by Paula Allia – PT, DHSc, MTC, OCS
Hip pain is something that many people experience. Whether it is a sport injury, trauma, or wear and tear over the course of a lifetime, taking care of the hip is pertinent to the activities of daily living.
The hip itself moves in three different planes of motion and functions as a ball and socket joint. It is the anchor of the leg to the torso via the pelvis region. This most proximal joint of the leg can flex-extend, rotate in and out, and movement sideways in and out.
Do to the significant role the hip plays in life and locomotion large muscles work in concert to support the joint while allowing the propulsion through motion for the activities that each person performs.
What is it that causes hip pain? More importantly, what can someone do to understand their own hips and help it succeed and avoid the slow failing and breakdown of the joint. It is not uncommon that one may strain the hip and the doctor takes an x-ray and the joint has arthritis. How did that happen? Why does that happen?
Arthritis involves the breakdown of cartilage at the ends of bones. In the case of the hip, the thigh bone (femur) has hyaline cartilage at the ball of the joint. This cartilage when healthy has a shiny appearance to it. It has resilient properties, less friction and can usually handle the natural compressive forces of everyday life.
There are variations in the angle of hip joints. Some people can cross their legs comfortably while others cannot. The angle of the hip joint guides the rest of the leg in many instances. Some people have the perfect average biomechanical angles in not only the hip but the knee and ankle as well.
Without trauma, these joints can last and arthritis does not become a factor. Some joints cause the legs to turn in while others cause the turn out position. The hip joint also has a capsule, ligaments, and synovial fluid. Each part of the joint plays a role in the stability of the joint while allowing mobility and extensibility.
When the muscles work together in a healthy joint, the biomechanics work to keep the ball centered properly and this avoids wear and tear.
The problem is that abnormal or excessive joint angles can, over time, cause malalignments and thus changes in the muscles flexibility and strength alter the mechanics even further. Working with the hip joint and providing it with proper prompts to strengthen and stretch are key to keeping the joint healthy with normal function.
If this has already been altered, new mechanics have to be considered when exercising or performing in functional activities. This joint should never be forced.
There is a capsule surrounding the joint that sometimes get altered and this may allow a tightness or a hypermobility in one direction that can throw the whole mechanics off. Stretching this capsule is tricky and then requires neuromuscular re-education to get it to be aware along with the muscles and ligaments to work together.
It is not uncommon to have malalignment issues in the hip joint. An example of this is when someone demonstrates poor posture. The upper back rounds more and the person then leans forward sending the hip joint more forward than normal. This can stretch the front part of the hip capsule and actually cause tightness of the capsule’s back side.
Performing core exercise and being aware of proper positioning can help to decrease these faults. Specific exercises are designed depending upon the faults present.
In summary, the hip joint should be naturally centered and with the right coordination of muscles firing, the joint is guided in motion so that minimal excessive compression occurs. It is when this system fails that the joint can start to move more in one direction or another. Engaging the right muscles in combination with the right stretches can help to counter and deter the degeneration process.
Here’s to your health!
If you would like to find out more about this topic, please call Paula @ Fitness Together at (239) 263-9348.