cause of pain and make a plan to rid yourself of it!
Ask yourself these Three Questions
Where do I feel pain? When do I feel pain/limited movement? How does my lifestyle contribute to my pain?
To answer the first question simply perform a body scan. Close your eyes and allow yourself to explore where exactly you feel pain on your body. Since the hip is capable of so many movements and the muscles connect to various other pieces of your body, you may be experiencing pain in the hip, knee, groin, or back! The location of the pain provides the first clue to the culprit.
Answering ‘when do I feel pain’ allows you to explore different movements that aggravate your areas of pain. In my experience working with clients presenting with hip problems I have heard things such as “It hurts when I have been standing on my feet for prolonged periods of time,” “I feel pain when I try to bend to pick something off of the ground,” “It is really difficult for me to stand up after sitting for a long time.” Now these are just a few answers to this question, make sure that your answer is true to your experience. I would also suggest putting your knowledge of how the hip moves to good use! Simply move through all the muscle actions listed earlier. Try them one leg at a time to see what causes pain and where you feel limited in your movement.
Answering the final question requires analyzing your standard day to day activities. Based on my personal training experience, some of the most common lifestyle factors that contribute to hip pain are
- Sitting and driving. Unfortunately, a lot of jobs require working at a desk which can cause the muscles of our hip to tighten, weaken, and to be turned off. The same effect can occur to driving as we are cramped into that same seated position. I had fairly significant discomfort in the front of my hip during a summer landscaping job that was a 90-minute one-way commute. That pain was caused over the course of only one summer, now imagine what working a desk job for 5, 10, 20 years could do!
- Compensations you have been unaware of. At Towson University, where I completed my undergraduate degree, there is a large flight of steps in the middle of campus. I noticed on the days where I had to climb that staircase a few times, the outside of my right hip would be killing me! What I noticed was that I would always take the first step with my right leg, and when I would step up with the left leg, I would still try to drive up from that right foot. I quickly realized this was not an isolated phenomenon as when standing stationary, me weight would shift to that right leg!
- Limited physical activity or an exercise regiment that is limited. If you don’t use it, you lose it. If you are not engaging in any physical activity your muscles will ‘forget’ how to work for you. If you have been sitting much of your day for several years, you shouldn’t be stunned when walking to the mailbox starts to cause pain. The same goes for those currently involved in a regular exercise program! For instance, when I was first getting into weightlifting and strength training, I really wanted tree trunk legs. I associated this with speed, power, and strength! So I started to squat. A LOT. At one point I was back squatting and front squatting twice a week each and getting in some sets of leg press with leg extensions. My quads got massive. One of the best compliments I ever received was from a gym member who said, “Your quads belong in a book.” Looking back that book would probably be called “The dummy who forgot about glutes and hamstrings.” Loading the squat pattern to the point of obsession caused a massive discrepancy in the muscle mass of the front and back of my legs. This caused me knee and hip pain. By adding in movements like Romanian Deadlifts, banded abductions, Copenhagen planks, among others, allowed me to target all of the muscles in my hip and get rid of the pain I had been experiencing. Oh, and it made my squat get even better!
Putting it Together
To give summary to this blog, the hip is capable of a wide array of movements, all of which support our longevity in activities of daily living. Hip dysfunction can present as pain in many different spots, so it is necessary to explore what makes the pain worse, so you know where to target your efforts. It is also important to understand how your lifestyle can be impacting the pain you experience, so you can make the necessary changes, and take meaningful action to overcome it.