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Why Your Hip Still Hurts: 5 Uncommon Reasons

Why does your hip still hurt??

You foam roll and massage your IT Band endlessly and that nagging pain is…still…. THERE.

Doctors diagnosed you with Hip Bursitis, IT Band syndrome, Femoral Acetabular Impingement (FAI), Piriformis syndrome, Hip Flexor tendinitis, you name it.

You’ve tried all the YouTube and traditional exercises that strengthens your glutes.

However, your hip pain remains. It’s affecting your walk, running, your workouts and your LIFE.

Patients that suffer from chronic hip pan, they often worry and ask:
– Do I need surgery?
– Do I need to take pain medication forever?
– Will I need total hip replacements?
– Can I walk/run normal again?

These are serious questions to consider. If you are looking to improve your chronic hip pain naturally without medications or surgery, this blog is for you. To start improving, it is important to become aware of what is leading to the problem.

Now, let’s get into 5 reasons your hip still hurts.

Warning: Each reason can become large posts itself. However, it will be relatively short for simplicity’s sake.

1. Not able to load into the Hip Joint

Before I explain further, let’s look at these pictures.

For this blog’s context, we have a loading leg and an unloaded leg during walking and running. To have a hip working well, your leg needs to load efficiently and unload efficiently. If you can focus on the lines I drew on the pictures above, the opposite pelvis drops a little lower than the loaded standing leg. This mechanism helps eccentrically load the outside hip and leg muscles. Mind you, there is a lot more happening, but we are just focusing on this mechanism in this section. Once you finish loading, then it unloads by pushing off the ground. During the unloading phase, the opposite pelvis will go higher than the standing leg.

In layman’s terms, when your right foot hits the ground while walking or running, your right hip loads and the left hip should drop. When your right foot is getting ready to push off the ground, the left hip should rise to unload the leg.

When you do both mechanisms well, these are excellent signs for hip health.

Now, I want you to put attention to the pictures # 3 and #4 above. When these individuals’ leg load, the opposite hip does not drop. Notice the line. The opposite hip is level or higher than the loaded leg. When this mechanism happens, the outer hip muscles do not stretch. This can lead to increased stiffness in the back/hip and knees.

In short, relearning how to load the hip joint becomes a crucial factor in improving hip pain (and back, knee and foot pain).

2. You’re Doing Too Much Hip Openers

The yoga industry commonly uses hip opening exercises. Hip opening exercises often include stretching the front and the groin of the hip. Hip opening stretches without the balance of strength and proprioception of the hip, can lead to unstable hips.
An unstable hip has difficulty loading. When the hip joint does not load well, the hip gets stiffer and other parts of the body start to compensate to absorb the forces. Like how I brought it back to #1?

Typical presentations of this composition are groin pain, hip and back pain when transitioning through poses in yoga or any activities with transitioning body positions or pain with prolonged sitting.

3. Poor Pelvis Position

When one performs hip exercises, it is crucial to look at the pelvis position during the movement. For example, if the pelvis is in an anterior pelvic tilt (pelvic tilted forward), your hip bone is in a position where it has less space in the front. When you have a neutral pelvis, there is more space in the front to allow the hip to flex. This can lead to different symptoms such as low back pain, pinched hips, tight hips, IT band syndrome, etc. See picture below for visual.

Anterior Pelvic Tilt Neutral Pelvis

A great life example is lifting your arm up with good and bad posture. Raise your arm up while holding good posture and then raise your arm up again with a slouched posture. You may notice your shoulder getting blocked earlier when you were slouched versus when you were upright. A pelvis tilted forward can have a similar effect to the hip.

4. Poor Rib Cage Position

Your rib bones have a powerful impact on the pelvis position. Why? To name a few, it involves the breath, your core, fascia, fluid dynamics and organs. Poor management of the rib cage may lead to breathing issues, core, back and hips instability. Said differently, poor breathing patterns leads to poor abdominal (aka core) activation. When the core is not functioning well, usually hip stiffness and dysfunction follows.

5. Pelvic Floor Problems

The fascia of the pelvic floor has direct connections to the deep hip and groin muscles. To discuss about ‘fascia’ in layman’s terms, imagine a peeled orange. The white covering around a piece of orange resembles the fascia in the body. The white covering holds the orange together and connects with the whole fruit. Fascia in the body surrounds and intertwines in the muscles, organs and the whole body.

When one suffers from pelvic floor dysfunctions such as incontinence, continence, constipation, diarrhea, vulvodynia, and erectile dysfunction, these will affect how the hip muscles will expand and contract. In other words, the hip will not function at its best. When the hip does not function for a prolonged period, this can lead to hip stiffness and pain.

There you have it. These are 5 reasons your hip has not improved yet. In July, we are hosting a Chronic Hip Pain Webinar to explore tips to start people on the right foot to end their chronic hip issues.

If you are interested, e-mail on how to sign up.

Image References.
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Health Advice Disclaimer
We make every effort to ensure that we accurately represent the injury advice and prognosis displayed throughout this Guide.
However, examples of injuries and their prognosis are based on typical representations of those injuries that we commonly see in our physical therapy clinics. The information given is not intended as representations of every individual’s potential injury. As with any injury, each person’s symptoms can vary widely and each person’s recovery from injury can also vary depending upon background, genetics, previous medical history, application of exercises, posture, motivation to follow physio advice and various other physical factors.
It is impossible to give a 100% complete accurate diagnosis and prognosis without a thorough physical examination and likewise the advice given for management of an injury cannot be deemed fully accurate in the absence of this examination from a qualified healthcare practitioner
We are able to offer you this service at a standard charge. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied in this report.

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